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评估2019冠状病毒病感染对孕妇多普勒超声及胎盘检查结果的影响:一项系统评价和荟萃分析。

Evaluation of the effect of SARS-CoV-2 infection on Doppler ultrasound and placental findings of pregnant women: a systematic review and meta-analysis.

作者信息

Chen Lanying, Yin Tingting, Cai Danni, Chen Xiaomin

机构信息

Department of Obstetrics, Yiwu Central Hospital, Yiwu, China.

Department of Ultrasound, Huaian Hospital of Huaian City, Huaian, China.

出版信息

Ultrasonography. 2024 Nov;43(6):424-437. doi: 10.14366/usg.24038. Epub 2024 Jul 15.

Abstract

PURPOSE

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can infect the human placenta and has been shown to have an adverse effect on Doppler ultrasound parameters and placental features. However, the specific effects of the SAS-CoV-2 infection on the fetal-placental unit in pregnant women remain unclear. The aim of this systematic review and meta-analysis was to evaluate the impact of SARS-CoV-2 infection on Doppler ultrasound and placental findings in pregnant women.

METHODS

A systematic search was conducted using four electronic databases (PubMed, Embase, Scopus, and Cochrane Library) to select publications published in peer-reviewed journals written in English. Odds ratios (ORs) were calculated, along with their 95% confidence intervals (CIs). Heterogeneity was assessed using Cochrane Q and I2 statistics and the appropriate P-value. The analysis used RevMan 5.3.

RESULTS

This meta-analysis included 1,210 pregnant women from 10 case-control studies. SARS-CoV-2-infected pregnant women exhibited higher likelihoods of placental abnormalities (OR, 2.62; 95% CI, 1.66 to 4.13), aberrant Doppler values (OR, 1.95; 95% CI, 1.16 to 3.27), an abnormal cerebroplacental ratio (OR, 2.68; 95% CI, 1.52 to 4.75), altered fetoplacental circulation (OR, 1.56; 95% CI, 1.07 to 2.28), and increased placental thickness and placental venous lakes (OR, 1.85; 95% CI, 1.25 to 2.72).

CONCLUSION

According to this meta-analysis, pregnant women infected with SARS-CoV-2 are more likely to experience altered Doppler ultrasonography parameters and placental abnormalities, including increased placental thickness, placental venous lakes, altered fetoplacental circulation, and cerebroplacental ratio. However, the limited number of case-control studies requires larger sample sizes to validate and enhance the evidence.

摘要

目的

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)可感染人胎盘,并已显示出对多普勒超声参数和胎盘特征有不利影响。然而,SARS-CoV-2感染对孕妇胎儿-胎盘单位的具体影响仍不清楚。本系统评价和荟萃分析的目的是评估SARS-CoV-2感染对孕妇多普勒超声和胎盘检查结果的影响。

方法

使用四个电子数据库(PubMed、Embase、Scopus和Cochrane图书馆)进行系统检索,以选择在同行评审期刊上发表的英文文献。计算比值比(OR)及其95%置信区间(CI)。使用Cochrane Q和I²统计量以及适当的P值评估异质性。分析使用RevMan 5.3。

结果

该荟萃分析纳入了来自10项病例对照研究的1210名孕妇。感染SARS-CoV-2的孕妇出现胎盘异常(OR,2.62;95%CI,1.66至4.13)、异常多普勒值(OR,1.95;95%CI,1.16至3.27)、异常脑胎盘比值(OR,2.68;95%CI,1.52至4.75)、胎儿-胎盘循环改变(OR,1.56;95%CI,1.07至2.28)以及胎盘厚度和胎盘静脉湖增加(OR,1.85;95%CI,1.25至2.72)的可能性更高。

结论

根据这项荟萃分析,感染SARS-CoV-2的孕妇更有可能出现多普勒超声参数改变和胎盘异常,包括胎盘厚度增加、胎盘静脉湖、胎儿-胎盘循环改变和脑胎盘比值。然而,病例对照研究数量有限,需要更大的样本量来验证和加强证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/566d/11532520/5963733448e6/usg-24038f1.jpg

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