Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.
Department of Neonatology, Obstetrics and Gynecology Clinic "Narodni Front", Belgrade, Serbia.
Int Endod J. 2021 Sep;54(9):1527-1537. doi: 10.1111/iej.13538. Epub 2021 May 28.
The association between adverse pregnancy outcomes (APOs) and maternal apical periodontitis remains unclear as it has not been examined rigorously or reviewed systematically.
To systematically review and critically evaluate the available evidence on the association of maternal apical periodontitis with several APOs.
A literature search was conducted using the following electronic databases: Clarivate Analytics' Web of Science, Scopus, PubMed, and Cochrane Central Register of Controlled Trials (CENTRAL), from inception to 25 February 2021, with no language restrictions. Observational studies including longitudinal clinical trials, cohort, case-control and cross-sectional studies of prospective and retrospective design were included. Articles with duplicate or overlapping results, abstract-only papers, case reports, case series, animal studies and reviews were excluded. Two independent reviewers were involved in study selection, data extraction and appraising the included studies; disagreements were resolved by a third reviewer. The Newcastle-Ottawa Scale (NOS) and the adapted form of the NOS were used to assess the quality for case-control and cross-sectional studies, respectively.
Two case-control and one cross-sectional study were included in the current review. The included studies were published between 2015 and 2017, with a total of 1187 participating individuals with an approximate age range of 15 to 40 years. As the included studies reported different outcomes, the heterogeneity of data prevented a meta-analysis being undertaken. The overall quality of the evidence was 'Fair' for two out of three included studies, while one study was categorized as 'Good'.
Two out of three included primary studies had a substantial number of methodological inconsistencies and flaws, and therefore caution should be exercised in interpreting the results of this systematic review because several important covariates were not considered in the original investigations.
Based on a limited volume and 'Fair' and 'Good' quality of evidence, a positive association between maternal apical periodontitis and APOs was observed. However, more 'Good' quality clinical studies are needed to confirm the results of the current review.
None REGISTRATION: PROSPERO database (CRD42-2191987).
不良妊娠结局（APOs）与母体根尖周炎之间的关联尚不清楚，因为尚未对其进行严格检查或系统审查。
系统回顾和批判性评估现有关于母体根尖周炎与几种 APOs 之间关联的证据。
从 2021 年 2 月 25 日之前，使用 Clarivate Analytics 的 Web of Science、Scopus、PubMed 和 Cochrane 中央对照试验注册库（CENTRAL）等电子数据库进行文献检索，无语言限制。纳入的研究包括纵向临床试验、队列研究、病例对照研究和前瞻性及回顾性设计的横断面研究。重复或重叠结果的文章、仅有摘要的论文、病例报告、病例系列、动物研究和综述均被排除。两名独立的审查员参与了研究选择、数据提取和纳入研究的评估；意见分歧由第三名审查员解决。使用纽卡斯尔-渥太华量表（NOS）和 NOS 的改编形式分别评估病例对照和横断面研究的质量。
本次综述纳入了 2 项病例对照研究和 1 项横断面研究。纳入的研究发表于 2015 年至 2017 年之间，共有 1187 名年龄约为 15 至 40 岁的参与者。由于纳入的研究报告了不同的结局，数据的异质性阻止了进行荟萃分析。三项纳入研究中有两项的证据总体质量为“中等”，而一项研究被归类为“良好”。
三项纳入的主要研究中有两项存在大量方法学上的不一致和缺陷，因此在解释本系统综述的结果时应谨慎，因为原始研究中没有考虑到几个重要的协变量。
基于有限的数量和“中等”和“良好”质量的证据，观察到母体根尖周炎与 APOs 之间存在正相关。然而，需要更多“良好”质量的临床研究来证实本综述的结果。
无
PROSPERO 数据库（CRD42-2191987）。
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