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系统评价和荟萃分析年轻母亲年龄与胎儿异常之间的关联。

Systematic review and meta-analysis of the association between young maternal age and fetal abnormalities.

机构信息

Department of Gynecology, Obstetrics and Gynecological Oncology, Medical University of Silesia, Katowice, 40-211, Poland.

Department of Obstetrics and Perinatology, University Hospital, Krakow, 30-688, Poland.

出版信息

Sci Rep. 2024 Sep 29;14(1):22562. doi: 10.1038/s41598-024-74015-1.

DOI:10.1038/s41598-024-74015-1
PMID:39343828
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11439902/
Abstract

Fetal anomalies among young women and adolescents pose major public health concerns. This systematic review aims to elucidate the relationship between young maternal age and the incidence of fetal abnormalities. According to the systematic review and meta-analysis PRISMA protocol, cohort, cross-sectional and case-control studies were scrutinized to include 80,393,450 participants across diverse regions. The meta-analysis utilized Odds Ratios (OR) as the effect measure, adopting a random-effects model. The screening process involved 157 selected and verified manuscripts, which ultimately resulted in the final inclusion of 20 studied in the meta-analysis. The criterion for young maternal age was the age of ≤ 20 years. The meta-analysis revealed a pooled OR of 0.93 (95% CI: 0.82-1.05, p = 0.252), indicating no statistically significant association between young maternal age (≤ 20 years) and fetal anomalies. However, considerable heterogeneity (I² = 96.21%) was noted, prompting the use of a random-effects model to derive the reported results. The meta-analysis did not find statistically significant differences in the occurrence of congenital anomalies in fetuses of younger women than in overall population. Although due to significant heterogeneity of the analyzed studies, and a risk of bias, caution should be exercised when interpreting the results, further investigation may be warranted to understand the relationship between maternal age and risk of fetal anomalies. Nevertheless, the study shows significant differences, which diminish in collective analysis, suggests that factors beyond age may be influential. Specifically, the limited access to or quality of healthcare in certain regions could be a more critical factor than maternal age itself.

摘要

年轻女性和青少年的胎儿异常是主要的公共卫生问题。本系统评价旨在阐明年轻母亲年龄与胎儿异常发生率之间的关系。根据系统评价和荟萃分析 PRISMA 方案,对队列、横断面和病例对照研究进行了仔细审查,共纳入了来自不同地区的 80393450 名参与者。荟萃分析采用优势比(OR)作为效应量,采用随机效应模型。筛选过程涉及 157 篇选定和验证的手稿,最终有 20 篇纳入荟萃分析。年轻母亲年龄的标准是年龄≤20 岁。荟萃分析显示,合并 OR 为 0.93(95%CI:0.82-1.05,p=0.252),表明年轻母亲年龄(≤20 岁)与胎儿异常之间没有统计学上的显著关联。然而,存在很大的异质性(I²=96.21%),因此使用随机效应模型得出报告的结果。荟萃分析没有发现年轻女性的胎儿先天性异常发生率与总体人群有统计学上的显著差异。尽管由于分析研究的异质性和偏倚风险,在解释结果时应谨慎,但进一步的调查可能是必要的,以了解母亲年龄与胎儿异常风险之间的关系。然而,该研究显示出显著的差异,这些差异在集体分析中减小,表明除了年龄之外,其他因素可能也有影响。具体来说,某些地区获得医疗保健的机会有限或质量较差可能是比母亲年龄本身更关键的因素。

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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c8/11439902/dd57fc50d1e8/41598_2024_74015_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c8/11439902/aaee659f9297/41598_2024_74015_Fig10_HTML.jpg
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