Prevalence and risk factors for congenital diaphragmatic hernia: A global view
Prevalence and risk factors for congenital diaphragmatic hernia: A global view
复制标题
DOI：
10.1016/j.jpedsurg.2020.06.022
复制
发表时间：
2020-11-01
影响因子：
2.4
通讯作者：
Zani, Augusto
中科院分区：
文献类型：
--
作者：
Paoletti, Monica;Raffler, Gabriele;Zani, Augusto
目的：为了确定先天性腹股沟疝（CDH）的全球患病率，并确定CDH相关的风险factors.Methods：使用一个定义的策略，文献进行了系统的回顾，根据PRISMA指南，搜索以人群为基础的流行病学研究，以评估CDH的患病率全球和每个国家。排除了包含重叠人群或时间范围的研究。采用RevMan 5. 3软件进行Meta分析，计算CDH相关危险因素，并表示为风险比和95%可信区间。结果：患病率：筛选出8230篇摘要，纳入1980 - 2019年发表的30篇全文文章。CDH的总体患病率为2.3/10，000例分娩（73，663，758例活产婴儿中有16，710例CDH婴儿）。风险因素：从9项研究中，我们发现男性[RR 1.38（1.05-1.80），p= 0.02]和母亲年龄N 35岁[RR 1.69（1.26-2.25），p = 0.0004]与CDH相关。相反，母亲的黑人种族导致作为一个保护因素[RR 0.82（0.77-0.89，pb0.00001].结论：这项研究表明，有一个世界范围内缺乏人口为基础的研究，这些研究报告的患病率和危险因素来自少数国家。CDH的患病率在世界各地理区域内和各地理区域之间存在差异。CDH的主要危险因素是男性和高龄产妇。需要更多涉及世界更多地区的流行病学研究来确定可能的策略，以帮助加强我们对风险因素的理解，为临床医生提供产前和产后咨询所需的工具，并告知政策制定者如何在世界不同地区制定CDH护理策略。研究类型：系统综述和荟萃分析。(c)2020爱思唯尔公司All rights reserved.
Purpose: To determine the global prevalence for congenital diaphragmatic hernia (CDH) and identify CDHrelated risk factors.Methods: Using a defined strategy, a systematic review of the literature was conducted according to PRISMA guidelines, searching for population-based epidemiological studies to evaluate the prevalence of CDH globally and per country. Studies containing overlapping populations or timeframes were excluded. CDH-related risk factors were calculated by meta-analysis using RevMan5.3 and expressed as risk ratio and 95% confidence interval.Results: Prevalence: Of 8230 abstracts screened, 30 full-text articles published between 1980 and 2019 were included. The overall prevalence of CDH was 2.3 in 10,000 births (16,710 CDH babies in 73,663,758 livebirths). Risk factors: From 9 studies we found that male sex [RR 1.38 (1.05-1.80), p= 0.02] and maternal age N 35 years [RR 1.69 (1.26-2.25), p = 0.0004] were associated with CDH. Conversely, maternal black ethnicity resulted as a protective factor [RR 0.82 (0.77-0.89, pb0.00001].Conclusion: This study reveals that there is a worldwide paucity of population-based studies, and those studies that report on prevalence and risk factors come from a small number of countries. The prevalence of CDH varies within and across geographical world regions. The main risk factors for CDH identified are male sex and older maternal age. More epidemiological studies, involving more world regions, are needed to identify possible strategies to help strengthen our understanding of the risk factors, provide clinicians with the tools necessary for prenatal and postnatal counseling, and inform policy makers on how to strategize CDH care in different parts of the world. Type of study: Systematic review and meta-analysis. (c) 2020 Elsevier Inc. All rights reserved.