产前血清乳酸脱氢酶和子痫前期的不良产科结局:来自中低收入国家的预后证据的系统回顾。

IF 1.3 Q3 MEDICINE, GENERAL & INTERNAL
Cureus Pub Date : 2025-06-21 eCollection Date: 2025-06-01 DOI:10.7759/cureus.86496
Ky D Nguyen, Anh Tn Khuc, Vu A Tran, Hieu S Nguyen, Phong H Nguyen, Anh Th Nguyen
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引用次数: 0

摘要

本系统综述评估了中低收入国家(LMICs)产前血清乳酸脱氢酶(LDH)水平与子痫前期妊娠不良孕产妇和围产期结局之间的关系。对PubMed、Embase和Scopus的综合检索确定了2000年至2025年间发表的19项观察性研究,包括5039名孕妇,其中包括3782例先兆子痫诊断。大多数研究是在南亚和中东进行的。尽管LDH阈值不同,但观察到一个一致的趋势:较高的LDH水平与产妇并发症(如HELLP综合征、弥散性血管内凝血、急性肾功能衰竭和ICU入院)的风险增加有关。围产期并发症,包括死产、宫内生长受限、低Apgar评分和新生儿重症监护病房(NICU)入院,在LDH水平为0 ~ 800 IU/L时也更为常见。例如,在LDH最高的组中,死产的发生率高达77.7%
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antepartum Serum Lactate Dehydrogenase and Adverse Obstetric Outcomes in Preeclampsia: A Systematic Review of Prognostic Evidence From Low- and Middle-Income Countries.

This systematic review evaluated the association between antepartum serum lactate dehydrogenase (LDH) levels and adverse maternal and perinatal outcomes in preeclamptic pregnancies in low- and middle-income countries (LMICs). A comprehensive search of PubMed, Embase, and Scopus identified 19 observational studies published between 2000 and 2025, comprising 5,039 pregnant women, including 3,782 preeclampsia diagnoses. Most studies were conducted in South Asia and the Middle East. Although LDH thresholds varied, a consistent trend was observed: higher LDH levels were associated with increased risk of maternal complications such as HELLP syndrome, disseminated intravascular coagulation, acute renal failure, and ICU admission. Perinatal complications, including stillbirth, intrauterine growth restriction, low Apgar scores, and neonatal intensive care unit (NICU) admission, were also more common at LDH levels >800 IU/L. For example, stillbirth occurred in up to 77.7% of cases in the highest LDH group compared to <3% in the lowest. Due to heterogeneity in cut-offs and outcome definitions, meta-analysis was not performed. Overall, elevated antepartum serum LDH appears to be a strong prognostic marker for severe outcomes in preeclamptic pregnancies and may aid clinical triage in LMICs. Further prospective studies are needed to establish standardized thresholds and validate their predictive utility.

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