Micronutrient supplementation interventions in preconception and pregnant women at increased risk of developing pre-eclampsia: a systematic review and meta-analysis.
Micronutrient supplementation interventions in preconception and pregnant women at increased risk of developing pre-eclampsia: a systematic review and meta-analysis.
复制标题
在先入后和孕妇中的微量营养素补充干预措施增加了前宾夕法尼亚前的风险：系统的审查和荟萃分析。
DOI：
10.1038/s41430-022-01232-0
复制
发表时间：
2023-07
影响因子：
4.7
通讯作者：
中科院分区：
文献类型：
--
作者：
先兆子痫可导致孕产妇和新生儿并发症，是全球孕产妇死亡的常见原因。这篇综述研究了微量营养素补充干预措施对被确定为具有更大的先兆子痫风险的妇女的影响。使用PRISMA指南进行系统评价。检索电子数据库MEDLINE、EMBASE和对照试验的科克伦中心登记系统，以获得相关文献和根据预先规定的标准确定的合格研究。对随机对照试验（RCT）进行荟萃分析，以检查微量营养素补充对高危妇女先兆子痫的影响。确定了20项RCT，补充包括维生素C和E（n = 7）、钙（n = 5）、维生素D（n = 3）、叶酸（n = 2）、镁（n = 1）和多种微量营养素（n = 2）。样本量和招募时间点在不同的研究中有所不同，并且使用各种预测因素来识别参与者，其中先兆子痫的既往史是最常见的。没有研究使用经验证的预测模型。补充钙（风险差，-0.15（-0.27，-0.03，I2 = 83.4%））和维生素D（风险差，-0.09（-0.17，-0.02，I2 = 0.0%））可降低先兆子痫。我们的研究结果显示，钙和维生素D的先兆子痫发生率较低，然而，由于样本量小，方法学差异和研究之间的异质性，结论受到限制。更高质量的、大规模的钙和维生素D的RCT是必要的。探索在怀孕前和怀孕期间不同时间点的干预措施以及利用预测建模方法的干预措施，将更深入地了解微量营养素补充干预在预防高危妇女先兆子痫中的疗效。
Pre-eclampsia can lead to maternal and neonatal complications and is a common cause of maternal mortality worldwide. This review has examined the effect of micronutrient supplementation interventions in women identified as having a greater risk of developing pre-eclampsia. A systematic review was performed using the PRISMA guidelines. The electronic databases MEDLINE, EMBASE and the Cochrane Central Register of Controlled trials were searched for relevant literature and eligible studies identified according to a pre-specified criteria. A meta-analysis of randomised controlled trials (RCTs) was conducted to examine the effect of micronutrient supplementation on pre-eclampsia in high-risk women. Twenty RCTs were identified and supplementation included vitamin C and E (n = 7), calcium (n = 5), vitamin D (n = 3), folic acid (n = 2), magnesium (n = 1) and multiple micronutrients (n = 2). Sample size and recruitment time point varied across studies and a variety of predictive factors were used to identify participants, with a previous history of pre-eclampsia being the most common. No studies utilised a validated prediction model. There was a reduction in pre-eclampsia with calcium (risk difference, −0.15 (−0.27, −0.03, I2 = 83.4%)), and vitamin D (risk difference, −0.09 (−0.17, −0.02, I2 = 0.0%)) supplementation. Our findings show a lower rate of pre-eclampsia with calcium and vitamin D, however, conclusions were limited by small sample sizes, methodological variability and heterogeneity between studies. Further higher quality, large-scale RCTs of calcium and vitamin D are warranted. Exploration of interventions at different time points before and during pregnancy as well as those which utilise prediction modelling methodology, would provide greater insight into the efficacy of micronutrient supplementation intervention in the prevention of pre-eclampsia in high-risk women.
登录
查看更多内容
DOI：
10.1136/bmj.h5948
发表时间：
2015-11-17
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Macdonald-Wallis C;Silverwood RJ;de Stavola BL;Inskip H;Cooper C;Godfrey KM;Crozier S;Fraser A;Nelson SM;Lawlor DA;Tilling K
通讯作者：
Tilling K
影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
168.9
作者：
Chappell, LC;Seed, PT;Poston, L
通讯作者：
Poston, L
DOI：
10.1016/s0020-7292(01)00374-5
发表时间：
2001-07-01
影响因子：
3.8
作者：
Niromanesh, S;Laghaii, S;Mosavi-Jarrahi, A
通讯作者：
Mosavi-Jarrahi, A
影响因子：
7.2
作者：
Herrera, JA;Arevalo-Herrera, M;Herrera, S
通讯作者：
Herrera, S