背景:妊娠高血糖症(HIP)是一种影响全球孕妇的重大医疗并发症,由于它可能对母婴造成负面后果,因此被认为是公共卫生负担。这项系统评价和荟萃分析的目的是检查患病率,危险因素,和埃塞俄比亚HIP的母婴结局。
方法:为了收集本研究的相关信息,在几个主要数据库中搜索了已发表和未发表的研究,包括PubMed,Embase,Hinari,WebofScienceDirect,和谷歌学者,以及其他来源。JoannaBriggs研究所(JBI)工具用于评估这些研究结果的方法学质量。然后使用MicrosoftExcel软件中的模板提取和汇总数据,提取的数据使用Stata软件16.0版进行分析。如果在研究之间发现显著的异质性,我们进行了亚组分析以进一步检查数据.
结果:本系统综述和荟萃分析包括18项研究,涉及埃塞俄比亚50,816名孕妇的总样本量。在主要研究中,孕妇的HIP患病率差异很大,从0.4%到26.2%不等。埃塞俄比亚孕妇中HIP的合并患病率为6.9%(95%C2.2-11.6)。与没有糖尿病家族史的孕妇相比,有糖尿病家族史的孕妇发生HIP的几率高2.5倍(OR=2.49;95%CI=2.02,2.96)。然而,HIP与产妇肥胖(OR2.31,95%CI=0.85,3.78)或既往流产史(OR3.89;95%CI0.85,6.94)之间无显著关联.与HIP相关的常见胎儿结局为入住重症监护病房(46.2;95%CI27.4,65.1),巨大儿(27.3%;95%CI9.4%,45.1%),和早产(16.9;95%CI12.5,21.3)。此外,妊娠高血压疾病(28.0%;95%CI15.2,40.8)和手术分娩(51.4%;95%CI35.9,66.8)在埃塞俄比亚患有HIP的女性中更为常见.
结论:尽管研究之间存在一些差异,荟萃分析显示,埃塞俄比亚100名孕妇中约有7名患有HIP.在埃塞俄比亚,发现糖尿病家族史是HIP的重要预测因素。此外,HIP与埃塞俄比亚母亲和婴儿的各种严重不良后果有关。这些发现强调了国家指南的必要性,以确保孕妇得到统一的HIP筛查。
BACKGROUND: Hyperglycemia in pregnancy (HIP) is a significant medical complication affecting pregnant women globally and is considered a public health burden due to the negative outcomes it can cause for both mother and infant. The aim of this systematic
review and meta-analysis was to examine the prevalence, risk factors, and feto-maternal outcomes of HIP in Ethiopia.
METHODS: To gather relevant information for this study, both published and unpublished studies were searched for in several major databases, including PubMed, Embase, HINARI, Web of Science direct, and Google Scholar, as well as other sources. The Joanna Briggs Institute (JBI) tool was used to evaluate the methodological quality of the findings from these studies. Data was then extracted and summarized using a template in Microsoft Excel software, and the extracted data was analyzed using Stata software version 16.0. If significant heterogeneity was found between studies, subgroup analyses were conducted to further examine the data.
RESULTS: Eighteen studies were included in this systematic
review and meta-analysis, involving a total sample size of 50,816 pregnant women in Ethiopia. The prevalence of HIP among pregnant women varied considerably across the primary studies, ranging from 0.4 to 26.2%. The pooled prevalence of HIP among pregnant women in Ethiopia was found to be 6.9% (95% C 2.2-11.6). Pregnant women with a family history of diabetes had 2.5 times higher odds of developing HIP compared to those without a family history of diabetes (OR = 2.49; 95% CI = 2.02, 2.96). However, there was no significant association found between HIP and maternal obesity (OR 2.31, 95% CI = 0.85, 3.78) or previous history of abortion (OR 3.89; 95% CI 0.85, 6.94). The common fetal outcomes associated with HIP were admission to the intensive care unit (46.2; 95% CI 27.4, 65.1), macrosomia (27.3%; 95% CI 9.4%, 45.1%), and preterm birth (16.9; 95% CI 12.5, 21.3). Additionally, hypertensive disorders of pregnancy (28.0%; 95% CI 15.2, 40.8) and operative delivery (51.4%; 95% CI 35.9, 66.8) were more common among women with HIP in Ethiopia.
CONCLUSIONS: Although there was some variation between studies, the meta-analysis revealed that approximately seven out of 100 pregnant women in Ethiopia had HIP. A family history of diabetes was found to be a significant predictor of HIP in Ethiopia. Additionally, HIP was associated with various serious adverse outcomes for both mothers and infants in Ethiopia. These findings highlight the need for national guidelines to ensure that pregnant women are uniformly screened for HIP.