Cavalcante Marcelo B, Sarno Manoel, Peixoto Alberto B, Araujo Júnior Edward, Barini Ricardo
Department of Obstetrics and Gynecology, Fortaleza University (UNIFOR), Fortaleza, Brazil.
Department of Obstetrics and Gynecology, Federal University of Bahia (UFBA), Salvador, Brazil.
J Obstet Gynaecol Res. 2019 Jan;45(1):30-38. doi: 10.1111/jog.13799. Epub 2018 Aug 28.
The aim of this study is to perform a systematic review and meta-analysis on the relationship between excess weight and risk of recurrent pregnancy loss (RPL) and to highlight the common immunological mechanisms of these two conditions. The PubMed and MEDLINE databases were searched for publications in English available as of November 2017. The search terms used were 'recurrent pregnancy loss', 'body mass index' (BMI), 'overweight' and 'obesity'. For calculation of the odds ratio (OR) and 95% confidence intervals (CI) for miscarriage in different BMI groups, RevMan software was used (Review Manager, Version 5.3.5 for Windows; The Cochrane Collaboration). In total, 100 publications including the search terms were identified. Six studies were included for qualitative analysis, and two studies were included for quantitative analysis (meta-analysis). The association between excess weight and RPL was significant (OR, 1.34; 95% CI, 1.05-1.70; P = 0.02). The isolated analyses of the groups of obese and overweight women revealed an association only between obesity and RPL (OR, 1.75; 95% CI, 1.24-2.47; P = 0.001). The data available in the current literature revealed that obese women with a history of RPL have a high risk of future pregnancy losses, a risk which was not found among overweight women.
本研究旨在对超重与复发性流产（RPL）风险之间的关系进行系统评价和荟萃分析，并突出这两种情况常见的免疫机制。检索了截至2017年11月可获取的英文出版物的PubMed和MEDLINE数据库。使用的检索词为“复发性流产”、“体重指数”（BMI）、“超重”和“肥胖”。为计算不同BMI组流产的比值比（OR）和95%置信区间（CI），使用了RevMan软件（Review Manager，适用于Windows的5.3.5版本；Cochrane协作网）。总共识别出100篇包含检索词的出版物。纳入6项研究进行定性分析，2项研究进行定量分析（荟萃分析）。超重与RPL之间的关联具有显著性（OR，1.34；95%CI，1.05 - 1.70；P = 0.02）。对肥胖和超重女性组的单独分析显示，仅肥胖与RPL之间存在关联（OR，1.75；95%CI，1.24 - 2.47；P = 0.001）。当前文献中的现有数据显示，有RPL病史的肥胖女性未来发生流产的风险较高，而超重女性中未发现这种风险。
