Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates.
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
Syst Rev. 2020 Jan 16;9(1):14. doi: 10.1186/s13643-020-1277-0.
We systematically reviewed and chronicled exposures and outcomes measured in the maternal and birth cohort studies in the Gulf Cooperation Council (GCC) countries and quantitatively summarized the weighted effect estimates between maternal obesity and (1) cesarean section (CS) and (2) fetal macrosomia.
We searched MEDLINE-PubMed, Embase, Cochrane Library, Scopus, and Web of Science electronic databases up to 30 June 2019. We considered all maternal and birth cohort studies conducted in the six GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE)). We categorized cohort studies on the basis of the exposure(s) (anthropometric, environmental, medical, maternal/reproductive, perinatal, or socioeconomic) and outcome(s) (maternal or birth) being measured. Adjusted weighted effect estimates, in the form of relative risks, between maternal obesity and CS and fetal macrosomia were generated using a random-effects model.
Of 3502 citations, 81 published cohort studies were included. One cohort study was in Bahrain, eight in Kuwait, seven in Qatar, six in Oman, 52 in Saudi Arabia, and seven in the UAE. Majority of the exposures studied were maternal/reproductive (65.2%) or medical (39.5%). Birth and maternal outcomes were reported in 82.7% and in 74.1% of the cohort studies, respectively. In Saudi Arabia, babies born to obese women were at a higher risk of macrosomia (adjusted relative risk (aRR), 1.15; 95% confidence interval (CI), 1.10-1.20; I = 50%) or cesarean section (aRR, 1.21; 95% CI, 1.15-1.26; I = 62.0%). Several cohort studies were only descriptive without reporting the magnitude of the effect estimate between the assessed exposures and outcomes.
Cohort studies in the GCC have predominantly focused on reproductive and medical exposures. Obese pregnant women are at an increased risk of undergoing CS delivery or macrosomic births. Longer-term studies that explore a wider range of environmental and biological exposures and outcomes relevant to the GCC region are needed.
PROSPERO CRD42017068910.
我们系统地回顾和记录了海湾合作委员会（GCC）国家的母婴队列研究中的暴露和结局，并对母亲肥胖与（1）剖宫产（CS）和（2）胎儿巨大儿之间的加权效应估计值进行了定量总结。
我们检索了 MEDLINE-PubMed、Embase、Cochrane 图书馆、Scopus 和 Web of Science 电子数据库，截至 2019 年 6 月 30 日。我们考虑了在六个 GCC 国家（巴林、科威特、阿曼、卡塔尔、沙特阿拉伯和阿拉伯联合酋长国（UAE））进行的所有母婴队列研究。我们根据所测量的暴露（体重指数、环境、医疗、母婴/生殖、围产期或社会经济）和结局（母婴或出生）对队列研究进行分类。使用随机效应模型生成母亲肥胖与 CS 和胎儿巨大儿之间的调整后的加权效应估计值，以相对风险的形式表示。
在 3502 条引文中，有 81 篇已发表的队列研究被纳入。其中一项队列研究在巴林进行，八项在科威特进行，七项在卡塔尔进行，六项在阿曼进行，52 项在沙特阿拉伯进行，七项在阿联酋进行。研究最多的暴露是母婴/生殖（65.2%）或医疗（39.5%）。82.7%的队列研究报告了出生结局，74.1%的队列研究报告了母婴结局。在沙特阿拉伯，肥胖女性所生的婴儿巨大儿的风险更高（调整后的相对风险（aRR），1.15；95%置信区间（CI），1.10-1.20；I=50%）或剖宫产（aRR，1.21；95%CI，1.15-1.26；I=62.0%）。一些队列研究仅为描述性研究，没有报告评估的暴露与结局之间的效应估计值的大小。
GCC 的队列研究主要集中在生殖和医疗暴露上。肥胖孕妇行剖宫产或分娩巨大儿的风险增加。需要进行更长期的研究，以探索与 GCC 地区相关的更广泛的环境和生物暴露及结局。
PROSPERO CRD42017068910。
