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早产儿低血糖危险因素Meta分析
作者:李容丹  谢巧庆  司徒妙琼  何美群  罗美  李智英 
单位:中山大学附属第一医院 新生儿科, 广东 广州 510000
关键词:早产儿 低血糖 危险因素 Meta分析 
分类号:R722.6
出版年·卷·期(页码):2024·52·第六期(904-909)
摘要:

目的: 对早产儿低血糖危险因素的病例对照研究进行Meta分析,为临床预防早产儿低血糖提供理论依据。方法: 计算机系统地检索Pubmed、Web of Science、The Cochrane Library、Embase、中国医学文献服务系统(CBM)、维普数据库、中国知网、万方数据库中发表的关于早产儿低血糖影响因素研究的文章,检索自数据库建立至2023年3月7日的所有中英文文献。用纽卡斯尔-渥太华量表评价文献质量,用RevMan 5.4软件进行Meta分析。结果: 共检索文献5 232篇,根据纳入与排除标准进行筛选,最终有9篇病例对照研究纳入Meta分析中。Meta分析结果显示,早产儿低血糖的危险因素按照其关联性由强到弱依次为:妊娠期高血压(OR=2.72,95%CI 1.77~4.17, P<0.01)、小于胎龄儿(OR=2.37,95%CI 1.48~3.80,P<0.01)、妊娠糖尿病(OR=2.15,95%CI 1.33~3.49, P<0.01)、剖宫产(OR=1.87,95%CI 1.71~2.99,P<0.01)、胎膜早破(OR=0.71,95%CI 0.53~0.95,P=0.02)。结论: 当前证据表明,妊娠高血压、小于胎龄儿、妊娠糖尿病、剖宫产、胎膜早破是早产儿低血糖危险因素,但结论尚需进一步开展高质量的前瞻性研究进行验证。

Objective: To conduct a Meta-analysis of case-control studies on risk factors of hypoglycemia in preterm infants to provide a theoretical basis for clinical prevention of hypoglycemia in preterm infants. Methods: Articles published in Pubmed, Web of Science, Scopus, China Knowledge Network, Wanfang Database, Vipshop Database, and China Biomedical Medical Literature Database(CBM) on the study of factors influencing hypoglycemia in preterm infants were systematically searched for all Chinese and English literature from the inception of the database to March 7, 2023. The quality of the literature was evaluated using the Newcastle-Ottawa scale, and Meta-analysis was performed using RevMan 5.4 software. Results: A total of 5 232 papers were retrieved and screened according to the inclusion and exclusion criteria, and finally 9 case-control studies were included in the Meta-analysis. Meta-analysis showed that the risk factors for hypoglycemia in preterm infants, in descending order of their associations, were gestational hypertension(OR=2.72, 95%CI:1.77-4.17, P<0.01); less than gestational age(OR=2.37, 95%CI:1.48-3.80, P<0.01); gestational diabetes(OR=2.15, 95%CI:1.33-3.49, P<0.01); cesarean section(OR=1.87, 95%CI:1.71-2.99, P<0.01); premature rupture of membranes(OR=0.71, 95%CI:0.53-0.95, P=0.02). Conclusion: The current evidence suggests that gestational hypertension, gestational diabetes mellitus, cesarean section, and young for gestational age are risk factors for hypoglycemia in preterm infants, but further high-quality prospective studies are needed to verify the findings.

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