METHODS: From inception to November 2021, we searched PubMed/Medline, Scopus and The Cochrane Library for papers comparing the risk of SGA and preeclampsia, as well as other perinatal outcomes in singleton pregnancies with a prenatally identified lateral placenta to those with non-lateral placentas. The revised Newcastle-Ottawa Scale was used to evaluate the quality of eligible papers. The I2 test was employed to evaluate the heterogeneity of outcomes among the studies. To investigate the possibility of publication bias, funnel plots were constructed. Prospero RN: CRD42021251590.
RESULTS: The search yielded 5,420 articles, of which 16 were chosen, comprising of 15 cohort studies and one case control study with a total of 4,947 cases of lateral and 96,035 of non-lateral placenta (controls) reported. SGA neonates were more likely to be delivered in cases with a lateral placenta (OR: 1.74; 95% CI: 1.54-1.96; p<0.00001; I2=47%). Likewise, placental laterality was linked to a higher risk of fetal growth restriction (OR: 2.18; 95% CI: 1.54-3.06; p<0.00001; I2=0%), hypertensive disorders of pregnancy (OR: 2.39; 95% CI: 1.65-3.51; p=0.0001; I2=80%), preeclampsia (OR: 2.92; 95% CI: 1.92-4.44; p<0.0001; I2=82%) and preterm delivery (OR: 1.65; 95% CI: 1.46-1.87; p<0.00001; I2=0%).
CONCLUSIONS: The prenatal diagnosis of a lateral placenta appears to be associated with a higher incidence of preeclampsia, fetal growth restriction, preterm delivery and SGA. This may prove useful in screening for these conditions at the second trimester anomaly scan.
方法:从成立到2021年11月,我们搜索了PubMed/Medline,Scopus和Cochrane图书馆的论文比较了SGA和先兆子痫的风险,以及其他围产期结局的单胎妊娠与产前确定的侧方胎盘与非侧方胎盘。修订后的纽卡斯尔-渥太华量表用于评估合格论文的质量。采用I2检验评估研究结果的异质性。为了调查发表偏倚的可能性,漏斗图被建造。ProsperoRN:CRD42021251590。
结果:搜索产生了5,420篇文章,其中16人被选中,包括15项队列研究和一项病例对照研究,共报告了4,947例外侧胎盘和96,035例非外侧胎盘(对照)。在具有外侧胎盘的情况下,SGA新生儿更有可能分娩(OR:1.74;95%CI:1.54-1.96;p<0.00001;I2=47%)。同样,胎盘偏侧与胎儿生长受限的高风险相关(OR:2.18;95%CI:1.54-3.06;p<0.00001;I2=0%),妊娠期高血压疾病(OR:2.39;95%CI:1.65-3.51;p=0.0001;I2=80%),先兆子痫(OR:2.92;95%CI:1.92-4.44;p<0.0001;I2=82%)和早产(OR:1.65;95%CI:1.46-1.87;p<0.00001;I2=0%)。
结论:外侧胎盘的产前诊断似乎与先兆子痫的发生率较高有关,胎儿生长受限,早产和SGA。这可能证明在妊娠中期异常扫描时对这些条件进行筛查是有用的。