目的:早产(PTB)是系统性红斑狼疮(SLE)妇女最常见的妊娠并发症之一。由于妊娠高血压疾病和/或胎儿生长受限而导致的高指示PTB比例是众所周知的,并采取预防措施以及早期发现的筛查。自发性PTB的风险没有得到很好的认识。这项研究的目的是确定具有SLE数据来源的女性的妊娠中自发性和指示性PTB的比例:使用Pubmed进行系统的文献检索,Embase,WebofScience和GoogleScholar于2021年6月进行了研究资格标准:选择了患有SLE报告自发性和指示PTB发生率的孕妇的研究。1995年至2021年6月发表的原始研究文章包括研究评估和综合方法:使用纽卡斯尔-渥太华质量评估量表评估纳入研究的质量和偏倚风险。为了估计合并事件率和95%置信区间,采用随机效应模型对单一比例进行荟萃分析.
结果:我们收录了21篇文章,包含8157例SLE女性怀孕的数据。平均31%(95%预测间隔[0.14;0.50])的妊娠导致PTB,包括14%(95%预测间隔[0.04;0.27])自发,16%(95%的预测间隔[0.03;0.35])表明PTB结论:在患有SLE的孕妇中,自发的和指示的PTB比例很高。此信息应应用于(孕前)怀孕咨询和管理。通过这项荟萃分析获得的知识,为进一步研究相关危险因素和制定降低SLE妊娠自发性PTB的干预措施铺平了道路。
OBJECTIVE: Preterm birth is one of the most frequent complications of pregnancy in women with systemic
lupus erythematosus. The high indicated preterm birth proportion due to hypertensive disorders of pregnancy and/or fetal growth restriction is well known, and preventive measures and screening for early detection are performed. The risk of spontaneous preterm birth is less well recognized. This study aimed to determine the proportions of spontaneous and indicated preterm birth in pregnancies of women with systemic
lupus erythematosus.
METHODS: A systematic literature search using Pubmed, Embase, Web of Science, and Google Scholar was performed in June 2021.
METHODS: Studies in pregnant women with systemic
lupus erythematosus reporting spontaneous and indicated preterm birth rates were selected. Original research articles published from 1995 to June 2021 were included.
METHODS: Quality and risk of bias of the included studies were assessed using the Newcastle-Ottawa quality assessment scale. To estimate the pooled event rates and 95% confidence intervals, meta-analysis of single proportions with a random-effects model was performed.
RESULTS: We included 21 articles, containing data of 8157 pregnancies in women with systemic
lupus erythematosus. On average, 31% (95% prediction interval, 0.14-0.50) of the pregnancies resulted in preterm birth, including 14% (95% prediction interval, 0.04-0.27) spontaneous and 16% (95% prediction interval, 0.03-0.35) indicated preterm birth.
CONCLUSIONS: In pregnant women with systemic
lupus erythematosus, spontaneous and indicated preterm birth proportions are high. This information should be applied in (prepregnancy) counseling and management in pregnancy. The knowledge obtained by this meta-analysis paves the way for further research of associated risk factors and development of interventions to reduce spontaneous preterm birth in systemic lupus erythematosus pregnancies.