Olson-Chen Courtney, Balaram Kripa, Hackney David N
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester Medical Center, Strong Memorial Hospital, University of Rochester School of Medicine, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
Northeast Ohio Medical University, 4209 OH-44, Rootstown, OH, 44272, USA.
Matern Child Health J. 2018 Jun;22(6):812-821. doi: 10.1007/s10995-018-2451-z.
We conducted a meta-analysis to determine the association between Chlamydia trachomatis and adverse perinatal outcomes.
Electronic databases were searched between 1970 and 2013. Included studies reported perinatal outcomes in women with and without chlamydia. Summary odds ratios were calculated using fixed- and random-effects models. Study bias was assessed using a Funnel Plot and Begg's test.
Of 129 articles identified, 56 studies met the inclusion criteria encompassing 614,892 subjects. Chlamydia infection in pregnancy was associated with preterm birth (OR = 1.27, 95% CI 1.05, 1.54) with a large quantity of heterogeneity (I = 61%). This association lost significance when limiting the analysis to high-quality studies based on the Newcastle-Ottawa Scale. Chlamydia infection in pregnancy was also associated with preterm premature rupture of membranes (OR = 1.81, 95% CI 1.0, 3.29), endometritis (OR 1.69, 95% CI 1.20, 2.38), low birthweight (OR 1.34, 95% CI 1.21, 1.48), small for gestational age (OR 1.14, 95% CI 1.05, 1.25) and intrauterine fetal demise (OR 1.44, 95% CI 1.06, 1.94).
This review provides evidence that chlamydia in pregnancy is associated with a small increase in the odds of multiple adverse pregnancy outcomes. The literature is complicated by heterogeneity and the fact that the association may not hold in higher quality and prospective studies or those that use more contemporary nucleic acid testing.
我们进行了一项荟萃分析，以确定沙眼衣原体与不良围产期结局之间的关联。
检索了1970年至2013年期间的电子数据库。纳入的研究报告了有或无衣原体感染的女性的围产期结局。使用固定效应模型和随机效应模型计算汇总比值比。使用漏斗图和Begg检验评估研究偏倚。
在识别出的129篇文章中，56项研究符合纳入标准，涵盖614,892名受试者。妊娠期间的衣原体感染与早产相关（OR = 1.27，95% CI 1.05，1.54），存在大量异质性（I = 61%）。当根据纽卡斯尔-渥太华量表将分析限于高质量研究时，这种关联失去了显著性。妊娠期间的衣原体感染还与胎膜早破（OR = 1.81，95% CI 1.0，3.29）、子宫内膜炎（OR 1.69，95% CI 1.20，2.38）、低出生体重（OR 1.34，95% CI 1.21，1.48）、小于胎龄儿（OR 1.14，95% CI 1.05，1.25）和宫内胎儿死亡（OR 1.44，95% CI 1.06，1.94）相关。
本综述提供的证据表明，妊娠期间的衣原体感染与多种不良妊娠结局的几率小幅增加相关。文献因异质性以及这种关联可能在更高质量的前瞻性研究或使用更现代核酸检测的研究中不成立这一事实而变得复杂。
