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孕前肥胖与巨大儿风险:一项荟萃分析。

Maternal pre-pregnancy obesity and the risk of macrosomia: a meta-analysis.

作者信息

Dai Rui-Xue, He Xiu-Jie, Hu Chuan-Lai

机构信息

Disease Control Center of Fuyang, 19 Zhongnan Road, Yingzhou district, Fuyang, 236000, Anhui, China.

Fuyang Hospital of Anhui Medical University, 99 Huangshan Road, Yingzhou district, Fuyang, 236000, Anhui, China.

出版信息

Arch Gynecol Obstet. 2018 Jan;297(1):139-145. doi: 10.1007/s00404-017-4573-8. Epub 2017 Oct 28.

Abstract

PURPOSE

The aim of our meta-analysis was to explore whether pre-pregnancy obesity is regarded as an important risk factor for predicting macrosomia or not.

METHODS

Three databases were systematically reviewed and reference lists of relevant articles were checked. Meta-analysis of published cohort studies comparing whether pre-pregnancy obesity was associated with macrosomia and adjusting for potential confounding factors. Calculations of pooled estimates were conducted in random-effect model. Heterogeneity was tested by using Chi-square test and I statistics. Publication bias was estimated from Egger's test (linear regression method) and Begg's test (rank correlation method).

RESULTS

Sixteen cohort studies met the inclusion criteria. The meta-analysis showed that pre-pregnancy obesity was associated with macrosomia as an important risk factor. The adjusted odds ratio was 1.93, 95% CI (1.65, 2.27) in random-effect model, stratified analyses showed no differences regarding different quality grade, definition of macrosomia, location of study and number of confounding factors adjusted for. There was no indication of a publication bias either from the result of Egger's test or Begg's test.

CONCLUSION

Our findings indicated that pre-pregnancy obesity should be considered as an important risk factor for macrosomia. The effect of pre-pregnancy obesity on macrosomia need to be carefully assessed and monitored.

摘要

目的

我们进行这项荟萃分析的目的是探讨孕前肥胖是否被视为预测巨大儿的重要危险因素。

方法

系统检索了三个数据库,并查阅了相关文章的参考文献列表。对已发表的队列研究进行荟萃分析,比较孕前肥胖是否与巨大儿相关,并对潜在的混杂因素进行调整。采用随机效应模型进行合并估计的计算。使用卡方检验和I²统计量检验异质性。通过Egger检验(线性回归法)和Begg检验(秩相关法)评估发表偏倚。

结果

16项队列研究符合纳入标准。荟萃分析表明,孕前肥胖作为一个重要危险因素与巨大儿相关。随机效应模型中调整后的优势比为1.93,95%置信区间为(1.65, 2.27),分层分析显示,在不同质量等级、巨大儿定义、研究地点以及调整的混杂因素数量方面均无差异。Egger检验和Begg检验的结果均未显示存在发表偏倚。

结论

我们的研究结果表明,孕前肥胖应被视为巨大儿的重要危险因素。需要对孕前肥胖对巨大儿的影响进行仔细评估和监测。

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