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抗 SSA/RO 抗体相关妊娠的母婴结局:系统评价和荟萃分析。

Maternal and infant outcomes of pregnancy associated with anti-SSA/RO antibodies: a systematic review and meta-analysis.

机构信息

Department of Rheumatology, The First Affiliated Hospital of Soochow University, No.188 Shizi St, Suzhou, 215006, Jiangsu, China.

出版信息

Pediatr Rheumatol Online J. 2023 Mar 4;21(1):22. doi: 10.1186/s12969-023-00803-0.

Abstract

OBJECTIVE

The relationship between anti-SSA/RO antibodies and pregnancy has been reported previously, and we aim to visualize the rates of maternal and infant outcomes with anti-SSA/RO.

METHODS

We systematically searched records from Pubmed, Cochrane, Embase, and Web of Science databases, pooled incidence rates of adverse outcomes of pregnancy, and 95% confidence intervals (CIs) were performed with RStudio.

RESULTS

A total of 890 records comprising 1675 patients and 1920 pregnancies were searched from the electronic databases. For maternal outcomes, the pooled estimate rates were 4% for termination of pregnancy, 5% for spontaneous abortion, 26% for preterm labor, and 50% for cesarean operation. While for fetal outcomes, the pooled estimate rates were 4% for perinatal death, 3% for intrauterine growth retardation, 6% for endocardial fibroelastosis, 6% for dilated cardiomyopathy, 7% for congenital heart block, 12% for congenital heart block recurrence, 19% for cutaneous neonatal lupus erythematosus, 12% for hepatobiliary disease and 16% for hematological manifestations. A subgroup analysis of congenital heart block prevalence was performed, diagnostic method and study region were found to affect heterogeneity to some extent.

CONCLUSION

Cumulative analysis of data from real-world studies confirmed adverse pregnancy outcomes of women with anti-SSA/RO, serves as a reference and a guide for the diagnosis and subsequent treatment of these women, thereby enhancing maternal and infant health. Additional studies with real-world cohorts are required to validate these results.

摘要

目的

先前已有报道抗 SSA/RO 抗体与妊娠之间的关系,本研究旨在观察抗 SSA/RO 与母婴结局的关系。

方法

我们系统地检索了 Pubmed、Cochrane、Embase 和 Web of Science 数据库中的记录,使用 RStudio 计算了不良妊娠结局的合并发生率及其 95%置信区间(CI)。

结果

从电子数据库中搜索到 890 条记录,包含 1675 例患者和 1920 例妊娠。对于母体结局,合并估计发生率为终止妊娠 4%、自然流产 5%、早产 26%和剖宫产 50%。对于胎儿结局,合并估计发生率为围产儿死亡 4%、宫内生长受限 3%、心内膜弹力纤维增生症 6%、扩张型心肌病 6%、先天性心脏传导阻滞 7%、先天性心脏传导阻滞复发 12%、新生儿红斑狼疮 19%、肝胆疾病 12%和血液学表现 16%。我们对先天性心脏传导阻滞的患病率进行了亚组分析,发现诊断方法和研究区域在一定程度上影响了异质性。

结论

对真实世界研究数据的累积分析证实了抗 SSA/RO 妇女的不良妊娠结局,为这些妇女的诊断和后续治疗提供了参考和指导,从而提高了母婴健康水平。需要更多真实世界队列研究来验证这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7f7/9985242/e10a0cb58b3f/12969_2023_803_Fig1_HTML.jpg

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