Senra Janaína Campos, Carvalho Mariana Azevedo, Rodrigues Agatha Sacramento, Krebs Vera Lúcia Jornada, Gibelli Maria Augusta Bento Cicaroni, Francisco Rossana Pulcineli Vieira, Bernardes Lisandra Stein
Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Unidade Neonatal, Departamento de Pediatria Faculdade de Medicina FMUSP, Universidade de Sao Paulo Sao Paulo, SP, BR.
Clinics (Sao Paulo). 2018 Oct 18;73:e401. doi: 10.6061/clinics/2018/e401.
Since studies show that an unfavorable environment during intrauterine development predisposes individuals to several diseases in adulthood, our objective is to assess the relation between fetal growth restriction and chronic renal disease in adults. We searched four different electronic databases through November 2017: CENTRAL, EMBASE, LILACS and MEDLINE. We selected studies with longitudinal or transversal designs associating kidney function in adulthood with low birth weight. Two reviewers evaluated the inclusion criteria and the risk of bias and extracted data from the included papers. Thirteen studies were selected for the systematic review and meta-analysis. We observed increased risks of presenting end-stage renal disease (risk ratio 1.31, 95% confidence interval: 1.17, 1.47), a lower glomerular filtration rate (ml/min) (mean difference 7.14; 95% confidence interval: -12.12, -2.16), microalbuminuria (risk ratio 1.40; 95% confidence interval: 1.28, 1.52) and a small increase in the albumin/creatinine ratio (mean difference 0.46; 95% confidence interval: 0.03, 0.90) in the low birth weight patients, compared with control group. These findings suggest that low birth weight is associated with renal dysfunction in adults.
由于研究表明，子宫内发育期间的不良环境会使个体在成年后患多种疾病，我们的目标是评估胎儿生长受限与成人慢性肾病之间的关系。我们检索了截至2017年11月的四个不同电子数据库：Cochrane系统评价数据库、荷兰医学文摘数据库、拉丁美洲和加勒比地区卫生科学数据库以及医学期刊数据库。我们选择了将成年肾功能与低出生体重相关联的纵向或横向设计研究。两名评审员评估纳入标准和偏倚风险，并从纳入的论文中提取数据。13项研究被选入系统评价和荟萃分析。我们观察到，与对照组相比，低出生体重患者出现终末期肾病的风险增加（风险比1.31，95%置信区间：1.17，1.47），肾小球滤过率（ml/min）较低（平均差7.14；95%置信区间：-12.12，-2.16），微量白蛋白尿（风险比1.40；95%置信区间：1.28，1.52），以及白蛋白/肌酐比值略有增加（平均差0.46；95%置信区间：0.03，0.90）。这些发现表明，低出生体重与成人肾功能障碍有关。
