Preterm Birth Associated With Group B Streptococcus Maternal Colonization Worldwide: Systematic Review and Meta-analyses.
Preterm Birth Associated With Group B Streptococcus Maternal Colonization Worldwide: Systematic Review and Meta-analyses.
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DOI：
10.1093/cid/cix661
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发表时间：
2017-11-06
期刊：
影响因子：
--
通讯作者：
Rubens CE
中科院分区：
文献类型：
--
作者：
Bianchi-Jassir F;Seale AC;Kohli-Lynch M;Lawn JE;Baker CJ;Bartlett L;Cutland C;Gravett MG;Heath PT;Ip M;Le Doare K;Madhi SA;Saha SK;Schrag S;Sobanjo-Ter Meulen A;Vekemans J;Rubens CE
早产并发症是5岁以下儿童死亡的主要原因。B群链球菌可能是可预防的，也是造成这种负担的重要因素。早产并发症是5岁以下儿童死亡的主要原因。研究表明，B族链球菌（GBS）在怀孕期间母体直肠阴道定植可能是早产的危险因素。本文是本系列11篇文章中的第五篇。我们的目的是评估GBS母体定植与早产之间的关系，以便为GBS负担的估计提供信息。我们进行了系统的文献综述（PubMed/Medline、Embase、拉丁美洲和加勒比健康科学文献[LILACS]、世界卫生组织图书馆信息系统[WHOLIS]和Scopus），并从研究小组中寻找未发表的关于早产（妊娠<37周）和母体GBS定植（GBS从阴道、宫颈和/或直肠拭子分离；对GBS细菌尿进行单独亚分析）之间关系的数据。我们进行了荟萃分析，得出了风险和优势比的汇总估计（根据研究设计），并进行了敏感性分析，以调查潜在的偏差。我们确定了45项研究纳入。我们估计，在队列研究和横断面研究中，早产与母体GBS定殖的风险比（RR）为1.21(95%可信区间[CI]， 0.99 - 1.48; P = 0.061)，在病例对照研究中，优势比为1.85 （95% CI, 1.24-2.77; P = 0.003）。在队列研究中，早产与GBS细菌有关（RR, 1.98 [95% CI, 1.45-2.69]; P < .001）。从这篇综述中，有证据表明早产与母体GBS定植有关，特别是在有上行感染（细菌尿）证据的情况下。一些偏差降低了发现效应的机会。然而，同样地，结果，包括相关性的证据，可能是由于混杂，这在研究中很少得到解决。对早产影响的评估应包括在未来的母体GBS疫苗试验中。
Complications of preterm birth are the leading cause of deaths in children aged <5 years. Group B Streptococcus may be a preventable and important contributor to this burden. Preterm birth complications are the leading cause of deaths among children <5 years of age. Studies have suggested that group B Streptococcus (GBS) maternal rectovaginal colonization during pregnancy may be a risk factor for preterm delivery. This article is the fifth of 11 in a series. We aimed to assess the association between GBS maternal colonization and preterm birth in order to inform estimates of the burden of GBS. We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus) and sought unpublished data from investigator groups on the association of preterm birth (<37 weeks’ gestation) and maternal GBS colonization (GBS isolation from vaginal, cervical, and/or rectal swabs; with separate subanalysis on GBS bacteriuria). We did meta-analyses to derive pooled estimates of the risk and odds ratios (according to study design), with sensitivity analyses to investigate potential biases. We identified 45 studies for inclusion. We estimated the risk ratio (RR) for preterm birth with maternal GBS colonization to be 1.21 (95% confidence interval [CI], .99–1.48; P = .061) in cohort and cross-sectional studies, and the odds ratio to be 1.85 (95% CI, 1.24–2.77; P = .003) in case-control studies. Preterm birth was associated with GBS bacteriuria in cohort studies (RR, 1.98 [95% CI, 1.45–2.69]; P < .001). From this review, there is evidence to suggest that preterm birth is associated with maternal GBS colonization, especially where there is evidence of ascending infection (bacteriuria). Several biases reduce the chance of detecting an effect. Equally, however, results, including evidence for the association, may be due to confounding, which is rarely addressed in studies. Assessment of any effect on preterm delivery should be included in future maternal GBS vaccine trials.
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影响因子：
4.9
作者：
Choi, Seong Jin;Park, Soon Deok;Lee, Anna
通讯作者：
Lee, Anna
影响因子：
9.8
作者：
Feikin, DR;Thorsen, P;Schuchat, A
通讯作者：
Schuchat, A
DOI：
10.1155/s106474490000017x
发表时间：
2000-01-01
影响因子：
--
作者：
Garland, S M;Kelly, N;Ugoni, A M
通讯作者：
Ugoni, A M
影响因子：
28.2
作者：
HASTINGS, MJG;EASMON, CSF;RIVERS, RPA
通讯作者：
RIVERS, RPA
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N