Wang Jinjing, Chen Kang, Jin Xinye, Li Xueqiong, An Ping, Yang Nan, Chen Yaolong, Fang Yi, Mu Yiming
Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, People's Republic of China.
Department of Endocrinology, Fifth Medical Center of PLA General Hospital, Beijing 100071, People's Republic of China.
Diabetes Metab Syndr Obes. 2019 Jun 21;12:913-929. doi: 10.2147/DMSO.S188293. eCollection 2019.
To evaluate the prognostic factors for cesarean section outcome of pregnant women with diabetes mellitus. MEDLINE, EMBASE, Cochrane Library, CBM, CNKI and Wanfang database were searched. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias of included studies. For pooled data with factors of perioperative outcome, the RevMan software was used for data translation and meta-analysis. The result is shown intuitively with the bubble diagram of evidence mapping by Excel 2016. We included 12 randomized controlled trials (RCTs) in the meta-analysis. Twelve RCTs with 1,390 patients were included in the systematic review. The results show that the perioperative blood glucose management regimens, preoperative fasting and water deprivation, anesthesia regimens, postoperative fluid regimens, postoperative analgesia regimens, postoperative wound care regimens, psychological interventions, different dosing regimens for antibiotics, and obesity may affect the cesarean section outcome of diabetic mothers and newborns. The evidence for all the outcomes was low quality. Many prognostic factors have shown significant association with postoperative outcomes of cesarean section. More clinical research evidence with high-quality is needed.
评估糖尿病孕妇剖宫产结局的预后因素。检索了MEDLINE、EMBASE、Cochrane图书馆、中国生物医学文献数据库、中国知网和万方数据库。两名研究人员独立筛选文献、提取数据并评估纳入研究的偏倚风险。对于具有围手术期结局因素的汇总数据，使用RevMan软件进行数据转换和荟萃分析。结果通过Excel 2016的证据映射气泡图直观显示。我们在荟萃分析中纳入了12项随机对照试验（RCT）。系统评价纳入了12项RCT，共1390例患者。结果表明，围手术期血糖管理方案、术前禁食禁水、麻醉方案、术后液体方案、术后镇痛方案、术后伤口护理方案、心理干预、抗生素不同给药方案以及肥胖可能影响糖尿病母亲和新生儿的剖宫产结局。所有结局的证据质量均较低。许多预后因素已显示出与剖宫产术后结局有显著关联。需要更多高质量的临床研究证据。
