目的 分析剖宫产术与脑性瘫痪发生率的关系,以降低脑性瘫痪的发病率和致残率。方法 以(脑性瘫痪/脑瘫)和(病因/高危因素/剖腹产/剖宫产)等关键词及主题词对数据库包括中国期刊全文数据库 (CNKI)、万方数据库、中国维普数据库(VIP)、PubMed数据库、MEDLINE数据库、OVID数据库、Cochrane图书馆循证医学评价数据库进行检索,检索时间为1990年1月1日-2016年4月1日。对纳入文献采用 Review Manager5.2软件对符合条件的数据进行Meta分析,检验水准为α=0.05。结果 共检索出文献9篇,其中中文文献2篇,英文文献7篇。累计病历,观察组共纳入3 327名脑性瘫痪儿童,共852名进行了剖宫产,对照组纳入1 700 535名儿童,共126 323名进行了剖宫产。其分析结果如下:总的剖宫产与脑性瘫痪儿童关系(OR=1.61;95%CI:0.93~2.79;I2=95%);足月的剖宫产与脑性瘫痪儿童的关系(OR=2.04;95%CI:1.81~2.29;I2=23%);早产的剖宫产与脑性瘫痪儿童的关系(OR=0.84;95%CI:0.63~1.13;I2=94%);急诊的剖宫产与脑性瘫痪儿童的关系(OR=9.77;95%CI:7.37~12.96;I2=95%)。结论 总体而言,剖宫产并不能减低脑性瘫痪的发生率,但在急诊剖宫产中,需要一步研究证明到底在那些情况下更容易发生脑性瘫痪。
Abstract
Objective To analyze the relationship between cesarean section and incidence of cerebral palsy. Methods Using the keywords (cerebral palsy,causes or risk factors or caesarean section),a search was performed to collect the case-control studies on the risk factors of cerebral palsy childhren from 1990 to 2016,the data base included the China journal full text database (CNKI),Wanfang database,Chinese VIP database (VIP) and PubMed,MEDLIN,OVID,the Cochrane library database.The included literatures were conducted the Meta analysis by the Manager 5.2 Review software,the test level of α=0.05. Results A total of 9 literatures were included,2 Chinese,7 English.And the observation group were included 3 327 children with cerebral palsy children,totally 852 were performed by caesarean section; and the control group were included 1 700 535 children,a total of 126 323 performed by caesarean section.The analysis Results were as follows:the relationship between the cesarean section and cerebral palsy children(OR=1.61;95%CI:0.93~2.79;I2=95%);Term cesarean section and cerebral palsy children (OR=2.04,95%CI:1.81~2.29;I2=23%); premature caesarean section and cerebral palsy children (OR=0.84;95%CI:0.63~1.13;I2=94%); emergency caesarean and cerebral palsy children (OR=9.77;95%CI:7.37~12.96;I2=95%). Conclusion Cesarean section is not a protective factor for cerebral palsy,but about the emergency caesarean section,we need to conduct a further study to demonstrate the relationship with cerebral palsy.
关键词
剖产宫 /
脑性瘫痪 /
Meta分析
Key words
cesarean /
cerebral palsy /
Meta analysis
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