Postgraduate Program in Health Sciences, Faculdade de Medicina do ABC/Centro Universitário Saúde ABC, Santo André, Avenida Lauro Gomes 2000, Santo André, SP, CEP 09060-870, Brazil.
Postgraduate Program in Health Sciences, Faculdade de Medicina do ABC/Centro Universitário Saúde ABC, Santo André, Avenida Lauro Gomes 2000, Santo André, SP, CEP 09060-870, Brazil; Discipline of Sexual and Reproductive Health and Populational Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro Universitário Saúde ABC, Santo André, Avenida Lauro Gomes 2000, Santo André, SP, CEP 09060-870, Brazil.
Eur J Obstet Gynecol Reprod Biol. 2020 May;248:177-186. doi: 10.1016/j.ejogrb.2020.03.043. Epub 2020 Mar 19.
Hypertensive disorders are among the main causes of maternal and perinatal morbidity and mortality, and the findings regarding the occurrence of preeclampsia (PE) and eclampsia (E) in adolescent pregnancy are conflicting. We performed a systematic review and meta-analysis aimed to determining the prevalence of PE and E in adolescent pregnancy considering socioeconomic and temporal characteristics.
MEDLINE, EMBASE and SciELO databases, with no time span restrictions. Studies that reported the occurrence of PE and E in adolescent pregnancy. Study selection, data extraction and bias assessment were performed by three independent investigators. Meta-analysis techniques comprised random-effects model and double-arcsine transformation; χ and I tests were used to assess heterogeneity. Meta-regression used Hunter-Schmidt model; publication bias were assessed by funnel and Baujat plots.
Seventy studies were included, ranging from 1969 to 2019 and comprising 30 countries and 291,247 adolescents. The overall prevalence rate of PE/E was 6.7 % (95 % CI = 5.8-7.6). Subgroup analysis revealed association of PE/E (P = 0.050) and E (P = 0.0113) with country income, and the highest prevalences were found in low-and medium-income country groups (11.5 %, 95 % CI=7.8-15.8 and 10.6 %, 95 % CI=6.05-16.2). Association of PE with publication year (P = 0.0022) was also found with an observable reduction in prevalence rate across the years.
The findings seem to confirm that socioeconomic and demographic characteristics play a role for the risk of PE/E in adolescent pregnancy. Although the occurrence of PE has declined worldwide, the problem has broader dimensions beyond health issues.
高血压疾病是孕产妇和围产儿发病率和死亡率的主要原因之一，关于青少年妊娠中先兆子痫 (PE) 和子痫 (E) 的发生情况的研究结果存在争议。我们进行了一项系统评价和荟萃分析，旨在根据社会经济和时间特征确定青少年妊娠中 PE 和 E 的患病率。
使用 MEDLINE、EMBASE 和 SciELO 数据库，无时间跨度限制。报告青少年妊娠中 PE 和 E 发生情况的研究。研究选择、数据提取和偏倚评估由三位独立研究者进行。荟萃分析技术包括随机效应模型和双弧形变换； χ 和 I 检验用于评估异质性。Meta 回归采用 Hunter-Schmidt 模型；漏斗图和 Baujat 图评估发表偏倚。
共纳入 70 项研究，时间跨度从 1969 年至 2019 年，涵盖 30 个国家和 291,247 名青少年。PE/E 的总体患病率为 6.7%（95%CI=5.8-7.6）。亚组分析显示，PE/E（P=0.050）和 E（P=0.0113）与国家收入有关，在中低收入国家组中发现的患病率最高（11.5%，95%CI=7.8-15.8 和 10.6%，95%CI=6.05-16.2）。PE 与发表年份之间也存在相关性（P=0.0022），随着时间的推移，患病率呈下降趋势。
这些发现似乎证实了社会经济和人口统计学特征在青少年妊娠中 PE/E 风险中起作用。尽管全球范围内 PE 的发生有所下降，但问题的维度超出了健康问题。
