母体乙肝携带者状态对先天性异常的影响：系统评价和荟萃分析。
Impact of maternal hepatitis B carrier status on congenital abnormalities: a systematic review and meta-analysis.
机构信息
Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, Sichuan, China.
出版信息
BMJ Open. 2023 Mar 28;13(3):e066017. doi: 10.1136/bmjopen-2022-066017.
OBJECTIVES
This study aims to explore whether maternal hepatitis B carrier status is associated with an increased risk of congenital abnormalities.
DESIGN
A systematic review and meta-analysis of observational studies.
DATA SOURCES
PubMed, Embase (Ovid), Scopus, the China National Knowledge Infrastructure (CNKI) and the Wanfang databases.
STUDY SELECTION
Five databases were searched systematically from inception to 7 September 2021. Cohort and case-control studies that investigated the association between maternal hepatitis B virus (HBV) infection and congenital abnormalities were included. This study was conducted according to MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines.
DATA EXTRACTION AND SYNTHESIS
Two reviewers independently collected data, as well as assessed risk of bias by using Newcastle-Ottawa Scale. We pooled crude relative risk (cRR) and adjusted OR (aOR) by DerSimonian-Laird random-effects model. Heterogeneity was explored by statistics, Cochran's Q test. Several subgroup analyses and sensitivity analyses were performed.
RESULTS
In total, 14 studies involving 16 205 pregnant women exposed to HBV were included. The pooled cRR of 1.15 (95% CI: 0.92 to 1.45; 14 studies included) showed a marginal but not significant association between maternal HBV-carrier status and congenital abnormalities. However, the pooled aOR of 1.40 (95% CI: 1.01 to 1.93; 8 studies included) indicated that pregnant women with HBV infection might be associated with a higher risk of congenital abnormalities. Subgroup analyses of adjusted data showed a higher pooling cRR or aOR on high prevalence HBV infection populations, as well as studies from Asia and Oceania.
CONCLUSIONS
Maternal hepatitis B carrier status might be at potential risk for congenital abnormalities. The existing evidence was not sufficient to draw a firm conclusion. Additional studies may be warranted to confirm the association.
PROSPERO REGISTRATION NUMBER
CRD42020205459.
目的
本研究旨在探讨母体乙肝病毒（HBV）携带状态是否与先天性异常风险增加有关。
设计
系统评价和观察性研究的荟萃分析。
数据来源
PubMed、Embase（Ovid）、Scopus、中国知网（CNKI）和万方数据库。
研究选择
从建库到 2021 年 9 月 7 日，系统地在 5 个数据库中进行检索。纳入了研究母体 HBV 感染与先天性异常之间关联的队列研究和病例对照研究。本研究根据 MOOSE（流行病学观察性研究荟萃分析）指南进行。
数据提取与合成
两位审查员独立收集数据，并使用 Newcastle-Ottawa 量表评估偏倚风险。我们使用 DerSimonian-Laird 随机效应模型汇总了未调整的相对风险（cRR）和调整后的比值比（aOR）。通过 统计量和 Cochran's Q 检验来探索异质性。进行了多项亚组分析和敏感性分析。
结果
共纳入 14 项研究，涉及 16205 名暴露于 HBV 的孕妇。汇总的 cRR 为 1.15（95%CI：0.92 至 1.45；14 项研究纳入）显示母体 HBV 携带状态与先天性异常之间存在边缘但无统计学意义的关联。然而，汇总的 aOR 为 1.40（95%CI：1.01 至 1.93；8 项研究纳入）表明，HBV 感染的孕妇可能与先天性异常风险增加相关。调整数据的亚组分析显示，在 HBV 感染高发人群以及来自亚洲和大洋洲的研究中，汇总的 cRR 或 aOR 更高。
结论
母体乙肝病毒携带状态可能与先天性异常有关。现有证据不足以得出明确的结论。可能需要进一步的研究来证实这种关联。
PROSPERO 注册号：CRD42020205459。
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