Department of Women's Health, King's College London, London, England.
Obstetrics and Gynaecology, Guy's and St Thomas' NHS Foundation Trust, London, England.
Eur J Intern Med. 2023 Feb;108:52-59. doi: 10.1016/j.ejim.2022.11.003. Epub 2022 Nov 23.
Beyond diabetes mellitus little data reports outcomes of women with chronic medical conditions who have received pre-conception counselling (PCC). This study aimed to perform a systematic review of the literature to evaluate evidence regarding the impact of PCC on maternal and fetal outcomes in women with chronic medical conditions aside from diabetes mellitus.
A systematic review was conducted in accordance with PRISMA. PubMed, Cochrane, Ovid Medline and Web of Science were searched. Two reviewers screened abstracts and full texts. Inclusion criteria included studies relating to chronic medical disorders of interest published between database inception and 21 May 2022, reporting outcomes relating to disease activity and perinatal outcomes.
The search yielded 11,814 results of which six met criteria for inclusion. Two papers describe the demographics of women more likely to receive PCC which included younger age, shorter disease duration, nulliparity, IVF pregnancy and higher education/job security. Two reported the effects of PCC on women's behaviour with improvements demonstrated in correct medication adherence, folic acid intake and smoking cessation. Five studies reported outcomes related to disease activity; those receiving PCC were more likely to have quiescent disease during pregnancy. Improvements in pregnancy outcomes were described including reduced rates of small for gestational age, low birth weight, preterm birth, congenital abnormality and obstetric complications.
A paucity of data exists relating to pregnancy outcomes in women with chronic medical conditions receiving PCC. Reported outcomes are favorable, supporting the routine inclusion of PCC in preparation for pregnancy in such patients.
除了糖尿病之外，很少有数据报告接受孕前咨询 (PCC) 的患有慢性疾病的女性的母婴结局。本研究旨在进行系统评价，以评估除糖尿病以外患有慢性疾病的女性接受 PCC 对母婴结局的影响的证据。
按照 PRISMA 进行系统评价。检索了 PubMed、Cochrane、Ovid Medline 和 Web of Science。两位评审员筛选了摘要和全文。纳入标准包括自数据库建立以来至 2022 年 5 月 21 日发表的与慢性疾病相关的研究，报告与疾病活动和围产期结局相关的结局。
搜索结果为 11814 项，其中 6 项符合纳入标准。有两篇文章描述了更有可能接受 PCC 的女性的人口统计学特征，包括年龄较小、疾病持续时间较短、未婚、IVF 妊娠和较高的教育/工作保障。有两篇文章报告了 PCC 对女性行为的影响，表现为正确服药、叶酸摄入和戒烟的改善。五项研究报告了与疾病活动相关的结局；接受 PCC 的女性在怀孕期间更有可能处于静止状态。描述了妊娠结局的改善，包括减少小于胎龄儿、低出生体重、早产、先天性异常和产科并发症的发生率。
关于接受 PCC 的慢性疾病女性的妊娠结局的数据很少。报告的结局是有利的，支持在这些患者中常规纳入 PCC 以准备怀孕。
