Pre-existing Diabetes and Stillbirth or Perinatal Mortality: A Systematic Review and Meta-analysis.

IF 8.3 2区材料科学 Q1 MATERIALS SCIENCE, MULTIDISCIPLINARY

ACS Applied Materials & Interfaces Pub Date : 2024-11-01 Epub Date: 2024-08-01 DOI:10.1097/AOG.0000000000005682

Anna R Blankstein, Sarah M Sigurdson, Levi Frehlich, Zach Raizman, Lois E Donovan, Patricia Lemieux, Christy Pylypjuk, Jamie L Benham, Jennifer M Yamamoto

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引用次数: 0

Abstract

Objective: Despite the well-recognized association between pre-existing diabetes mellitus and stillbirth or perinatal mortality, there remain knowledge gaps about the strength of association across different populations. The primary objective of this systematic review and meta-analysis was to quantify the association between pre-existing diabetes and stillbirth or perinatal mortality, and secondarily, to identify risk factors predictive of stillbirth or perinatal mortality among those with pre-existing diabetes.

Data sources: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from inception to April 2022.

Methods of study selection: Cohort studies and randomized controlled trials in English or French that examined the association between pre-existing diabetes and stillbirth or perinatal mortality (as defined by the original authors) or identified risk factors for stillbirth and perinatal mortality in individuals with pre-existing diabetes were included. Data extraction was performed independently and in duplicate with the use of prespecified inclusion and exclusion criteria. Assessment for heterogeneity and risk of bias was performed. Meta-analyses were completed with a random-effects model.

Tabulation, integration, and results: From 7,777 citations, 91 studies met the inclusion criteria. Pre-existing diabetes was associated with higher odds of stillbirth (37 studies; pooled odds ratio [OR] 3.74, 95% CI, 3.17-4.41, I2 =82.5%) and perinatal mortality (14 studies; pooled OR 3.22, 95% CI, 2.54-4.07, I2 =82.7%). Individuals with type 1 diabetes had lower odds of stillbirth (pooled OR 0.81, 95% CI, 0.68-0.95, I2 =0%) and perinatal mortality (pooled OR 0.73, 95% CI, 0.61-0.87, I2 =0%) compared with those with type 2 diabetes. Prenatal care and prepregnancy diabetes care were significantly associated with lower odds of stillbirth (OR 0.26, 95% CI, 0.11-0.62, I2 =87.0%) and perinatal mortality (OR 0.41, 95% CI, 0.29-0.59, I2 =0%).

Conclusion: Pre-existing diabetes confers a more than threefold increased odds of both stillbirth and perinatal mortality. Maternal type 2 diabetes was associated with a higher risk of stillbirth and perinatal mortality compared with maternal type 1 diabetes.

Systematic review registration: PROSPERO, CRD42022303112.

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既往糖尿病与死产或围产期死亡率：系统回顾与元分析》。

目的：尽管已有糖尿病与死产或围产期死亡率之间的关联已得到广泛认可，但在不同人群之间的关联强度方面仍存在知识空白。本系统综述和荟萃分析的主要目的是量化原有糖尿病与死产或围产期死亡率之间的关联，其次是确定可预测原有糖尿病患者死产或围产期死亡率的风险因素：数据来源：MEDLINE、EMBASE、Cochrane 系统综述数据库和 Cochrane 对照试验中央登记册（从开始到 2022 年 4 月）：研究方法：纳入以英文或法文撰写的队列研究和随机对照试验，这些研究考察了原有糖尿病与死胎或围产期死亡率（由原作者定义）之间的关系，或确定了原有糖尿病患者死胎和围产期死亡率的风险因素。数据提取采用预设的纳入和排除标准，独立进行，一式两份。对异质性和偏倚风险进行了评估。采用随机效应模型完成 Meta 分析：在 7777 条引用文献中，有 91 项研究符合纳入标准。既往糖尿病与死产（37 项研究；汇总比值比 [OR] 3.74，95% CI，3.17-4.41，I2=82.5%）和围产期死亡率（14 项研究；汇总比值比 3.22，95% CI，2.54-4.07，I2=82.7%）较高有关。与 2 型糖尿病患者相比，1 型糖尿病患者的死产几率（汇总 OR 0.81，95% CI，0.68-0.95，I2=0%）和围产期死亡率（汇总 OR 0.73，95% CI，0.61-0.87，I2=0%）较低。产前护理和孕前糖尿病护理与较低的死胎几率（OR 0.26，95% CI，0.11-0.62，I2=87.0%）和围产期死亡率（OR 0.41，95% CI，0.29-0.59，I2=0%）显著相关：结论：先证糖尿病导致死产和围产期死亡的几率增加三倍以上。与 1 型糖尿病产妇相比，2 型糖尿病产妇死产和围产期死亡的风险更高：prospero，CRD42022303112。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Materials & Interfaces 工程技术-材料科学：综合

CiteScore

16.00

自引率

6.30%

发文量

4978

审稿时长

1.8 months

期刊介绍： ACS Applied Materials & Interfaces is a leading interdisciplinary journal that brings together chemists, engineers, physicists, and biologists to explore the development and utilization of newly-discovered materials and interfacial processes for specific applications. Our journal has experienced remarkable growth since its establishment in 2009, both in terms of the number of articles published and the impact of the research showcased. We are proud to foster a truly global community, with the majority of published articles originating from outside the United States, reflecting the rapid growth of applied research worldwide.