Clinic of Obstetrics and Gynecology, Ospedale della Murgia, ASL Bari, Bari.
Clinic of Obstetrics and Gynecology, University of Brescia, Brescia, Italy.
Curr Opin Obstet Gynecol. 2019 Dec;31(6):410-417. doi: 10.1097/GCO.0000000000000581.
To review literature about risk factors of neonatal hypoxic-ischemic encephalopathy (HIE).
Search in PubMed, MEDLINE, Embase, Clinicaltrials.gov and reference lists from 1999 to 2018.
study population composed of neonates who manifested HIE within 28 days from delivery, data reported as proportional rate. Studies were excluded if they included preterm pregnancies, postnatal conditions leading to HIE and/or fetal malformations, focused on a single risk factor, were not in English language. PRISMA guidelines were followed. Interstudies heterogeneity was assessed and a random/fixed models were generated as appropriate. Comparison between neonates with HIE vs. controls was performed by calculating odds ratio-95% confidence interval (OR-95% CI). Differences were significant if 95% CI did not encompass 1. Twelve articles were included. Fetuses with growth restriction (OR: 2.87; 95% CI: 1.77-4.67), nonreassuring cardiotocography (OR: 6.38; 95% CI: 2.56-15.93), emergency cesarean section (OR: 3.69; 95% CI: 2.75-4.96), meconium (OR: 3.76; 95% CI: 2.58-5.46) and chorioamnionitis (OR: 3.46: 95% CI: 2.07-5.79) were at higher risk of developing HIE. Nulliparity, gestational diabetes, hypertension, oligohydramnios, polyhydramnios, male sex, induction of labor, labor augmentation, premature rupture of membrane, and vacuum delivery were not significantly different.
Neonatal HIE has multifactorial origin and its cause is often undetermined and not preventable.PROSPERO (Registration number: CRD42018106563).
综述新生儿缺氧缺血性脑病（HIE）危险因素的相关文献。
在 1999 年至 2018 年间，在 PubMed、MEDLINE、Embase、Clinicaltrials.gov 和参考文献中进行了检索。
研究人群由分娩后 28 天内出现 HIE 的新生儿组成，数据以比例率报告。如果研究包括早产妊娠、导致 HIE 和/或胎儿畸形的产后情况、仅关注单一危险因素、非英语语言，则将其排除在外。遵循 PRISMA 指南。评估了研究间的异质性，并根据需要生成了随机/固定模型。通过计算比值比-95%置信区间（OR-95%CI），对 HIE 新生儿与对照组进行比较。如果 95%CI 不包含 1，则差异具有统计学意义。共纳入 12 篇文章。生长受限的胎儿（OR：2.87；95%CI：1.77-4.67）、非反应性胎心监护（OR：6.38；95%CI：2.56-15.93）、紧急剖宫产（OR：3.69；95%CI：2.75-4.96）、胎粪（OR：3.76；95%CI：2.58-5.46）和绒毛膜羊膜炎（OR：3.46：95%CI：2.07-5.79）发生 HIE 的风险更高。初产妇、妊娠期糖尿病、高血压、羊水过少、羊水过多、男性、引产、催产、胎膜早破和真空分娩与 HIE 无显著差异。
新生儿 HIE 具有多因素起源，其病因往往不确定且无法预防。
PROSPERO（注册号：CRD42018106563）。
