Maternal homocysteine and small-for-gestational-age offspring: systematic review and meta-analysis
Maternal homocysteine and small-for-gestational-age offspring: systematic review and meta-analysis
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DOI：
10.3945/ajcn.111.016212
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发表时间：
2012-01-01
影响因子：
7.1
通讯作者：
den Heijer, Martin
中科院分区：
文献类型：
--
作者：
Hogeveen, Marije;Blom, Henk J.;den Heijer, Martin
背景资料：宫内生长迟缓导致小于胎龄儿（SGA）的新生儿与新生儿发病率和死亡率增加以及终身后果（如认知功能差和心血管疾病）相关。母体总同型半胱氨酸（tHcy）浓度与广泛的不良妊娠结局有关，并可能影响出生体重。目的：我们对母体tHcy与出生体重的关系进行了系统回顾和荟萃分析。设计：使用PubMed数据库（1966年1月至2010年7月）对英语、德语和法语出版物进行文献检索，发现78篇摘要。检索词如下：同型半胱氨酸和（出生体重或小于胎龄儿或宫内发育迟缓）。如果有关于母体tHcy和出生体重以及母体tHcy和出生体重之间可能相关性的信息，则研究合格。效应量估计值转换为OR，作为估计的RR的一名妇女提供SGA后代时，母亲tHcy超过第90百分位数。结果：搜索产生了19项研究进行分析，包括21,326人。合并分析得出的粗OR为1.25（95% CI：1.09，1.44）。当这一估计值表示为线性效应时，它对应于母体tHcy增加1-SD时出生体重降低31 g（95%CI：-13，-51 g）。结论：母体tHcy浓度升高与SGA后代风险小幅增加相关。估计的出生体重差异较小，可能与个体新生儿的临床相关性很小;但是，在人群水平上可能更重要。美国临床营养杂志2012;95：130-6.
Background: Growth retardation in utero leading to small-for-gestational-age (SGA) newborns is associated with increased neonatal morbidity and mortality and with lifelong consequences such as poor cognitive function and cardiovascular diseases. Maternal total homocysteine (tHcy) concentrations have been linked to a wide range of adverse pregnancy outcomes and could possibly influence birth weight.Objective: We performed a systematic review of and meta-analysis on the association of maternal tHcy and birth weight.Design: A literature search of English, German, and French publications with the use of the PubMed database (January 1966-July 2010) found 78 abstracts. Search terms were as follows: homocysteine AND (birth weight OR small for gestational age OR intrauterine growth retardation). Studies were eligible if information on maternal tHcy and birth weight and the possible association between maternal tHcy and birth weight was available. Effect size estimates were converted to ORs as estimates of the RR of a woman to deliver SGA offspring when maternal tHcy exceeded the 90th percentile.Results: The search yielded 19 studies for analysis, consisting of 21,326 individuals. Pooled analysis resulted in a crude OR of 1.25 (95% CI: 1.09, 1.44). When this estimate was expressed as a linear effect, it corresponded to a decrease in birth weight of 31 g (95% CI: -13, -51 g) for a 1-SD increase in maternal tHcy.Conclusions: Higher maternal tHcy concentrations are associated with a small increased risk for SGA offspring. The small estimated birth weight difference might be of little clinical relevance for the individual newborn; however, it could be of greater importance at a population level. Am J Clin Nutr 2012;95:130-6.