Janoudi Ghayath, Uzun Rada Mara, Boyd Stephanie T, Fell Deshayne B, Ray Joel G, Foster Angel M, Giffen Randy, Clifford Tammy J, Walker Mark C
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Int J Womens Health. 2023 Mar 21;15:411-425. doi: 10.2147/IJWH.S397680. eCollection 2023.
Preeclampsia is a leading cause of maternal and perinatal mortality and morbidity. The management of preeclampsia has not changed much in more than two decades, and its aetiology is still not fully understood. Case reports and case series have traditionally been used to communicate new knowledge about existing conditions. Whether this is true for preeclampsia is not known.
To determine whether recent case reports or case series have generated new knowledge and clinical discoveries about preeclampsia.
A detailed search strategy was developed in consultation with a medical librarian. Two bibliographic databases were searched through Ovid: Embase and MEDLINE. We selected case reports or case series published between 2015 and 2020, comprising pregnant persons diagnosed with hypertensive disorders of pregnancy, including preeclampsia. Two reviewers independently screened all publications. One reviewer extracted data from included studies, while another conducted a quality check of extracted data. We developed a codebook to guide our data extraction and outcomes assessment. The quality of each report was determined based on Joanna Briggs Institute (JBI) critical appraisal checklist for case reports and case series.
We included 104 case reports and three case series, together comprising 118 pregnancies. A severe presentation or complication of preeclampsia was reported in 81% of pregnancies, and 84% had a positive maternal outcome, free of death or persistent complications. Only 8% of the case reports were deemed to be of high quality, and 53.8% of moderate quality; none of the case series were of high quality. A total of 26 of the 107 publications (24.3%) included a novel clinical discovery as a central theme.
Over two-thirds of recent case reports and case series about preeclampsia do not appear to present new knowledge or discoveries about preeclampsia, and most are of low quality.
子痫前期是孕产妇和围产儿发病和死亡的主要原因。二十多年来，子痫前期的管理变化不大，其病因仍未完全明确。传统上，病例报告和病例系列用于传播有关现有疾病的新知识。子痫前期是否如此尚不清楚。
确定近期的病例报告或病例系列是否产生了关于子痫前期的新知识和临床发现。
与医学图书馆员协商制定了详细的检索策略。通过Ovid检索了两个文献数据库：Embase和MEDLINE。我们选择了2015年至2020年发表的病例报告或病例系列，包括被诊断为妊娠高血压疾病（包括子痫前期）的孕妇。两名审阅者独立筛选所有出版物。一名审阅者从纳入的研究中提取数据，另一名审阅者对提取的数据进行质量检查。我们制定了一个编码手册来指导数据提取和结果评估。根据乔安娜·布里格斯研究所（JBI）病例报告和病例系列的批判性评价清单确定每份报告的质量。
我们纳入了104例病例报告和3个病例系列，共涉及118例妊娠。81%的妊娠报告了子痫前期的严重表现或并发症，84%的孕产妇结局良好，无死亡或持续性并发症。只有8%的病例报告被认为质量高，53.8%为中等质量；没有一个病例系列质量高。107篇出版物中有26篇（24.3%）将一项新的临床发现作为核心主题。
近期关于子痫前期的病例报告和病例系列中，超过三分之二似乎没有呈现关于子痫前期的新知识或发现，且大多数质量较低。
