产时胎儿脉搏血氧饱和度与围产期不良及长期结局之间的关联：一项系统评价和荟萃分析方案
Association between intrapartum fetal pulse oximetry and adverse perinatal and long-term outcomes: a systematic review and meta-analysis protocol.
作者信息
Mitchell Jill M, Walsh Siobhan, O'Byrne Laura J, Conrick Virginia, Burke Ray, Khashan Ali S, Higgins John, Greene Richard, Maher Gillian M, McCarthy Fergus P
机构信息
INFANT Research Centre, University College Cork, Cork, County Cork, Ireland.
Department of Obstetrics and Gynaecology, University College Cork, Cork, County Cork, Ireland.
出版信息
HRB Open Res. 2024 Mar 28;6:63. doi: 10.12688/hrbopenres.13802.2. eCollection 2023.
BACKGROUND
Current methods of intrapartum fetal monitoring based on heart rate, increase the rates of operative delivery but do not prevent or accurately detect fetal hypoxic brain injury. There is a need for more accurate methods of intrapartum fetal surveillance that will decrease the incidence of adverse perinatal and long-term neurodevelopmental outcomes while maintaining the lowest possible rate of obstetric intervention. Fetal pulse oximetry (FPO) is a technology that may contribute to improved intrapartum fetal wellbeing evaluation by providing a non-invasive measurement of fetal oxygenation status.
OBJECTIVE
This systematic review and meta-analysis aims to synthesise the evidence examining the association between intrapartum fetal oxygen saturation levels and adverse perinatal and long-term outcomes in the offspring.
METHODS
We will include randomised control trials (RCTs), cohort, cross-sectional and case-control studies which examine the use of FPO during labour as a means of measuring intrapartum fetal oxygen saturation and assess its effectiveness at detecting adverse perinatal and long-term outcomes compared to existing intrapartum surveillance methods. A detailed systematic search of PubMed, EMBASE, CINAHL, The Cochrane Library, Web of Science, ClinicalTrials.Gov and WHO ICTRP will be conducted following a detailed search strategy until February 2024. Three authors will independently review titles, abstracts and full text of articles. Two reviewers will independently extract data using a pre-defined data extraction form and assess the quality of included studies using the Risk of Bias tool for RCTs and Newcastle-Ottawa Scale for observational studies. The grading of recommendations, assessment, development, and evaluation (GRADE) approach will be used to evaluate the certainty of the evidence. We will use random-effects meta-analysis for each exposure-outcome association to calculate pooled estimates using the generic variance method. This systematic review will follow the Preferred Reporting Items for Systematic reviews and Meta-analyses and MOOSE guidelines.
PROSPERO REGISTRATION
CRD42023457368 (04/09/2023).
背景
目前基于心率的产时胎儿监测方法增加了手术分娩率，但不能预防或准确检测胎儿缺氧性脑损伤。需要更准确的产时胎儿监测方法，以降低不良围产期和长期神经发育结局的发生率，同时保持尽可能低的产科干预率。胎儿脉搏血氧饱和度测定法（FPO）是一项技术，可通过提供胎儿氧合状态的非侵入性测量，有助于改善产时胎儿健康状况评估。
目的
本系统评价和荟萃分析旨在综合证据，研究产时胎儿血氧饱和度水平与后代不良围产期和长期结局之间的关联。
方法
我们将纳入随机对照试验（RCT）、队列研究、横断面研究和病例对照研究，这些研究考察分娩期间使用FPO作为测量产时胎儿血氧饱和度的手段，并评估其与现有产时监测方法相比在检测不良围产期和长期结局方面的有效性。将按照详细的检索策略，对PubMed、EMBASE、CINAHL、Cochrane图书馆、科学网、ClinicalTrials.Gov和WHO ICTRP进行详细的系统检索，直至2024年2月。三位作者将独立审查文章的标题、摘要和全文。两位审查员将使用预定义的数据提取表独立提取数据，并使用RCT的偏倚风险工具和观察性研究的纽卡斯尔-渥太华量表评估纳入研究的质量。将使用推荐分级、评估、制定和评价（GRADE）方法来评估证据的确定性。我们将对每个暴露-结局关联使用随机效应荟萃分析，采用通用方差法计算合并估计值。本系统评价将遵循系统评价和荟萃分析的首选报告项目以及MOOSE指南。
PROSPERO注册编号：CRD42023457368（2023年9月4日）。
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