Abstract:
The present umbrella review evaluated the environmental risk factors prior to conception associated with fetal macrosomia based on meta-analyses and systematic reviews. We systematically searched international databases, including PubMed, Scopus, and Web of Science, until April 2023 by using some relevant keywords. The quality of the included studies was assessed using the AMSTAR 2checklist. The risk factor of advanced maternal age 35-39 years compared with <30 years (OR 1·42, 95 % CI: 1·25, 1·60), prepregnancy obesity (OR 1.93, 95 % CI: 1.65, 2.27) and excessive weight gain before and during pregnancy (OR 2.35, 95 % CI: 1.95, 2.85) were graded as suggestive evidence (class III). Two risk factors of advanced maternal age >40 years compared with <30 years (OR 1.40, 95 % CI: 1.02, 1.78) and gestational diabetes mellitus (GDM) without insulin use (OR 1.70, 95 % CI: 1.23, 2.36) were graded as risk factors with weak evidence (class IV). Advanced maternal age, prepregnancy obesity, excessive weight gain before and during pregnancy, and GDM without insulin use were environmental risk factors for macrosomia.
摘要:
本综述基于荟萃分析和系统评价,评估了受孕前与巨大胎儿相关的环境危险因素。我们系统地检索了国际数据库,包括PubMed,Scopus,和WebofScience,直到2023年4月,通过使用一些相关的关键字。使用AMSTAR2清单评估纳入研究的质量。与<30岁相比,高龄产妇年龄35-39岁的危险因素(OR1·42,95%CI:1·25,1·60),孕前肥胖(OR1.93,95%CI:1.65,2.27)和孕期和孕期体重过度增加(OR2.35,95%CI:1.95,2.85)被列为提示证据(III类).高龄>40岁与<30岁相比(OR1.40,95%CI:1.02,1.78)和未使用胰岛素的妊娠期糖尿病(GDM)两个危险因素(OR1.70,95%CI:1.23,2.36)被列为危险因素,证据较弱(IV级)。高龄产妇,孕前肥胖,怀孕前和怀孕期间体重增加过多,不使用胰岛素的GDM是巨大儿的环境危险因素。