A meta-analysis of selected maternal and fetal factors for perinatal mortality.
A meta-analysis of selected maternal and fetal factors for perinatal mortality.
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DOI：
10.4314/ejhs.v24i0.6s
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发表时间：
2014-09
影响因子：
1.2
通讯作者：
Berhan A
中科院分区：
文献类型：
--
作者：
Berhan Y;Berhan A
在一些发展中国家，实现千年发展目标4仍未步入正轨。发展中国家围产期死亡率高的原因是多种母体和胎儿的危险因素。然而，没有荟萃分析评估这些因素对围产期死亡率的综合影响。本荟萃分析的目的是确定预测围产期死亡率的母体和胎儿因素。在这项荟萃分析中，我们纳入了23项研究，这些研究评估了围产期死亡率与产前护理、胎次、分娩方式、胎龄、出生体重和胎儿性别的关系。计算机检索文章主要在PUBMED、MEDLINE、HINARI、AJOL、b谷歌Scholar和Cochrane Library等数据库中进行。总优势比（OR）由随机效应模型确定。并进行异质性检验和敏感性分析。汇总分析显示，围产期死亡率与缺乏产前护理（OR=3.2）、早产（OR=7.9）、低出生体重（OR=9.6）有很强的相关性，与原始迁移（OR=1.5）和男性性别（OR=1.2）有轻微的相关性。回归分析还显示，死产和新生儿死亡率与产前护理比例有关，呈下降趋势。荟萃分析显示，分娩方式与围产期死亡率之间没有关联。目前的荟萃分析表明，参加产前护理、分娩足月和正常出生体重婴儿的妇女围产期死亡率显著降低。然而，围产期死亡率与胎次、分娩方式和胎儿性别的关系需要进一步调查。
In several developing countries, achieving Millennium Development Goal 4 is still off track. Multiple maternal and fetal risk factors were inconsistently attributed to the high perinatal mortality in developing countries. However, there was no meta-analysis that assessed the pooled effect of these factors on perinatal mortality. The purpose of this meta-analysis was to identify maternal and fetal factors predicting perinatal mortality. In this meta-analysis, we included 23 studies that assessed perinatal mortality in relation to antenatal care, parity, mode of delivery, gestational age, birth weight and sex of the fetus. A computer based search of articles was conducted mainly in the databases of PUBMED, MEDLINE, HINARI, AJOL, Google Scholar and Cochrane Library. The overall odds ratios (OR) were determined by the random-effect model. Heterogeneity testing and sensitivity analysis were also conducted. The pooled analysis showed a strong association of perinatal mortality with lack of antenatal care (OR=3.2), prematurity (OR=7.9), low birth weight (OR=9.6), and marginal association with primigravidity (OR=1.5) and male sex (OR=1.2). The regression analysis also showed down-going trend lines of stillbirth and neonatal mortality rates in relation to the proportion of antenatal care. The metaanalysis showed that there was no association between mode of delivery and perinatal mortality. The present meta-analysis indicated a significant reduction in perinatal mortality among women who attended antenatal care, gave birth to term and normal birth weight baby. However, the association of perinatal mortality with parity, mode of delivery and fetal sex needs further investigation.