The relationship between pre-eclampsia and peripartum cardiomyopathy: a systematic review and meta-analysis.
The relationship between pre-eclampsia and peripartum cardiomyopathy: a systematic review and meta-analysis.
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DOI：
10.1016/j.jacc.2013.08.717
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发表时间：
2013-10-29
影响因子：
24
通讯作者：
Arany, Zoltan
中科院分区：
文献类型：
--
作者：
Bello, Natalie;Rendon, Iliana S. Hurtado;Arany, Zoltan
本研究的目的是系统地回顾围产期心肌病（PPCM）的文献，并确定PPCM妇女先兆子痫（PE）的患病率。二次分析包括高血压疾病、多胎妊娠和多胎的患病率评估。PPCM是全世界孕产妇和婴儿发病率和死亡率的重要原因，但其病因尚不清楚。PE经常被认为是PPCM发展的危险因素，最近的研究表明PE和PPCM具有共同的病理生物学机制。PE与PPCM之间的关系尚未有全面的评价。在多个数据库中进行系统的预定搜索策略，以确定描述≥3名PPCM女性的研究。汇总了PE、高血压、多胎妊娠和多胎的患病率。该分析纳入了22项研究（979例患者）的数据。合并患病率为22%(95%可信区间[CI] 16 ~ 28)，是全球妊娠期PE平均背景发生率5%的四倍多（p < 0.001）。在PPCM女性中PE的患病率没有发现地理或种族差异。妊娠期高血压发生率（37% [95% CI 29 ~ 45]）和多胎妊娠发生率（9% [95% CI 7 ~ 11]）也升高。PPCM妇女的PE、高血压疾病和多胎妊娠的患病率明显高于一般人群。这些发现支持PE和PPCM之间有共同发病机制的概念，并强调有必要认识到这两种疾病之间的重叠。
The goal of this study was to systematically review the peripartum cardiomyopathy (PPCM) literature and determine the prevalence of preeclampsia (PE) in women with PPCM. Secondary analyses included evaluation of the prevalence of hypertensive disorders, multiple gestations, and multiparity. PPCM is a significant cause of maternal and infant morbidity and mortality worldwide, yet its etiology remains unknown. PE is often cited as a risk factor for the development of PPCM, and recent research suggests that PE and PPCM share mechanisms that contribute to their pathobiology. No comprehensive evaluation of the relationship between PE and PPCM exists. A systematic predetermined search strategy was performed in multiple databases to identify studies describing ≥3 women with PPCM. Prevalence rates of PE, hypertension, multiple gestations, and multiparity were pooled. Data from 22 studies (979 patients) were included in this analysis. The pooled prevalence of 22% (95% confidence interval [CI] 16 to 28) was more than quadruple the 5% average worldwide background rate of PE in pregnancy (p < 0.001). There were no geographic or racial differences detected in the prevalence of PE in women with PPCM. The rates of hypertension during pregnancy (37% [95% CI 29 to 45) and multiple gestations (9% [95% CI 7 to 11]) were also elevated. The prevalence of PE, hypertensive disorders, and multiple gestations in women with PPCM is markedly higher than that in the general population. These findings support the concept of a shared pathogenesis between PE and PPCM and highlight the need for awareness of the overlap between these 2 diseases.
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