Effects of smoking during pregnancy - Five meta-analyses
Effects of smoking during pregnancy - Five meta-analyses
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DOI：
10.1016/s0749-3797(98)00089-0
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发表时间：
1999-04-01
影响因子：
5.5
通讯作者：
Boulton, ML
中科院分区：
文献类型：
--
作者：
Castles, A;Adams, EK;Boulton, ML
背景：本研究旨在通过荟萃分析评估吸烟对五种妊娠并发症的综合优势比，这五种并发症包括前置胎盘、胎盘早剥、异位妊娠、胎膜早破（PPROM）以及子痫前期。
方法：通过计算机检索和文献综述确定已发表的文章。对最初确定的研究应用五项标准来确定符合荟萃分析条件的研究。针对每种妊娠并发症，对符合条件的研究采用随机效应模型得出综合优势比。对研究子集重复进行荟萃分析以确认总体结果。
结果：发现吸烟与前置胎盘、胎盘早剥、异位妊娠和胎膜早破的风险升高密切相关，与子痫前期的风险降低有关。所有综合优势比均具有统计学意义。综合比率从前置胎盘的1.58到异位妊娠的1.77不等。子痫前期的综合优势比为0.51，所有子集分析都证实了这种看似具有保护作用的效应。
结论：孕期吸烟是影响异位妊娠、胎盘早剥、前置胎盘和胎膜早破的一个重要且可预防的因素。吸烟对子痫前期明显的保护作用这一发现应与这些有害影响相权衡。此外，吸烟与子痫前期之间的生物学联系尚未完全清楚。应建议孕妇戒烟，以降低妊娠并发症的总体风险以及对胎儿产生不良影响的任何风险。（C）1999年《美国预防医学杂志》
Background: The purpose of this study was to estimate, using meta-analysis, pooled odds ratios for the effects of smoking on five pregnancy complications: placenta previa, abruptio placenta, ectopic pregnancy, preterm premature rupture of the membrane (PPROM), and preeclampsia.Methods: Published articles were identified through computer search and literature review. Five criteria were applied to those studies initially identified to determine tl-lose eligible for the meta-analysis. A random effects model was applied to derive pooled odds ratios for the eligible studies for each pregnancy complication. Meta-analyses were repeated on subsets of the studies to confirm the overall results.Results: Smoking Tvas found to be strongly associated with an elevated risk of placenta previa, abruptio placenta, ectopic pregnancy and PPROM, and a decreased risk of pre-eclampsia. All pooled odds ratios were statistically significant. The pooled ratios ranged from 1.58 for placenta previa to 1.77 for ectopic pregnancy. The pooled odds ratio for pre-eclampsia was 0.51 and all subset analyses confirmed this seemingly protective effect.Conclusion: Smoking during pregnancy is a significant and preventable factor affecting ectopic pregnancy, placental abruption, placenta previa, and PPROM. The findings of smoking's apparently protective effect on pre-eclampsia should be balanced with these harmful effects. In addition, the biological linkage between smoking and pre-eclampsia is not yet well understood. Pregnant women should be advised to stop smoking in order to reduce the overall risk of pregnancy complications as well as any risk of adverse impact on the unborn child. (C) 1999 American Journal of Preventive Medicine.