Department of Metabolism, Digestion and Reproduction & Department of Surgery and Cancer, Faculty of Medicine, IRDB, Imperial College London, Hammersmith Campus, Du Cane Road, 3rd Floor, London, W12 0NN, UK.
Department of Nutrition and Dietetics, Royal Marsden Hospital, London, UK.
Sci Rep. 2024 Mar 4;14(1):5296. doi: 10.1038/s41598-024-54840-0.
Although the assessment of the amniotic fluid volume in pregnancy is part of the fetal wellbeing surveillance, the impact of idiopathic polyhydramnios (IP) on maternal and perinatal outcomes in unknown. The aim of this meta-analysis was to investigate the association of IP with different maternal and perinatal outcomes. We screened five electronic databases until December 2023 and performed data extraction and quality assessment using ROBINS-E in duplicates. Pooled risk ratios and 95% confidence intervals (95% CI) were calculated with a random effects model. 38 studies were included. Patients with IP were at increased risk of perinatal complications including preterm delivery (RR 1.96, 95% CI 1.35-2.86; I = 92%), placental abruption (RR 3.20, 95% CI 2.20-4.65; I = 2%), delivery via caesarean section (RR 1.60, 95% CI 1.39-1.84; I = 95%) and postpartum haemorrhage (RR 1.98, 95% CI 1.22-3.22; I = 84%). Similarly, IP was associated with increased risk of adverse perinatal outcomes including low APGAR score (RR 3.0, 95% CI 1.23-7.35; I = 95%), stillbirth (RR 4.75, 95% CI 2.54-8.86; I = 9%) and perinatal mortality (RR 4.75, 95% CI 2.67-8.48; I = 37%). This meta-analysis suggests that pregnant women with IP may be at increased risk of perinatal complications and adverse neonatal outcomes. However, data remains inconclusive considering the low quality and high heterogeneity of included studies.PROSPERO registration number: CRD42022359944.
虽然评估孕期羊水量是胎儿健康监测的一部分，但特发性羊水过多（IP）对母婴围生期结局的影响尚不清楚。本荟萃分析的目的是研究 IP 与不同母婴围生期结局的关系。我们在五个电子数据库中进行了筛选，直到 2023 年 12 月，并使用 ROBINS-E 进行了重复的数据提取和质量评估。使用随机效应模型计算汇总风险比和 95%置信区间（95%CI）。纳入了 38 项研究。IP 患者发生围生期并发症的风险增加，包括早产（RR 1.96，95%CI 1.35-2.86；I=92%）、胎盘早剥（RR 3.20，95%CI 2.20-4.65；I=2%）、剖宫产分娩（RR 1.60，95%CI 1.39-1.84；I=95%）和产后出血（RR 1.98，95%CI 1.22-3.22；I=84%）。同样，IP 与不良围生期结局的风险增加相关，包括低 Apgar 评分（RR 3.0，95%CI 1.23-7.35；I=95%）、死胎（RR 4.75，95%CI 2.54-8.86；I=9%）和围生期死亡率（RR 4.75，95%CI 2.67-8.48；I=37%）。本荟萃分析表明，IP 孕妇可能面临围生期并发症和不良新生儿结局的风险增加。然而，考虑到纳入研究的低质量和高异质性，数据仍然不确定。PROSPERO 注册号：CRD42022359944。
