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严重呕吐孕妇的不良新生儿结局:一项荟萃分析。

Adverse Neonatal Outcomes in Pregnant Women with Severe Vomiting: A Meta-Analysis.

作者信息

Huang Yuliu, Chen Shuixia

机构信息

Gynaecology Department, Zhejiang Hospital Sandun District, Hangzhou, 310030, China.

Obstetrical Department. Zhejiang Hospital Sandun District, Hangzhou, 310030, China.

出版信息

Iran J Public Health. 2025 May;54(5):906-914. doi: 10.18502/ijph.v54i5.18626.

Abstract

BACKGROUND

We aimed to systematically evaluate the risk of negative effect for newborns born to expectant mothers with severe vomiting in terms of birth weight, premature delivery, low Apgar score, and NICU hospitalization.

METHODS

We conducted a systematically search for relevant studies on PubMed, Embase, Cochrane Library, and CNKI databases, using Newcastle-Ottawa Scale to evaluate research quality, and RevMan 5.3 software for meta-analysis from 2009 to 2022. The main outcome measures were: Low-birth weight, preterm delivery, low Apgar score and growth restriction.

RESULTS

In 9 studies, the risk of Low birth weight in hyperemesis pregnant women was increased, and the random effect model was OR 2.38 (95% CI 0.43 to 13.13). The heterogeneity of the study was high (I=100%). Four studies showed an increased risk of low Apgar scores, with an OR of 2.69 (95% CI 0.30 to 24.48), and high heterogeneity (I=95%). The risk of premature birth in 5 papers is equivalent, with an OR of 0.93 (95% CI 0.71 to 1.22) and low heterogeneity (I=6%). The risk of growth restriction was higher in 7 papers, with an OR of 1.31 (95% CI 0.93 to 1.85) and lower heterogeneity (I=29%). Subgroup analysis showed that heterogeneity mainly stemmed from differences in the definition of hyperemesis.

CONCLUSION

Pregnant women with severe vomiting have a higher risk of giving birth to babies with low birth weight and low Apgar scores, and a higher risk of giving birth to babies with growth restriction, but the risk of premature birth is comparable.

摘要

背景

我们旨在从出生体重、早产、阿氏评分低和入住新生儿重症监护病房(NICU)等方面,系统评估严重呕吐的孕妇所分娩新生儿出现不良影响的风险。

方法

我们在PubMed、Embase、Cochrane图书馆和中国知网数据库中系统检索相关研究,使用纽卡斯尔-渥太华量表评估研究质量,并采用RevMan 5.3软件进行2009年至2022年的荟萃分析。主要结局指标为:低出生体重、早产、阿氏评分低和生长受限。

结果

9项研究中,妊娠剧吐孕妇低出生体重风险增加,随机效应模型下比值比(OR)为2.38(95%置信区间[CI]为0.43至13.13)。研究的异质性较高(I² = 100%)。4项研究显示阿氏评分低的风险增加,OR为2.69(95%CI为0.30至24.48),异质性高(I² = 95%)。5篇论文中早产风险相当,OR为0.93(95%CI为0.71至1.22),异质性低(I² = 6%)。7篇论文中生长受限风险较高,OR为1.31(95%CI为0.93至1.85),异质性较低(I² = 29%)。亚组分析表明,异质性主要源于妊娠剧吐定义的差异。

结论

严重呕吐的孕妇分娩低出生体重和阿氏评分低的婴儿风险较高,分娩生长受限婴儿的风险也较高,但早产风险相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3e7/12319452/70c40616322b/IJPH-54-906-g001.jpg

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