Laboratory of Experimental Surgery and Surgical Research N.S Christeas, National and Kapodistrian University of Athens, Athens, Greece.
1st department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Acta Obstet Gynecol Scand. 2020 Nov;99(11):1434-1443. doi: 10.1111/aogs.13893. Epub 2020 Jun 4.
Several studies acknowledge that the presence of amniotic fluid sludge (AFS) is an independent predictive factor for preterm birth. In the present systematic review, we summarize research that focuses on the comparison of pregnancy outcomes among women with and without AFS.
Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar databases were systematically searched from inception. Both observational and randomized controlled studies were considered eligible provided that they reported data on pregnancy outcomes among women with and without AFS. Outcomes were not meta-analyzed because of the high heterogeneity in terms of selected population and outcome reporting.
Seventeen studies of 2432 women were included in this review. Six studies evaluated women at high risk for preterm birth. Pregnancies complicated by AFS had a lower gestational age at delivery and increased incidence of preterm delivery at <37 weeks. Neonatal death rates and admission to the Neonatal Intensive Care Unit were also increased. Evidence in low-risk women, those with signs of preterm labor, in those carrying twins, and in women with cervical cerclage or Arabin pessary was extremely limited.
Women with AFS seem to deliver at an earlier gestational age, and preterm birth rates are also increased. Limited data seem to point to neonatal morbidity and mortality being increased. However, the presence of a direct association should not be assumed because the evidence is not adjusted for the presence of confounders.
多项研究承认羊水胎粪（AFS）的存在是预测早产的独立预测因素。在本系统评价中，我们总结了关注有和没有 AFS 的女性妊娠结局比较的研究。
从一开始，我们就在 Medline、Scopus、Clinicaltrials.gov、EMBASE、Cochrane 中央对照试验注册中心（CENTRAL）和 Google Scholar 数据库中进行了系统搜索。只要报告了有和没有 AFS 的女性妊娠结局数据，就可以考虑将观察性和随机对照研究纳入研究。由于所选人群和结局报告的高度异质性，因此没有进行荟萃分析。
本综述纳入了 17 项共 2432 名女性的研究。6 项研究评估了有早产风险的女性。AFS 合并妊娠的分娩时孕龄较低，<37 周的早产发生率增加。新生儿死亡率和入住新生儿重症监护病房的比例也有所增加。低风险女性、有早产迹象的女性、怀有双胞胎的女性以及接受宫颈环扎术或阿拉伯胶塞的女性的证据极其有限。
AFS 女性似乎分娩的孕龄更早，早产率也有所增加。有限的数据似乎表明新生儿发病率和死亡率增加。然而，由于没有调整混杂因素的存在，不能假设存在直接关联。
