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HELLP综合征对妊娠期急性肾损伤及妊娠结局的影响:一项系统评价和荟萃分析

Effect of HELLP syndrome on acute kidney injury in pregnancy and pregnancy outcomes: a systematic review and meta-analysis.

作者信息

Liu Qiang, Ling Guan-Jun, Zhang Shao-Quan, Zhai Wen-Qing, Chen Yi-Juan

机构信息

Maternity and Child Health Care & Red Cross Hospital of Qinzhou, Qinzhou, 535099, Guangxi, China.

出版信息

BMC Pregnancy Childbirth. 2020 Oct 30;20(1):657. doi: 10.1186/s12884-020-03346-4.

Abstract

BACKGROUND

HELLP syndrome may increase adverse pregnancy outcomes, though the incidence of it is not high. At present, the impact of HELLP syndrome on P-AKI (acute kidney injury during pregnancy) and maternal and infant outcomes is controversial. Thus, we conducted a meta-analysis to find out more about the relationship between HELLP syndrome and P-AKI and pregnancy outcomes.

METHODS

We systematically searched PubMed, Embassy and Cochrane Databases for cohort studies and RCT to assess the effect of HELLP syndrome on P-AKI and maternal and infant outcomes. Study-specific risk estimates were combined by using fixed-effect or random-effect models.

RESULTS

This meta-analysis included 11 cohort studies with a total of 6333 Participants, including 355 cases of pregnant women with HELLP syndrome and 5979 cases that without. HELLP syndrome was associated with relatively higher risk of P-AKI (OR4.87 95% CI 3.31 ~ 7.17, P<0.001), fetal mortality (OR1.56 95% CI 1.45 ~ 2.11, P<0.001) and Maternal death (OR3.70 95% CI 1.72 ~ 7.99, P<0.001).

CONCLUSIONS

HELLP syndrome is associated with relatively higher risk of P-AKI, fetal mortality and maternal death.

摘要

背景

尽管HELLP综合征的发病率不高,但它可能会增加不良妊娠结局的发生风险。目前,HELLP综合征对妊娠急性肾损伤(P-AKI)以及母婴结局的影响存在争议。因此,我们进行了一项荟萃分析,以进一步了解HELLP综合征与P-AKI以及妊娠结局之间的关系。

方法

我们系统检索了PubMed、Embase和Cochrane数据库,以寻找队列研究和随机对照试验,来评估HELLP综合征对P-AKI以及母婴结局的影响。采用固定效应或随机效应模型合并各研究的风险估计值。

结果

该荟萃分析纳入了11项队列研究,共6333名参与者,其中包括355例HELLP综合征孕妇和5979例非HELLP综合征孕妇。HELLP综合征与P-AKI(比值比4.87,95%置信区间3.31至7.17,P<0.001)、胎儿死亡(比值比1.56,95%置信区间1.45至2.11,P<0.001)和孕产妇死亡(比值比3.70,95%置信区间1.72至7.99,P<0.001)的相对较高风险相关。

结论

HELLP综合征与P-AKI、胎儿死亡和孕产妇死亡的相对较高风险相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32fd/7602332/cfa515b1c5f8/12884_2020_3346_Fig1_HTML.jpg

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