接触利妥昔单抗的多发性硬化症女性的妊娠结局：一项系统评价和荟萃分析。
Pregnancy Outcomes in Women with Multiple Sclerosis Who Had Exposure to Rituximab: a Systematic Review and Meta-Analysis.
作者信息
Askari Fariba, Rastkar Mohsen, Taghavi Elham Angouraj, Ghajarzadeh Mahsa
机构信息
Reproductive Health and Population Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
Student's Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Maedica (Bucur). 2025 Mar;20(1):106-111. doi: 10.26574/maedica.2025.20.1.106.
BACKGROUND
We designed this study to estimate pooled prevalence of preterm and term deliveries of women exposed to rituximab before pregnancy.
METHODS
A systematic review using PRISMA guideline was conducted. We performed a comprehensive search in PubMed, Scopus, EMBASE and Web of Science databases based on a predefined search strategy. The search was done on the 1st of May 2023 and there were no time or language limitations. Data were analyzed using random effect model and all estimated effect sizes were reported at a confidence interval of 95%. Also, we used the I-square index (I²) to assess statistical heterogeneity.
RESULTS
A literature search revealed 4059 records, of which 26 full-texts were evaluated, and finally, five studies remained for the systematic review. The pooled prevalence of term pregnancy in women with multiple sclerosis who were treated with rituximab was 64% (95% CI 31-96%) (I²=95.1%, P <0.001). The pooled prevalence of preterm pregnancy in women with MS who were treated with rituximab was 4% (95% CI 1-9%) (I²=16.6%, P=0.3).
CONCLUSION
The findings of this systematic review and meta-analysis indicate that rituximab exposure during conception is not associated with an increased rate of preterm deliveries.
背景
我们设计了这项研究，以估计妊娠前接触利妥昔单抗的女性早产和足月分娩的合并患病率。
方法
采用PRISMA指南进行系统评价。我们根据预定义的检索策略在PubMed、Scopus、EMBASE和Web of Science数据库中进行了全面检索。检索于2023年5月1日进行，没有时间或语言限制。使用随机效应模型分析数据，所有估计效应量均以95%置信区间报告。此外，我们使用I²指数评估统计异质性。
结果
文献检索共获得4059条记录，其中26篇全文被评估，最终有5项研究纳入系统评价。接受利妥昔单抗治疗的多发性硬化症女性足月妊娠的合并患病率为64%（95%CI 31-96%）（I²=95.1%，P<0.001）。接受利妥昔单抗治疗的多发性硬化症女性早产的合并患病率为4%（95%CI 1-9%）（I²=16.6%，P=0.3）。
结论
本系统评价和荟萃分析的结果表明，受孕期间接触利妥昔单抗与早产率增加无关。
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