尼日利亚孕妇子痫前期/子痫的患病率和母婴结局：系统评价和荟萃分析。
Prevalence and materno-fetal outcomes of preeclampsia/eclampsia among pregnant women in Nigeria: a systematic review and meta-analysis.
机构信息
Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria.
Department of Medicine and Surgery, Ladoke Akintola University of Technology, PMB 5000, Ogbomoso, Nigeria.
出版信息
Eur J Med Res. 2024 Oct 3;29(1):482. doi: 10.1186/s40001-024-02086-x.
BACKGROUND
Preeclampsia and eclampsia (PE/E) are hypertensive disorders of pregnancy with significant morbidity and mortality for both mothers and fetuses. This study aimed to investigate the prevalence of PE/E, associated complications, and mortality rates in pregnant women in Nigeria using a systematic review and meta-analysis approach.
METHODS
A search strategy was employed to identify relevant studies published in English from electronic databases like PubMed, Google Scholar, Science Direct, AJOL, DOAJ and Cochrane Library. Studies investigating the prevalence of PE/E, associated complications, and mortality rates in pregnant women in Nigeria were included. Data extraction and quality assessment were conducted using standardized tools. Pooled prevalence estimates were calculated using random-effects models. Statistical heterogeneity was assessed using the I statistic. Publication bias was evaluated using the Egger test.
RESULTS
The analysis revealed a pooled prevalence of 4.51% (95% CI 3.82-5.29) for preeclampsia and 1.39% (95% CI 1.02-1.84) for eclampsia in Nigerian pregnant women. Significant heterogeneity was observed for both PE (I = 99.20%, P < 0.001) and eclampsia (I = 97.43%, P < 0.001). The pooled maternal mortality rate associated with PE/E was 6.04% (95% CI 3.67-8.89), and the fetal mortality rate was 16.73% (95% CI 12.04-22.00). Analysis of complications associated with PE/E revealed a prevalence of 6.37% (95% CI 3.34-10.22) for acute kidney injury, 3.00% (95% CI 1.43-5.06) for cerebrovascular accident (stroke), 3.98% (95% CI 0.61-9.68) for puerperal sepsis, and 5.26% (95% CI 2.24-9.31) for aspiration pneumonia.
CONCLUSION
This study identified a significant burden of PE/E and associated complications in Nigerian pregnant women. High maternal and fetal mortality rates highlight the critical need for improved strategies in Nigeria. Future research should focus on identifying Nigerian-specific risk factors and implementing standardized diagnostic criteria.
背景
子痫前期和子痫（PE/E）是妊娠高血压疾病，对母亲和胎儿都有显著的发病率和死亡率。本研究旨在采用系统评价和荟萃分析的方法，调查尼日利亚孕妇中 PE/E 的流行率、相关并发症和死亡率。
方法
采用电子数据库（如 PubMed、Google Scholar、Science Direct、AJOL、DOAJ 和 Cochrane Library）的搜索策略，以英文发表的相关研究。纳入研究调查了尼日利亚孕妇中 PE/E 的流行率、相关并发症和死亡率。使用标准化工具进行数据提取和质量评估。使用随机效应模型计算汇总患病率估计值。使用 I ²统计量评估统计异质性。使用 Egger 检验评估发表偏倚。
结果
分析显示，尼日利亚孕妇中子痫前期的汇总患病率为 4.51%（95%CI 3.82-5.29），子痫的患病率为 1.39%（95%CI 1.02-1.84）。PE（I²=99.20%，P<0.001）和子痫（I²=97.43%，P<0.001）均存在显著的异质性。PE/E 相关的孕产妇死亡率汇总率为 6.04%（95%CI 3.67-8.89），胎儿死亡率为 16.73%（95%CI 12.04-22.00）。对与 PE/E 相关的并发症的分析显示，急性肾损伤的患病率为 6.37%（95%CI 3.34-10.22），脑血管意外（中风）的患病率为 3.00%（95%CI 1.43-5.06），产褥期败血症的患病率为 3.98%（95%CI 0.61-9.68），吸入性肺炎的患病率为 5.26%（95%CI 2.24-9.31）。
结论
本研究确定了尼日利亚孕妇中 PE/E 及其相关并发症的负担显著。高孕产妇和胎儿死亡率突出表明，尼日利亚需要改善策略。未来的研究应侧重于确定尼日利亚特有的危险因素并实施标准化的诊断标准。
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