Monash University Faculty of Medicine, Nursing and Health Sciences, Clayton, Victoria, Australia.
Department of Neonatology, Townsville Hospital and Health Service, Townsville, Queensland, Australia
BMJ Open. 2021 Aug 6;11(8):e047770. doi: 10.1136/bmjopen-2020-047770.
To investigate the literature and determine if prematurity has an impact on long-term adverse kidney outcomes.
Systematic review.
OVID Medline, PubMed, SCOPUS, CINAHL and EMBASE databases were searched for studies relating to the adverse outcomes of prematurity from 1990 to April 2021.
All articles published between January 1990 and April 2021 that investigated whether premature infants developed long-term adverse renal outcomes were included in this review. Articles must have been human studies and written in English. Case series with less than 20 participants and case studies were excluded.
One reviewer completed the database searches. Article selection was performed independently and in a non-blinded manner by both reviewers. Initial screening was by title and abstract. Full texts of remaining articles were reviewed. Articles for which inclusion was unclear were re-reviewed by both reviewers, and a unanimous decision was taken as to whether they should be included. The Newcastle-Ottawa Scale was used for quality assessment of the included articles.
The literature search yielded 31 human studies, which investigated the short-term and long-term kidney outcomes of prematurity. These studies were conducted in 17 different countries. The most common outcomes measured were blood pressure (BP) and glomerular filtration rate. Other common outcomes measured included kidney size and mass, proteinuria, albuminuria, chronic kidney disease (CKD) and physical parameters such as height, weight and body mass index.
Prematurity is likely linked to increased risk of kidney dysfunction and high BP in childhood and into early adulthood. Premature birth conferred a twofold increased risk of CKD and extremely premature birth conferred a threefold increased risk of CKD. However, further larger multicentre studies are needed to draw definitive conclusions on the long-term kidney outcomes of prematurity.
调查文献，确定早产是否对长期不良肾脏结局有影响。
系统评价。
从 1990 年到 2021 年 4 月，在 OVID Medline、PubMed、SCOPUS、CINAHL 和 EMBASE 数据库中搜索与早产不良结局相关的研究。
本综述纳入了所有发表于 1990 年 1 月至 2021 年 4 月间、探讨早产儿是否发生长期不良肾脏结局的研究。文章必须为人类研究，且用英文书写。排除病例系列研究（<20 例参与者）和病例研究。
一位评审员完成数据库检索。两位评审员独立且非盲法进行文章选择。初步筛选基于标题和摘要。对其余文章的全文进行审查。对纳入标准不明确的文章，由两位评审员重新审查，并就是否纳入达成一致意见。使用纽卡斯尔-渥太华量表对纳入文献进行质量评估。
文献检索共获得 31 项人类研究，这些研究调查了早产的短期和长期肾脏结局。这些研究在 17 个不同的国家进行。最常测量的结果是血压（BP）和肾小球滤过率。其他常见的测量结果包括肾脏大小和质量、蛋白尿、白蛋白尿、慢性肾脏病（CKD）以及身高、体重和体重指数等身体参数。
早产可能与儿童期和成年早期肾功能障碍和高血压风险增加有关。早产使 CKD 的风险增加两倍，极早产使 CKD 的风险增加三倍。然而，需要进一步开展更大规模的多中心研究，以明确早产对肾脏长期结局的影响。
