PDF(Pubmed)
Abstract：
Hypertensive disorders of pregnancy (HDPs) are a leading cause of maternal morbidity and mortality worldwide. Unfortunately, accurate early clinical screening methods for the development of these disorders are lacking. Arterial stiffness (AS) is an important hemodynamic indicator of vascular health that has shown promising results for the prediction of HDP onset. Past systematic reviews in the field have reported an increase in AS indices in women who develop HDPs and have highlighted the potential of AS measurements as a predictive tool early in pregnancy. The most recent systematic review, including papers up to 2015, assessed the differences in AS parameters between women with and without pregnancy complications. Since then, there has been a substantial influx of published research on the topic and a growing interest in the incorporation of AS measurements into clinical practice. Thus, we propose a systematic review and meta-analysis that is more inclusive to all HDP subsets and various hemodynamic indices of vascular health to provide a comprehensive overview of the current state of evidence. Specifically, we aim to evaluate these measures in women who develop HDPs compared to normotensive pregnancies to determine which measures are most associated with and/or can predict the development of HDPs. Major databases (Medline, Embase, The Cochrane Library, Web of Science, PubMed, and CINAHL), grey literature (Google Scholar) and clinical trials (clinicaltrials.gov) will be searched to identify studies that report AS and hemodynamic measurements in pregnant women with and without HDPs. No restrictions will be made on study type or year. Articles will be independently evaluated by three authors to determine eligibility based on inclusion and exclusion criteria. Methodological quality of included studies will be assessed. Pooled analyses will be conducted using a random-effects model. Publication bias and between-study heterogeneity will also be assessed. Sources of heterogeneity will be explored by sensitivity, subgroup, and/or meta-regression analyses. Results from this study will be shared through scientific conferences and publications in scientific journals. The analysis of potential AS and hemodynamic markers for HDP onset will help inform the development of screening guidelines and clinically relevant cut-off values of AS and hemodynamic markers for HDP risk, guiding future research. There are no applicable ethical considerations to the writing of this protocol.
摘要：
妊娠高血压疾病（HDP）是全球孕产妇发病和死亡的主要原因。不幸的是,这些疾病的发展缺乏准确的早期临床筛查方法。动脉僵硬度（AS）是血管健康的重要血液动力学指标，已显示出预测HDP发作的有希望的结果。该领域过去的系统评价报告了发生HDP的妇女AS指数的增加，并强调了AS测量作为妊娠早期预测工具的潜力。最近的系统审查，包括截至2015年的论文，评估了有和没有妊娠并发症的女性之间AS参数的差异。从那以后,关于该主题的已发表研究大量涌入，并且对将AS测量纳入临床实践的兴趣日益浓厚。因此，我们提出了一项系统综述和荟萃分析,该综述和荟萃分析更涵盖所有HDP亚群和血管健康的各种血液动力学指标,以全面概述目前的证据状况.具体来说,我们的目标是评估与正常血压妊娠相比发生HDPs的女性的这些指标,以确定哪些指标与HDPs的发生最相关和/或可以预测HDPs的发生.主要数据库(Medline，Embase,科克伦图书馆,WebofScience,PubMed,和CINAHL），将搜索灰色文献（GoogleScholar）和临床试验（clinicaltrials.gov），以确定报告有和没有HDP的孕妇AS和血液动力学测量的研究。对研究类型或年份没有限制。文章将由三位作者独立评估，以根据纳入和排除标准确定资格。将评估纳入研究的方法学质量。将使用随机效应模型进行汇集分析。还将评估发表偏倚和研究之间的异质性。异质性的来源将通过敏感性来探索，子组,和/或荟萃回归分析。这项研究的结果将通过科学会议和科学期刊上的出版物分享。对HDP发病的潜在AS和血流动力学标志物的分析将有助于制定筛查指南和临床相关的AS和HDP风险的血流动力学标志物的临界值。指导未来的研究。编写本协议没有适用的道德考虑。
