Adverse birth outcome research case definitions associated with maternal HIV and antiretroviral drug use in pregnancy: a scoping review.

IF 2.8 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Kopano R Dube, Shani T de Beer, Kathleen M Powis, Michael McCaul, Amy L Slogrove
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引用次数: 0

Abstract

Background: Adverse birth outcomes (preterm birth, low birth weight, small for gestational age, and stillbirth) seem to persist in infants born to people with HIV, even in the context of maternal antiretroviral therapy. However, findings have been disparate, inconclusive, and difficult to compare directly across settings, partly owing to variable outcome definitions. We aimed to collate, compare, and map existing adverse birth outcome definitions to inform a harmonized approach to universally measure these outcomes in studies including pregnant people with HIV.

Methods: We conducted a scoping review of studies that reported adverse birth outcomes associated with maternal HIV and antiretroviral use in pregnancy, specifically those that included definitions of 'preterm birth', 'low birth weight', 'small for gestational age', and 'stillbirth'. Five databases were searched from 01 January 2011 to 15 August 2022. Title, abstract and full-text screening was conducted independently in duplicate. A comparative quantitative analysis was conducted to compare study characteristics by period of study (< 2013; 2013-2015; > 2016) and country income group. A qualitative content analysis was conducted to compare and map deviations from the WHO definitions as a reference.

Results: Of the 294 articles that included at least one adverse birth outcome, 214 (73%) studies started before 2013, 268 (91%) were published as primary research articles, and 137 (47%) were conducted in Eastern and Southern Africa. Among the 283 studies included in the country income group analysis, 178 (63%) were conducted in low- and middle-income countries. Studies reporting low birth weight, preterm birth, small for gestational age and stillbirth deviated from the WHO definitions in n = 11/169 (7%), n = 93/246 (39%), n = 40/112 (36%) and n = 85/108 (79%) instances, respectively. The variations included the use of different thresholds and the addition of new terminology.

Conclusion: The current WHO definitions are valuable tools for population-level monitoring; however, through consensus, these definitions need to be optimized for research data collection, analysis, and presentation. In conjunction with good reporting, variation in adverse birth outcome definitions can be decreased to facilitate comparability of studies as well as pooling of data for enhanced evidence synthesis.

不良出生结局研究病例定义与孕产妇艾滋病毒和妊娠期抗逆转录病毒药物使用相关:范围审查。
背景:即使在母亲接受抗逆转录病毒治疗的情况下,艾滋病毒感染者所生婴儿的不良出生结局(早产、低出生体重、胎龄小和死产)似乎仍然存在。然而,研究结果是完全不同的,不确定的,并且很难直接比较不同的设置,部分原因是不同的结果定义。我们的目的是整理、比较和绘制现有的不良出生结果定义,以提供一个统一的方法来普遍测量包括艾滋病毒感染孕妇在内的研究中的这些结果。方法:我们对报告与妊娠期母体使用艾滋病毒和抗逆转录病毒相关的不良出生结果的研究进行了范围审查,特别是那些包括“早产”、“低出生体重”、“胎龄小”和“死胎”定义的研究。从2011年1月1日至2022年8月15日检索了5个数据库。题目、摘要和全文分别独立筛选,一式两份。进行了比较定量分析,按研究期间(2016年)和国家收入群体比较研究特征。进行了定性内容分析,以比较和绘制与世卫组织定义的偏差,作为参考。结果:在包含至少一种不良出生结局的294篇文章中,214篇(73%)研究开始于2013年之前,268篇(91%)作为主要研究文章发表,137篇(47%)在东部和南部非洲进行。在纳入国家收入组分析的283项研究中,178项(63%)在低收入和中等收入国家进行。报告低出生体重、早产、胎龄小和死产的研究分别在n = 11/169(7%)、n = 93/246(39%)、n = 40/112(36%)和n = 85/108(79%)例中偏离了世卫组织的定义。这些变化包括使用不同的阈值和增加新的术语。结论:目前世卫组织的定义是人群水平监测的宝贵工具;然而,通过共识,这些定义需要优化研究数据的收集,分析和展示。与良好的报告相结合,可以减少不良出生结局定义的差异,以促进研究的可比性,并汇集数据以加强证据综合。
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来源期刊
BMC Pregnancy and Childbirth
BMC Pregnancy and Childbirth OBSTETRICS & GYNECOLOGY-
CiteScore
4.90
自引率
6.50%
发文量
845
审稿时长
3-8 weeks
期刊介绍: BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.
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