Xiong Yi-Quan, Mo Yun, Shi Ting-Li, Zhu Lin, Chen Qing
Department of Epidemiology, School of Public Health, Southern Medical University, Guangdong Provincial Key Laboratory of Tropical Disease Research, Guangzhou, China.
The Third People's Hospital of Hainan Province, Hainan, China.
J Clin Virol. 2017 Sep;94:42-49. doi: 10.1016/j.jcv.2017.07.008. Epub 2017 Jul 19.
To evaluate the effect of maternal dengue virus (DENV) infection during pregnancy in premature birth, low birth weight, miscarriage and stillbirth.
Systematic electronic literature searches were conducted including PubMed, Medline, Embase, Web of science, Scopus and the Cochrane Library database, up until July 5, 2017. Effect sizes were estimated by using the relative risk (RR) or odds ratio (OR) with theirs corresponding 95% confidence interval (CI). Subgroup analyses were conducted for study design (prospective or retrospective) and clinical symptom of participants (symptomatic or asymptomatic). Statistical analysis was conducted by STATA 12.0.
The initial systematic literature searches identified 1048 studies. After screening, fourteen studies were included. The pooled results did not suggest maternal DENV infection might increase the risk of adverse fetal outcomes with a pooled RR of 0.96 (95% CI: 0.85-1.09, I=49.6%) for premature birth, RR of 0.99 (95%CI: 0.87-1.12, I=35.1%) for low birth weight, OR of 1.77 (95% CI: 0.99-3.15, I=17.5%) for miscarriage and RR of 3.42 (95% CI: 0.76-15.49, I=54.8%) for stillbirth. Subgroup analysis of studies in symptomatic participants still did not indicate DENV infection appeared to be a risk factor for premature birth, low birth weight and miscarriage with pooled effect size of 0.99 (95% CI: 0.87-1.13, I=49.3%), 1.22 (95% CI: 0.827-1.80, I=55.1%) and 1.19 (95% CI: 0.56-2.55, I=4.7%), respectively.
Current evidence did not suggest that maternal DENV infection during pregnancy might increase the risk of premature birth, low birth weight, miscarriage and stillbirth.
评估孕期孕妇感染登革热病毒（DENV）对早产、低出生体重、流产和死产的影响。
进行系统性电子文献检索，检索范围包括截至2017年7月5日的PubMed、Medline、Embase、科学网、Scopus和Cochrane图书馆数据库。采用相对危险度（RR）或比值比（OR）及其相应的95%置信区间（CI）来估计效应量。针对研究设计（前瞻性或回顾性）和参与者的临床症状（有症状或无症状）进行亚组分析。使用STATA 12.0进行统计分析。
最初的系统性文献检索共识别出1048项研究。经过筛选，纳入了14项研究。汇总结果表明，孕妇感染DENV似乎不会增加不良胎儿结局的风险，早产的汇总RR为0.96（95%CI：0.85 - 1.09，I = 49.6%），低出生体重的RR为0.99（95%CI：0.87 - 1.12，I = 35.1%），流产的OR为1.77（95%CI：0.99 - 3.15，I = 17.5%），死产的RR为3.42（95%CI：0.76 - 15.49，I = 54.8%）。对有症状参与者的研究进行亚组分析，结果仍未表明DENV感染是早产、低出生体重和流产的危险因素，其汇总效应量分别为0.99（95%CI：0.87 - 1.13，I = 49.3%）、1.22（95%CI：0.827 - 1.80，I = 55.1%）和1.19（95%CI：0.56 - 2.55，I = 4.7%）。
目前的证据并未表明孕期孕妇感染DENV会增加早产、低出生体重、流产和死产的风险。
