Hydroxychloroquine prophylaxis for preeclampsia, hypertension and prematurity in pregnant patients with systemic lupus erythematosus: A meta-analysis
Hydroxychloroquine prophylaxis for preeclampsia, hypertension and prematurity in pregnant patients with systemic lupus erythematosus: A meta-analysis
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DOI：
10.1177/09612033211007199
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发表时间：
2021-04-15
期刊：
影响因子：
2.6
通讯作者：
Zhang, Liyun
中科院分区：
文献类型：
--
作者：
Duan, Jiaoniu;Ma, Dan;Zhang, Liyun
目的本荟萃分析旨在评估HCQ在改善妊娠期SLE患者母儿结局方面的有效性。方法使用PubMed、MEDLINE、EMBASE和科克伦数据库检索相关英文文献，万方、CNKI和VIP检索中文文献，检索时间从数据库成立至2020年4月30日。这些研究比较了在妊娠期间给予HCQ的SLE妊娠患者（HCQ+组）和未给予HCQ的SLE妊娠患者（HCQ-组）的母体和/或胎儿结局。两名研究者提取数据并使用Newcastle-Ottawa量表（NOS）和GRADE标准独立评估质量。计算比值比（OR）和95%置信区间（CI）。所有的统计分析进行了使用Stata 12.0软件。ResultsNine研究，涉及1132例妊娠被纳入本研究（3例对照，2个前瞻性队列，4个回顾性队列）。HCQ+组中先兆子痫、妊娠期高血压和早产的发生率分别显著低于HCQ-组（OR 0.35，95%CI 0.21 - 0.59）、（OR 0.41，95%CI 0.19 - 0.89）和（OR 0.55，95%CI 0.36 - 0.86）。HELLP综合征的发生率没有显著差异（OR 0.88，95% CI 0.19 - 3.96），妊娠期糖尿病（OR 2.3，95% CI 0.44 - 12.12），血栓形成事件（OR 0.26，95% CI 0.05 - 1.51），自然流产（OR 1.77，95% CI 0.96 - 3.26），胎膜早破（OR 0.58，95% CI 0.24 - 1.39），羊水过少（OR 0.90，95% CI 0.38 - 2.14），活产（OR 1.22，95% CI 0.60 - 2.47），死产（OR 1.00，95% CI 0.50 - 2.00），先天畸形（OR 0.53，95% CI 0.14 - 2.04），低出生体重（OR 0.77，95% CI 0.43 - 1.39），宫内窘迫（OR 1.07，95% CI 0.41 - 2.76）、宫内生长受限（OR 0.57，95% CI 0.06 - 5.43）或5分钟APGAR评分
ObjectivesThis meta-analysis aimed to evaluate the effectiveness of HCQ in improving the maternal and fetal outcomes in pregnancies with SLE.MethodsA literature search was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane database for relevant English language articles, and Wanfang, CNKI and VIP for Chinese articles, from the databases' inception to April 30, 2020. These studies compared the maternal and/or fetal outcomes between pregnant patients with SLE who were administered HCQ during pregnancy (HCQ+ group) and those who were not administered HCQ (HCQ- group). Two investigators extracted the data and assessed the quality using the Newcastle-Ottawa Scale (NOS) and GRADE criteria independently. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated. All statistical analyses were conducted using the Stata 12.0 software.ResultsNine studies involving 1132 pregnancies were included in the study (3 case controls, 2 prospective cohorts, 4 retrospective cohorts). Preeclampsia, gestational hypertension, and prematurity were significantly lower in the HCQ+ group than in the HCQ- group (OR 0.35, 95% CI 0.21-0.59), (OR 0.41, 95% CI 0.19-0.89) and (OR 0.55, 95% CI 0.36-0.86), respectively. There were no significant differences in the rates of HELLP Syndrome (OR 0.88, 95% CI 0.19-3.96), gestational diabetes (OR 2.3, 95% CI 0.44-12.12), thrombotic events (OR 0.26, 95% CI 0.05-1.51), spontaneous abortion (OR 1.77, 95% CI 0.96-3.26), premature rupture of membranes (OR 0.58, 95% CI 0.24-1.39), oligohydramnios (OR 0.90, 95% CI 0.38-2.14), live birth (OR 1.22, 95% CI 0.60-2.47), stillbirth (OR 1.00, 95% CI 0.50-2.00), congenital malformation (OR 0.53, 95% CI 0.14-2.04), low birth weight (OR 0.77, 95% CI 0.43-1.39), intrauterine distress (OR 1.07, 95% CI 0.41-2.76,), intrauterine growth restriction (OR 0.57, 95% CI 0.06-5.43), or five-minute APGAR score