110 / 2019-10-31 19:01:34

Hypertensive disorders in pregnancy and risk of adverse pregnancy outcomes in offspring: a meta-analysis of cohort studies

adverse pregnancy outcomes,hypertensive disorders in pregnancy,cohort study,meta-analysis

B. 公共卫生相关主题 > Track - B 默认专题

Purpose: Presently, there is still no conclusion for this question that which type of adverse pregnancy outcomes (APOs) is increased among mothers with hypertensive disorders in pregnancy (HDP) compared with those without HDP; furthermore, a complete overview is missing. We performed a meta-analysis of cohort studies to review and summarize the epidemiologic evidence on the association between HDP and risk of specific APOs in offspring.
Method: PubMed, Embase, Cochrane Libraries, Web of Science, and Chinese databases were searched through May 2019 to identify cohort studies assessing the APOs risk associated with HDP. APOs involved perinatal mortality, congenital malformations, preterm birth (PTB), very PTB (VPTB), intrauterine growth restriction (IUGR), small for gestational age (SGA), low birth weight (LBW), and very LBW (VLBW). Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates. Subgroup analysis was performed to explore potential heterogeneity moderators.
Results: Total 152 cohort studies involving 1,426,742 mothers with HDP and 36,374,542 mothers without HDP were included for analysis. Overall, mothers who had HDP compared with those without HDP experienced a significantly higher risk of perinatal mortality (OR=2.19; 95%CI: 1.77-2.71), congenital malformations (OR=2.66; 95%CI: 1.86-3.78), IUGR (OR=5.48; 95%CI: 3.88-7.72), SGA (OR=3.39; 95%CI: 2.86-4.02), LBW (OR=5.02; 95%CI: 4.04-6.23), VLBW (OR=1.74; 95%CI: 1.07-2.82), PTB (OR=4.20; 95%CI: 3.59-4.91) and VPTB (OR=3.26; 95%CI: 1.92-5.54) in offspring. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. No evidence of publication bias was observed.
Conclusion: This meta-analysis indicates that APOs are more common among mothers with HDP than those without HDP. The information on the most frequent adverse outcomes in offspring associated with HDP could be of interest to health policymakers and patients.