尿道下裂风险与孕期慢性高血压有关:系统回顾和荟萃分析。

IF 2 3区 医学 Q2 PEDIATRICS
Gerhard Reinaldi Situmorang, Hasan, Irfan Wahyudi, Tariq Abbas, Arry Rodjani, Putu Angga Risky Raharja
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引用次数: 0

摘要

导言:以往的研究表明,妊娠期高血压疾病会增加尿道下裂的风险,但迄今为止还没有一项研究关注母体慢性高血压(CH)的影响。本研究旨在对目前可用的观察性数据进行系统回顾和荟萃分析,以评估母体慢性高血压与尿道下裂风险的关系:方法:根据 PRISMA 2020 指南和 MOOSE 核对表,使用 EMBASE、SCOPUS、Pubmed 和人工方法进行文献检索。符合条件的文章被纳入研究,并使用纽卡斯尔-渥太华量表(NOS)进行质量评估。提取的数据以综述表的形式呈现。使用 DerSimonian 和 Laird 模型对未调整和调整效应大小进行汇总分析,以确定 OR 和 95%CI。异质性采用 I2 检验,发表偏倚采用漏斗图检验。针对不确定性进行了敏感性分析:如扩展摘要图所示,检索共获得 1130 篇出版物,其中有 6 篇符合条件的研究,并选择了 NOS 质量评分较高(6-9 分)的研究。在这六项符合分析条件的研究中,有 519 例尿道下裂患者伴有母体 CH。经过敏感性分析,有一项研究因尿道下裂的定义不同而被排除。在余下的 5 项研究中,根据汇总的未调整 OR 和调整 OR(OR 分别为 1.50 95%CI 1.17-1.93;aOR 分别为 1.77 95%CI 1.54-2.04),发现尿道下裂发生在母体 CH 的风险较高。未调整汇总分析的异质性较高(I2 = 73% P = 0.005),调整分析的异质性较低(I2 = 0% P = 0.40)。两项分析的漏斗图均为对称,表明缺乏发表偏倚:这项荟萃分析表明,母体CH会增加男性后代尿道下裂的风险。未来的研究应权衡生物学机制和药理学效应,以阐明这种关联的发病机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hypospadias risk associated with chronic hypertension during pregnancy: A systematic review and meta-analysis.

Introduction: Previous studies have suggested that hypertensive disorders of pregnancy increase risk of hypospadias, but so far none have focused on the influence of maternal chronic hypertension (CH). This study aimed to conduct a systematic review and meta-analysis of currently available observational data to assess the association of maternal CH with hypospadias risk.

Methods: Literature searches were performed using EMBASE, SCOPUS, Pubmed, and manual methods according to PRISMA 2020 guidelines and MOOSE checklist. Eligible articles were included in the study and assessed for quality using the Newcastle-Ottawa Scale (NOS). Extracted data were presented in review tables. Pooled analysis for unadjusted and adjusted effect sizes was used to determine OR and 95%CI using DerSimonian and Laird model. Heterogeneity was tested using I2 test, and publication bias was examined using funnel plots. Sensitivity analyses are done to address uncertainties.

Results: Searches yielded a total of 1130 publications with six eligible studies and high NOS quality score (6-9) were selected as depicted in extended summary figure. There were 519 hypospadias patients with maternal CH among those six eligible studies for analysis. After sensitivity analysis, there is one study that is excluded due to different hypospadias definition. Among the 5 remaining studies, it is found that there is an elevated risk of hypospadias in the context of maternal CH as determined by pooled unadjusted and adjusted OR (OR 1.50 95%CI 1.17-1.93; aOR 1.77 95%CI 1.54-2.04 respectively). Heterogeneity was high in unadjusted pooled analysis (I2 = 73% P = 0.005) and low in adjusted analysis (I2 = 0% P = 0.40)). Funnel plots were symmetrical in both analyses indicating a lack of publication bias.

Conclusions: This meta-analysis indicates that maternal CH increases risk of hypospadias in male offspring. Future studies should weigh in biological mechanisms and pharmacological effects to elaborate the pathogenesis of this association.

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来源期刊
Journal of Pediatric Urology
Journal of Pediatric Urology PEDIATRICS-UROLOGY & NEPHROLOGY
CiteScore
3.70
自引率
15.00%
发文量
330
审稿时长
4-8 weeks
期刊介绍: The Journal of Pediatric Urology publishes submitted research and clinical articles relating to Pediatric Urology which have been accepted after adequate peer review. It publishes regular articles that have been submitted after invitation, that cover the curriculum of Pediatric Urology, and enable trainee surgeons to attain theoretical competence of the sub-specialty. It publishes regular reviews of pediatric urological articles appearing in other journals. It publishes invited review articles by recognised experts on modern or controversial aspects of the sub-specialty. It enables any affiliated society to advertise society events or information in the journal without charge and will publish abstracts of papers to be read at society meetings.
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