一项关于帆状胎盘前置在单胎妊娠中的系统评价和荟萃分析及其与早产风险的关系。
A systematic review and meta-analysis of velamentous cord insertion among singleton pregnancies and the risk of preterm delivery.
机构信息
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
Int J Gynaecol Obstet. 2018 Jul;142(1):9-14. doi: 10.1002/ijgo.12489. Epub 2018 Apr 10.
BACKGROUND
Observational studies have reported varying results about the association of velamentous cord insertion (VCI) with adverse pregnancy outcomes.
OBJECTIVES
To evaluate the risk of preterm delivery among singleton pregnancies complicated by VCI.
SEARCH STRATEGY
Various databases were searched for English-language articles published up to February, 28, 2017, using keywords including VCI; abnormal placentation; abnormal cord insertions; adverse perinatal outcomes; and preterm birth. Outcome measures included preterm delivery; pre-eclampsia; cesarean delivery; fetal demise in utero (FDIU); and small for gestational age (SGA).
SELECTION CRITERIA
Only studies involving VCI were included in the meta-analysis.
DATA COLLECTION AND ANALYSIS
Analyses were performed using RevMan version 5.3.5 (The Nordic Cochrane Centre, Copenhagen, Denmark).
MAIN RESULTS
There were six studies included in the analysis. The VCI and control groups comprised 16 295 and 1 366 485 women, respectively. An increased incidence of preterm delivery was found for the VCI group compared with the control group (11.8% vs 7.0%; adjusted odds ratio [aOR] 1.95, 95% confidence interval [CI] 1.85-2.04). A diagnosis of VCI was also associated with cesarean delivery (aOR 1.17, 95% CI 1.12-1.23), SGA (aOR 1.93, 95% CI 1.83-2.04), and FDIU (aOR 3.96, 95% CI 3.21-4.89).
CONCLUSION
The presence of VCI was associated with adverse pregnancy outcomes.
背景
观察性研究报告了帆状胎盘插入（VCI）与不良妊娠结局之间的关联存在差异结果。
目的
评估 VCI 合并单胎妊娠早产的风险。
检索策略
使用包括 VCI、异常胎盘形成、异常脐带插入、不良围产结局和早产在内的关键词，检索截至 2017 年 2 月 28 日发表的英文文献，检索数据库包括各种数据库。结局指标包括早产、子痫前期、剖宫产、胎儿宫内死亡（FDIU）和小于胎龄儿（SGA）。
选择标准
仅纳入涉及 VCI 的研究进行荟萃分析。
数据收集和分析
使用 RevMan 版本 5.3.5（丹麦哥本哈根北欧 Cochrane 中心）进行分析。
主要结果
有 6 项研究纳入分析。VCI 组和对照组分别包括 16295 名和 1366485 名女性。与对照组相比，VCI 组早产发生率增加（11.8% vs. 7.0%；调整后的优势比[aOR] 1.95，95%置信区间[CI] 1.85-2.04）。VCI 的诊断还与剖宫产（aOR 1.17，95% CI 1.12-1.23）、SGA（aOR 1.93，95% CI 1.83-2.04）和 FDIU（aOR 3.96，95% CI 3.21-4.89）相关。
结论
VCI 的存在与不良妊娠结局相关。
Zotero 插件