Murillo-Llorente María Teresa, Ventura Ignacio, Tomás-Aguirre Francisco, Defez-Martin Marta, Martín-Díaz María Inmaculada, Atienza-Ramirez Sandra, Llorca-Colomer Francisco, Asins-Cubells Adalberto, Legidos-García María Ester, Pérez-Bermejo Marcelino
School of Medicine and Health Sciences, Catholic University of Valencia, C/Quevedo nº 2, 46001 Valencia, Spain.
Molecular and Mitochondrial Medicine Research Group, School of Medicine and Health Sciences, Catholic University of Valencia, C/Quevedo nº 2, 46001 Valencia, Spain.
J Clin Med. 2024 Aug 23;13(17):4980. doi: 10.3390/jcm13174980.
Although articles and reviews have been published on the effect of SARS-CoV-2 infection on pregnancy outcomes, they show mixed results with different hypotheses, and no work has focused specifically on the prevalence of thrombocytopenia. The objective of this systematic review and meta-analysis was to synthesize previous evidence and estimate the prevalence of thrombocytopenia in pregnant women with COVID-19. This systematic review was conducted according to the PRISMA-2020 and MOOSE guidelines. The Medline and Web of Science databases were searched in February 2024, and a meta-analysis of the overall prevalence of thrombocytopenia in pregnant women with COVID-19 was performed. The risk of bias was assessed using the Joanna Briggs Institute checklists. A leave-1-out sensitivity analysis was performed to test for disproportionate effect. Publication bias was assessed by visual inspection of funnel plots and Egger's test. A total of 23 studies met the inclusion criteria, of which 8 were included in the meta-analysis. There was significant (Q = 101.04) and substantial heterogeneity among the studies (I = 93.07%). There were no quality-based exclusions from the review of eligible studies. The combined effect of the studies showed a prevalence of thrombocytopenia of 22.9% (95%CI 4.8-41.0%). Subgroup analysis revealed no statistically significant difference in the pooled prevalence of thrombocytopenia ([16.5%; 30.3%]; = 0.375. Egger's test for bias was not significant, indicating that smaller studies did not report larger estimates of prevalence ( = 1.01, = 0.353). Moreover, no potential publication bias was found. Our results are consistent with those obtained in pregnant women without COVID-19 infection and extend those of previous reviews of the effect of COVID-19 infection on pregnancy outcomes. Infection during pregnancy does not seem to be an additional risk factor for platelet count, although monitoring platelet count in pregnant women with COVID-19 may be of great importance to determine possible therapeutic strategies, especially in emergency cases.
尽管已有文章和综述发表了关于严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染对妊娠结局的影响，但它们的结果不一，存在不同的假设，且尚无研究专门关注血小板减少症的患病率。本系统评价和荟萃分析的目的是综合既往证据，估计新型冠状病毒肺炎（COVID-19）孕妇中血小板减少症的患病率。本系统评价按照PRISMA-2020和MOOSE指南进行。于2024年2月检索了Medline和科学网数据库，并对COVID-19孕妇血小板减少症的总体患病率进行了荟萃分析。使用乔安娜·布里格斯研究所清单评估偏倚风险。进行了留一法敏感性分析以检验是否存在不成比例的效应。通过漏斗图的视觉检查和埃格检验评估发表偏倚。共有23项研究符合纳入标准，其中8项纳入荟萃分析。研究之间存在显著的异质性（Q = 101.04）和高度异质性（I² = 93.07%）。在 eligible studies的综述中没有基于质量的排除。研究的综合效应显示血小板减少症的患病率为22.9%（95%CI 4.8 - 41.0%）。亚组分析显示血小板减少症合并患病率无统计学显著差异（[16.5%；30.3%]；P = 0.375）。埃格偏倚检验不显著，表明较小的研究没有报告更高的患病率估计值（P = 1.01，df = 0）。此外，未发现潜在的发表偏倚。我们的结果与未感染COVID-19的孕妇的结果一致，并扩展了既往关于COVID-19感染对妊娠结局影响的综述结果。孕期感染似乎不是血小板计数的额外危险因素，尽管监测COVID-19孕妇的血小板计数对于确定可能的治疗策略可能非常重要，尤其是在紧急情况下。
