Ménard L, Gagnon R
Clinique de médecine familiale du Centre hospitalier de Verdun, Qué.
CMAJ. 1994 Jun 1;150(11):1783-9.
To determine, through a review of published articles, whether a higher prevalence of pregnancy complications is associated with residency in medicine. DATA SOURCES: Articles published between January 1980 and December 1992 found through a MEDLINE search using the MeSH terms "pregnancy complications" and "internship and residency" and through a review of the bibliographies of articles found. STUDY SELECTION: Of the 17 articles found, 6 contained data on the prevalence of pregnancy complications in residents. DATA EXTRACTION: The methodologic quality of the studies was evaluated systematically with the use of a grid. Data on the prevalence of the six most common pregnancy complications were retained. DATA SYNTHESIS: Four of the six articles had methodologic weaknesses (missing or inappropriate control groups, poorly controlled historical bias). The best study showed a higher prevalence of premature labour, pre-eclampsia and voluntary abortion in the residents than in the control subjects. CONCLUSIONS: It is difficult to draw definitive conclusions from a single study that met the criteria for methodologic quality. More and better-controlled studies involving larger numbers of subjects are needed.
通过对已发表文章的回顾,确定医学住院医师妊娠并发症的较高患病率是否与住院医师身份有关。
通过使用医学主题词“妊娠并发症”和“实习医师和住院医师”进行医学文献数据库(MEDLINE)检索,并通过查阅所找到文章的参考文献,获取1980年1月至1992年12月发表的文章。
在所找到的17篇文章中,6篇包含住院医师妊娠并发症患病率的数据。
使用表格系统地评估研究的方法学质量。保留六种最常见妊娠并发症患病率的数据。
六篇文章中有四篇存在方法学缺陷(缺少或不适当的对照组、历史偏倚控制不佳)。最佳研究显示,住院医师中早产、先兆子痫和自愿流产的患病率高于对照组。
很难从一项符合方法学质量标准的单一研究中得出明确结论。需要开展更多涉及更多受试者且控制更好的研究。