Pregnancy Intention and Pregnancy Outcome: Systematic Review and Meta-Analysis.
Pregnancy Intention and Pregnancy Outcome: Systematic Review and Meta-Analysis.
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DOI：
10.1007/s10995-016-2237-0
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发表时间：
2017-03
影响因子：
2.3
通讯作者：
Stephenson J
中科院分区：
文献类型：
--
作者：
Hall JA;Benton L;Copas A;Stephenson J
前言以前的系统评价得出结论，严格的研究怀孕的意图和怀孕结果之间的关系是有限的。他们还指出，大多数研究是在高收入国家进行的，在方法上有局限性。我们的目的是评估目前的证据基础之间的关系怀孕的意图和流产，死产，低出生体重（LBW）和新生儿死亡率。2015年3月，Embase、PubMed、Scopus和PsychInfo检索了研究妊娠意向与关注结局之间关系的研究。方法纳入自1975年以来以英文、法文或西班牙文发表的研究。两名评审员筛选标题和摘要，阅读识别文章的全文并提取数据。尽可能进行荟萃分析。结果共纳入37篇研究，评价妊娠意向与LBW的关系。对其中17项研究的荟萃分析发现，意外怀孕与LBW婴儿的几率增加1.41倍相关（95%CI 1.31，1.51）。八项研究关注流产、死产或新生儿死亡，关于妊娠丢失和新生儿死亡的数据有限，排除了荟萃分析，但表明这些结果在意外妊娠中可能更常见。 讨论虽然意外怀孕中不良妊娠结局的风险似乎有所增加，但低收入国家的证据数量或证据质量总体上几乎没有改善。在高收入和低收入国家都需要对妊娠意向和妊娠结局进行纵向研究，其中采用经验证的措施对妊娠意向进行前瞻性评估，并进行包括混杂或中介因素的分析。
Introduction Previous systematic reviews concluded that rigorous research on the relationships between pregnancy intentions and pregnancy outcomes is limited. They further noted that most studies were conducted in high-income countries and had methodological limitations. We aim to assess the current evidence base for the relationship between pregnancy intention and miscarriage, stillbirth, low birthweight (LBW) and neonatal mortality. In March 2015 Embase, PubMed, Scopus and PsychInfo were searched for studies investigating the relationship between pregnancy intention and the outcomes of interest. Methods Studies published since 1975 and in English, French or Spanish were included. Two reviewers screened titles and abstracts, read the full text of identified articles and extracted data. Meta-analyses were conducted where possible. Results Thirty-seven studies assessing the relationships between pregnancy intention and LBW were identified. A meta-analysis of 17 of these studies found that unintended pregnancies are associated with 1.41 times greater odds of having a LBW baby (95%CI 1.31, 1.51). Eight studies looking at miscarriage, stillbirth or neonatal death were found. The limited data concerning pregnancy loss and neonatal mortality precluded meta-analysis but suggest these outcomes may be more common in unintended pregnancies. Discussion While there seems to be an increased risk of adverse pregnancy outcome in unintended pregnancies, there has been little improvement in either the quantity of evidence from low-income countries or in the quality of evidence generally. Longitudinal studies of pregnancy intention and pregnancy outcome, where pregnancy intention is assessed prospectively with a validated measure and where analyses include confounding or mediating factors, are required in both high- and low-income countries.