母体血清锌水平与子痫前期风险相关：系统评价和荟萃分析。
Maternal serum zinc level is associated with risk of preeclampsia: A systematic review and meta-analysis.
机构信息
Emergency and Critical Care Center, Department of Emergency Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China.
Center for Reproductive Medicine, Department of Obstetrics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China.
出版信息
Front Public Health. 2022 Aug 1;10:968045. doi: 10.3389/fpubh.2022.968045. eCollection 2022.
BACKGROUND
Preeclampsia (PE) is a multi-organ syndrome that onsets in the second half of pregnancy. It is the second leading cause of maternal death globally. The homeostasis of zinc (Zn) levels is important for feto-maternal health.
OBJECTIVE
We aimed to collect all studies available to synthesize the evidence regarding the association between maternal Zn levels and the risk of preeclampsia.
METHODS
A systematic review and meta-analysis was conducted searching seven electronic databases [PubMed, Web of Science, Embase, African Journals Online (AJOL), ClinicalTrial.gov, and two Chinese databases: Wanfang and Chinese National Knowledge Infrastructure, CNKI]. Studies reporting maternal serum Zn levels in pregnant women with or without preeclampsia were included. Eligible studies were assessed through Newcastle-Ottawa Scale (NOS) and the meta-analysis was performed RevMan and Stata. The random-effects method (REM) was used for the meta-analysis with 95% confidence interval (CI). The pooled result was assessed using standard mean difference (SMD). The heterogeneity test was carried out using statistics, and the publication bias was evaluated using Begg's and Egger's test. Meta-regression and sensitivity analysis was performed Stata software.
RESULTS
A total of 51 studies were included in the final analysis. 6,947 participants from 23 countries were involved in our study. All studies went through the quality assessment. The pooled results showed that maternal serum Zn levels were lower in preeclamptic women than in healthy pregnant women (SMD: -1.00, 95% CI: -1.29, -0.70). Sub-group analysis revealed that geographical, economic context, and disease severity may further influence serum Zn levels and preeclampsia.
LIMITATIONS
There are significant between-study heterogeneity and publication bias among included studies.
CONCLUSIONS
A lower level of maternal Zn was associated with increased risks of preeclampsia. The associations were not entirely consistent across countries and regions worldwide.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=337069, Identifier: CRD42022337069.
背景
子痫前期（PE）是一种发生在妊娠后半期的多器官综合征，是全球导致产妇死亡的第二大原因。锌（Zn）水平的体内平衡对母婴健康很重要。
目的
我们旨在收集所有可用的研究，以综合有关母体 Zn 水平与子痫前期风险之间关联的证据。
方法
系统检索了 7 个电子数据库[PubMed、Web of Science、Embase、African Journals Online (AJOL)、ClinicalTrials.gov 以及中国的两个数据库：万方和中国国家知识基础设施（CNKI）]，以收集关于患有或不患有子痫前期的孕妇母体血清 Zn 水平的研究。纳入了报告母体血清 Zn 水平的研究。通过 Newcastle-Ottawa 量表（NOS）对合格研究进行评估，并使用 RevMan 和 Stata 进行荟萃分析。采用随机效应法（REM）进行荟萃分析，置信区间为 95%。使用标准均数差（SMD）评估汇总结果。采用 统计量进行异质性检验，采用 Begg 和 Egger 检验评估发表偏倚。采用 Stata 软件进行元回归和敏感性分析。
结果
共有 51 项研究纳入最终分析，来自 23 个国家的 6947 名参与者参与了我们的研究。所有研究均经过质量评估。汇总结果表明，子痫前期妇女的母体血清 Zn 水平低于健康孕妇（SMD：-1.00，95%CI：-1.29，-0.70）。亚组分析显示，地理位置、经济背景和疾病严重程度可能进一步影响血清 Zn 水平和子痫前期。
局限性
纳入研究之间存在显著的异质性和发表偏倚。
结论
母体 Zn 水平较低与子痫前期风险增加相关。这些关联在全球不同国家和地区并不完全一致。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=337069，标识符：CRD42022337069。
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