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妊娠干预以改善生育结局:对产妇结局有何影响?系统评价。

Pregnancy Interventions to Improve Birth Outcomes: What Are the Effects on Maternal Outcomes? A Scoping Review.

机构信息

Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.

出版信息

Int J Public Health. 2022 Nov 2;67:1604620. doi: 10.3389/ijph.2022.1604620. eCollection 2022.

Abstract

Interventions in pregnancy are commonly evaluated for their effects on birth outcomes because maternal infection and poor nutrition are the primary contributors to adverse pregnancy outcomes, especially in low- and middle-income countries (LMICs). However, the extent to which such interventions directly impact maternal health and nutrition has not been succinctly characterized. We conducted a scoping review of systematic reviews and meta-analyses of 27 pregnancy interventions to summarize the evidence of impact on maternal outcomes. Overall, these were reported incompletely, and we failed to find any evidence for eight interventions. Influenza vaccination, insecticide-treated bed nets, intermittent preventive treatment for malaria, anthelmintic therapy, and treatment of bacterial vaginosis, asymptomatic bacteriuria, and periodontal disease during pregnancy provided direct benefit to women, with reductions in infection risk. Nutritional interventions such as micronutrient supplementation and balanced energy and protein improved outcomes of maternal anemia and gestational weight gain, particularly in deficient populations. Calcium and low dose aspirin significantly reduced the risk of pre-eclampsia. These findings highlight antenatal interventions benefitting maternal health and provide insights into pathways for impacting birth and infant outcomes.

摘要

干预妊娠通常会评估其对出生结局的影响,因为母体感染和营养状况不良是导致不良妊娠结局的主要原因,尤其是在中低收入国家(LMICs)。然而,这些干预措施在多大程度上直接影响孕产妇健康和营养状况,尚未得到简洁的描述。我们对 27 项妊娠干预措施的系统评价和荟萃分析进行了范围综述,以总结对孕产妇结局影响的证据。总体而言,这些报告并不完整,我们未能找到 8 种干预措施的任何证据。流感疫苗接种、经杀虫剂处理的蚊帐、间歇性预防治疗疟疾、驱虫治疗以及治疗细菌性阴道病、无症状菌尿和牙周病在怀孕期间为妇女提供了直接的益处,降低了感染风险。营养干预措施,如补充微量营养素和平衡能量和蛋白质,改善了孕产妇贫血和妊娠期体重增加的结局,尤其是在营养缺乏的人群中。钙和低剂量阿司匹林可显著降低子痫前期的风险。这些发现强调了产前干预措施有益于产妇健康,并为影响出生和婴儿结局的途径提供了思路。

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