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Honey for acute cough in children 蜂蜜治疗小儿急性咳嗽
Pub Date : 2014-06-16 DOI: 10.1002/ebch.1970
Olabisi Oduwole, Martin M Meremikwu, Angela Oyo-Ita, Ekong E Udoh

Background

Cough causes concern for parents and is a major cause of outpatient visits. It can impact on quality of life, cause anxiety and affect sleep in parents and children. Several remedies, including honey, have been used to alleviate cough symptoms.

Objectives

To evaluate the effectiveness of honey for acute cough in children in ambulatory settings.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2011) which contains the Cochrane Acute Respiratory Infections Group's Specialised Register; MEDLINE (1950 to December week 4, 2011); EMBASE (1990 to January 2012); CINAHL (1981 to January 2012); Web of Science (2000 to January 2012); AMED (1985 to January 2012); LILACS (1982 to January 2012); and CAB abstracts (2009 to January 2012).

Selection criteria

Randomised controlled trials (RCTs) comparing honey given alone, or in combination with antibiotics, versus nothing, placebo or other over-the-counter (OTC) cough medications to participants aged from two to 18 years for acute cough in ambulatory settings.

Data collection and analysis

Two review authors independently screened search results for eligible studies and extracted data on reported outcomes.

Main results

We included two RCTs of high risk of bias involving 265 children. The studies compared the effect of honey with dextromethorphan, diphenhydramine and 'no treatment' on symptomatic relief of cough using the 7-point Likert scale.

Honey was better than 'no treatment' in reducing frequency of cough (mean difference (MD) -1.07; 95% confidence interval (CI) -1.53 to -0.60; two studies; 154 participants). Moderate quality evidence suggests honey did not differ significantly from dextromethorphan in reducing cough frequency (MD -0.07; 95% CI -1.07 to 0.94; two studies; 149 participants). Low quality evidence suggests honey may be slightly better than diphenhydramine in reducing cough frequency (MD -0.57; 95% CI -0.90 to -0.24; one study; 80 participants).

Adverse events included mild reactions (nervousness, insomnia and hyperactivity) experienced by seven children (9.3%) from the honey group and two (2.7%) from the dextromethorphan group; the difference was not signifi

背景:咳嗽引起家长的关注,是门诊就诊的主要原因。它会影响生活质量,引起焦虑,影响父母和孩子的睡眠。包括蜂蜜在内的几种疗法已被用来缓解咳嗽症状。目的探讨蜂蜜治疗小儿急性咳嗽的临床疗效。我们检索了Cochrane中央对照试验登记(Central) (Cochrane图书馆2011年第4期),其中包含Cochrane急性呼吸道感染组的专业登记;MEDLINE(1950年至2011年12月第4周);EMBASE(1990 - 2012年1月);(1981 - 2012年1月);Web of Science(2000 - 2012年1月);AMED(1985 - 2012年1月);丁香(1982年至2012年1月);和CAB摘要(2009年至2012年1月)。选择标准随机对照试验(rct)比较蜂蜜单独给予,或与抗生素联合给予,与不给予,安慰剂或其他非处方(OTC)止咳药相比,2至18岁的参与者在门诊环境中急性咳嗽。数据收集和分析两位综述作者独立筛选符合条件的研究的搜索结果,并提取报告结果的数据。我们纳入了两项高偏倚风险的随机对照试验,涉及265名儿童。这些研究用7分李克特量表比较了蜂蜜与右美沙芬、苯海拉明和“不治疗”对咳嗽症状缓解的效果。蜂蜜在减少咳嗽频率方面优于“未治疗”(平均差值(MD) -1.07;95%置信区间(CI) -1.53 ~ -0.60;两项研究;154名参与者)。中等质量的证据表明,蜂蜜与右美沙芬在减少咳嗽频率方面没有显著差异(MD -0.07;95% CI -1.07 ~ 0.94;两项研究;149名参与者)。低质量的证据表明,蜂蜜在减少咳嗽频率方面可能略优于苯海拉明(MD -0.57;95% CI -0.90 ~ -0.24;一项研究;80名参与者)。不良反应包括蜂蜜组的7名儿童(9.3%)和右美沙芬组的2名儿童(2.7%)出现轻度反应(紧张、失眠和多动症);差异无统计学意义(风险比(RR) 2.94;95% Cl = 0.74 ~ 11.71;两项研究;149名参与者)。苯海拉明组3例患儿(7.5%)出现嗜睡(RR 0.14;95% Cl 0.01 ~ 2.68;一项研究;80名参与者),但蜂蜜与右美沙芬或蜂蜜与苯海拉明之间没有显著差异。“未治疗”组无不良事件报告。作者的结论:蜂蜜在缓解咳嗽症状方面可能优于“不治疗”和苯海拉明,但不如右美沙芬。没有强有力的证据支持或反对使用蜂蜜。蜂蜜治疗儿童急性咳嗽咳嗽是引起家长关注的一个原因,也是大多数儿童和成人门诊就诊的主要原因。咳嗽会影响生活质量,引起焦虑,影响父母和孩子的睡眠。由于这个原因,护理者和接受者通常都寻求立即的补救措施。Cochrane综述评估了非处方(OTC)止咳药的有效性,但没有人研究蜂蜜作为止咳药。系统评价蜂蜜对减轻儿童上呼吸道感染(URTIs)引起的急性咳嗽症状的有效性将是有用的。一项对两项小型随机对照试验(RCTs)的回顾显示,蜂蜜在缓解咳嗽、减少烦人的咳嗽、改善儿童和父母的睡眠质量以及减轻咳嗽严重程度方面,比“不治疗”要好一些。本综述包括两项小型试验,涉及265名2至18岁的儿童。蜂蜜和右美沙芬对儿童和家长咳嗽症状的缓解、烦人的咳嗽和睡眠质量的影响没有差异。蜂蜜可能比苯海拉明更能缓解咳嗽症状,减轻咳嗽的严重程度,改善父母和孩子的睡眠质量。右美沙芬和苯海拉明都是止咳药的常见成分。 7名孩子服用蜂蜜,2名孩子服用右美沙芬,他们的父母报告说,他们的孩子出现了轻微的失眠、多动和紧张反应。在苯海拉明组,有三个孩子的父母报告嗜睡。然而,与其他药物一样,它的好处应该与副作用一起考虑。本综述更新的局限性在于仅纳入了两项具有高偏倚风险的小型研究。
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引用次数: 24
Cochrane in context: Honey for acute cough in children 科克伦:蜂蜜治疗儿童急性咳嗽
Pub Date : 2014-06-16 DOI: 10.1002/ebch.1966
Olabisi Oduwole, Martin M. Meremikwu, Angela Oyo-Ita, Ekong E. Udoh

Cochrane Review: Honey for acute cough in children Oduwole O, Meremikwu MM, Oyo-Ita A, Udoh EE. Honey for acute cough in children. Cochrane Database of Systematic Reviews 2012, Issue 3. Art. No.: CD007094. DOI: 10.1002/14651858.CD007094.pub3.

This companion piece to the review, “Honey for acute cough in children,“ contains the following pieces:

Cochrane综述:蜂蜜治疗儿童急性咳嗽Oduwole, Meremikwu MM, Oyo-Ita A, Udoh EE。蜂蜜治疗小儿急性咳嗽。Cochrane Database of Systematic Reviews 2012,第3期。艺术。不。: CD007094。cd007094.pub3 DOI: 10.1002/14651858.。这篇评论的配套文章“蜂蜜治疗儿童急性咳嗽”包含以下内容:
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引用次数: 6
Cochrane in context: Effect of timing of umbilical cord clamping in term infants on maternal and neonatal outcomes Cochrane上下文:足月婴儿脐带夹紧时间对母婴结局的影响
Pub Date : 2014-06-16 DOI: 10.1002/ebch.1965
Susan J. McDonald, Philippa Middleton, Therese Dowswell, Peter S Morris

Cochrane Review: Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes McDonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping in term infants on maternal and neonatal outcomes. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD004074. DOI: 10.1002/14651858.CD004074.pub3.

This companion piece to the review, Effect of timing of umbilical cord clamping in term infants on maternal and neonatal outcomes, contains the following pieces:

McDonald SJ, Middleton P, Dowswell T, Morris PS.足月婴儿脐带夹断时机对孕产妇和新生儿结局的影响。Cochrane Database of Systematic Reviews 2013,第7期。艺术。不。: CD004074。cd004074.pub3 DOI: 10.1002/14651858.。这篇综述的配套文章,足月婴儿脐带夹紧时间对孕产妇和新生儿结局的影响,包含以下几个部分:
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引用次数: 22
Bronchodilators for bronchiolitis—should they be used routinely? 支气管扩张剂治疗细支气管炎——应该常规使用吗?
Pub Date : 2014-06-16 DOI: 10.1002/ebch.1964
Gary A. Emmett

Eco-paediatrics is an occasional feature in Evidence-Based Child Health: A Cochrane Review Journal. Our goal is to contribute to the worldwide discussion on reducing waste in health care. In each instalment, we will select a recent Cochrane review highlighting a practice, still in use, which the available evidence tells us should be discontinued.

生态儿科是《基于证据的儿童健康:Cochrane评论杂志》中偶尔出现的特色。我们的目标是促进世界范围内关于减少卫生保健浪费的讨论。在每一期中,我们将选择一篇最近的Cochrane综述,重点介绍一种仍在使用的做法,现有证据告诉我们应该停止这种做法。
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引用次数: 4
Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes 足月婴儿脐带夹紧时间对母婴结局的影响
Pub Date : 2014-06-16 DOI: 10.1002/ebch.1971
Susan J McDonald, Philippa Middleton, Therese Dowswell, Peter S Morris

Background

Policies for timing of cord clamping vary, with early cord clamping generally carried out in the first 60 seconds after birth, whereas later cord clamping usually involves clamping the umbilical cord more than one minute after the birth or when cord pulsation has ceased. The benefits and potential harms of each policy are debated.

Objectives

To determine the effects of early cord clamping compared with late cord clamping after birth on maternal and neonatal outcomes

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (13 February 2013).

Selection criteria

Randomised controlled trials comparing early and late cord clamping.

Data collection and analysis

Two review authors independently assessed trial eligibility and quality and extracted data.

Main results

We included 15 trials involving a total of 3911 women and infant pairs. We judged the trials to have an overall moderate risk of bias.

Maternal outcomes: No studies in this review reported on maternal death or on severe maternal morbidity. There were no significant differences between early versus late cord clamping groups for the primary outcome of severe postpartum haemorrhage (risk ratio (RR) 1.04, 95% confidence interval (CI) 0.65 to 1.65; five trials with data for 2066 women with a late clamping event rate (LCER) of ˜3.5%, I2 0%) or for postpartum haemorrhage of 500 mL or more (RR 1.17 95% CI 0.94 to 1.44; five trials, 2260 women with a LCER of ˜12%, I2 0%). There were no significant differences between subgroups depending on the use of uterotonic drugs. Mean blood loss was reported in only two trials with data for 1345 women, with no significant differences seen between groups; or for maternal haemoglobin values (mean difference (MD) -0.12 g/dL; 95% CI -0.30 to 0.06, I2 0%) at 24 to 72 hours after the birth in three trials.

Neonatal outcomes: There were no significant differences between early and late clamping for the primary outcome of neonatal mortality (RR 0.37, 95% CI 0.04 to 3.41, two trials, 381 infants with a LCER of ˜1%), or for most other neonatal morbidity outcomes, such as Apgar score less than seven at five minutes or admission to t

脐带夹紧时间的政策各不相同,早期脐带夹紧通常在出生后的前60秒进行,而后期脐带夹紧通常在出生后一分钟多或脐带脉动停止时进行。每项政策的好处和潜在危害都是有争议的。目的比较出生后早期脐带夹紧与晚期脐带夹紧对孕产妇和新生儿结局的影响。检索方法我们检索了Cochrane妊娠与分娩组的试验登记(2013年2月13日)。选择标准:比较早期和晚期脐带夹紧的随机对照试验。资料收集和分析两位综述作者独立评估试验资格和质量并提取资料。我们纳入了15项试验,共涉及3911对妇女和婴儿。我们判断这些试验总体偏倚风险为中等。产妇结局:本综述中没有关于产妇死亡或严重产妇发病率的研究报告。早期和晚期脐带夹紧组在严重产后出血的主要结局上无显著差异(风险比(RR) 1.04, 95%可信区间(CI) 0.65 ~ 1.65;5项试验的数据为2066名妇女,晚期夹持事件率(LCER)约3.5%,i2%)或产后出血500 mL或更多(RR 1.17, 95% CI 0.94至1.44;5项试验,2260名LCER为~ 12%,i20 %的女性)。不同亚组间子宫强直药物使用差异无统计学意义。平均失血量仅在两项涉及1345名女性的试验中报告,两组间无显著差异;或母体血红蛋白值(平均差(MD) -0.12 g/dL;95% CI -0.30 ~ 0.06, i2%),在出生后24 ~ 72小时。新生儿结局:在新生儿死亡率的主要结局(RR 0.37, 95% CI 0.04 - 3.41,两项试验,381名LCER为1%的婴儿)或大多数其他新生儿发病率结局(如5分钟时Apgar评分低于7分或进入特殊护理托儿所或新生儿重症监护病房)方面,早期和晚期夹钳无显著差异。平均出生体重在脐带夹紧后期明显高于早期(101 g增加95% CI 45 - 157,随机效应模型,12项试验,3139名婴儿,I2 62%)。早期脐带夹断组需要光疗黄疸的婴儿少于晚期脐带夹断组(RR 0.62, 95% CI 0.41至0.96,数据来自7项试验,2324名婴儿,LCER为4.36%,i2%)。早期脐带夹住组婴儿24 ~ 48小时血红蛋白浓度显著降低(MD -1.49 g/dL, 95% CI -1.78 ~ -1.21;婴儿884例,占2 59%)。在随后的评估中未见血红蛋白浓度的差异。然而,铁储量的改善似乎持续存在,与脐带夹紧延迟的婴儿相比,早期脐带夹紧的婴儿在3至6个月时缺铁的可能性是延迟脐带夹紧的婴儿的两倍多(RR 2.65 95% CI 1.04至6.73,5项试验,1152名婴儿,I2 82%)。在迄今为止唯一一项报告长期神经发育结果的试验中,年龄和阶段问卷得分在早期和晚期夹钳之间没有总体差异。在健康足月婴儿中,延迟脐带夹紧的更自由的方法似乎是合理的,特别是考虑到越来越多的证据表明,延迟脐带夹紧会增加婴儿早期血红蛋白浓度和铁储量。延迟脐带夹紧可能是有益的,只要获得治疗黄疸需要光疗是可用的。足月婴儿脐带夹紧时机对母婴结局的影响在出生时,婴儿仍然通过脐带与母亲相连,脐带是胎盘的一部分。婴儿通常通过夹住脐带与胎盘分离。夹钳是分娩第三阶段(从婴儿出生到胎盘娩出)的一部分,时间根据临床政策和实践而有所不同。 虽然早期脐带夹紧被认为可以降低产后出血(产后出血)的风险,但这篇对15项随机试验的综述共涉及3911名妇女和婴儿对,结果显示,在早期和晚期脐带夹紧(通常在1到3分钟之间)进行比较时,产后出血率没有显著差异。然而,延迟脐带夹紧对健康足月婴儿有一些潜在的重要优势,如出生体重较高,血红蛋白浓度较早,出生后6个月铁储备增加。这些需要与需要光疗的新生儿黄疸的小额外风险相平衡。
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引用次数: 491
Cochrane in context: Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child Cochrane综述:孕妇在妊娠期或哺乳期或两者均避免饮食抗原对预防或治疗儿童特应性疾病的作用
Pub Date : 2014-06-16 DOI: 10.1002/ebch.1967
Michael S. Kramer, Ritsuko Kakuma

Cochrane Review: Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child Kramer MS, Kakuma R. Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No.: CD000133. DOI: 10.1002/14651858.CD000133.pub3.

This companion piece to the review, “Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child,” contains the following pieces:

Cochrane综述:孕妇在孕期或哺乳期,或两者同时避免饮食抗原,预防或治疗儿童克雷默多发性硬化症,Kakuma R.孕妇在孕期或哺乳期,或两者同时避免饮食抗原,预防或治疗儿童特应性疾病。Cochrane Database of Systematic Reviews 2012,第9期。艺术。不。: CD000133。cd000133.pub3 DOI: 10.1002/14651858.。这篇综述的配套文章,“孕妇在怀孕或哺乳期间或两者之间避免饮食抗原,以预防或治疗儿童特应性疾病”,包含以下内容:
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引用次数: 16
Evidence synthesis in child health: overviews of reviews 儿童健康证据综合:综述
Pub Date : 2014-03-20 DOI: 10.1002/ebch.1963
Denise Thomson
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引用次数: 2
Rifamycins (rifampicin, rifabutin and rifapentine) compared to isoniazid for preventing tuberculosis in HIV-negative people at risk of active TB 利福霉素(利福平、利福布丁和利福喷丁)与异烟肼在预防活动性结核病风险的艾滋病毒阴性人群中的结核病方面的比较
Pub Date : 2014-03-20 DOI: 10.1002/ebch.1962
Surendra K Sharma, Anju Sharma, Tamilarasu Kadhiravan, Prathap Tharyan

Background

Preventing active tuberculosis (TB) from developing in people with latent tuberculosis infection (LTBI) is important for global TB control. Isoniazid (INH) for six to nine months has 60% to 90% protective efficacy, but the treatment period is long, liver toxicity is a problem, and completion rates outside trials are only around 50%. Rifampicin or rifamycin-combination treatments are shorter and may result in higher completion rates.

Objectives

To compare the effects of rifampicin monotherapy or rifamycin-combination therapy versus INH monotherapy for preventing active TB in HIV-negative people at risk of developing active TB.

Search methods

We searched the Cochrane Infectious Disease Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; LILACS; clinical trials registries; regional databases; conference proceedings; and references, without language restrictions to December 2012; and contacted experts for relevant published, unpublished and ongoing trials.

Selection criteria

Randomized controlled trials (RCTs) of HIV-negative adults and children at risk of active TB treated with rifampicin, or rifamycin-combination therapy with or without INH (any dose or duration), compared with INH for six to nine months.

Data collection and analysis

At least two authors independently screened and selected trials, assessed risk of bias, and extracted data. We sought clarifications from trial authors. We pooled relative risks (RRs) with their 95% confidence intervals (CIs), using a random-effects model if heterogeneity was significant. We assessed overall evidence quality using the GRADE approach.

Main results

Ten trials are included, enrolling 10,717 adults and children, mostly HIV-negative (2% HIV-positive), with a follow-up period ranging from two to five years.

Rifampicin (three/four months) vs. INH (six months)

Five trials published between 1992 to 2012 compared these regimens, and one small 1992 trial in adults with silicosis did not detect a difference in the occurrence of TB over five years of follow up (one trial, 312 participants; very low quality evidence). However, more people in these trials completed the shorter course

18 - 1.07,一项试验,7731名受试者;中等质量证据)。直接观察到,较短的方案具有更高的治疗完成率(82%对69%,RR 1.19, 95% CI 1.16至1.22,中等质量证据)和更少的肝毒性(0.4%对2.4%;RR 0.16, 95% CI 0.10 ~ 0.27;高质量证据),但限制治疗的不良事件更频繁(4.9%对3.7%;相对危险度1.32,95%可信区间1.07 - 1.64(中等质量证据))作者的结论:迄今为止,仅使用利福平的缩短预防方案的试验没有显示出与使用INH的较长方案相比,活动性结核病的发生率更高。使用较短的利福平治疗方案,治疗完成率可能更高,不良事件可能更少。缩短利福平与INH的治疗方案可能没有较长INH治疗方案的优势。利福平联合吡嗪酰胺与更多的不良事件相关。每周一次的利福喷丁加INH治疗方案具有更高的完成率和更少的肝毒性,尽管由于不良事件而中断治疗的可能性可能比INH治疗更大。结核(TB)是一种由细菌感染引起的疾病,估计有20亿人(约占世界人口的三分之一)受到影响。然而,大多数人患有潜伏感染,只有一小部分感染结核病的人会发展为活动性疾病。通过使用药物预防潜伏性结核感染发展为活动性结核是全球结核控制的一个重要组成部分。建议使用异烟肼治疗6个月,但治疗周期长,会导致肝损伤,而且只有大约一半开始这种药物治疗的人能完成治疗。本综述的作者评估了hiv阴性LTBI患者异烟肼单药治疗的替代方案。他们确定了10项随机对照试验,其中包括10717名成人和儿童,他们大多是艾滋病毒阴性,随访时间从2到5年不等。服用三到四个月的利福平在预防结核病方面的效果可能与服用六个月的异烟肼相当,而且副作用可能更少。由于利福平的治疗周期较短,可能会导致更多的人完成治疗。另外两种药物联合治疗(利福平加异烟肼和利福平加吡嗪酰胺)在预防结核病方面与单独使用异烟肼相比没有差异,但它们会导致更多的不良事件。第三种联合使用利福喷丁和异烟肼,每周监督一次,连续3个月,在预防结核病方面与自我使用异烟肼9个月一样有效,增加了治疗的完成度,并且引起的肝毒性更小,尽管每周一次的利福喷丁和异烟肼联合使用限制治疗的不良事件更频繁。
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引用次数: 12
Cochrane in context: Schedules for home visits in the early postpartum period 科克伦背景:产后早期家访的安排
Pub Date : 2014-03-20 DOI: 10.1002/ebch.1957
Yonemoto Naohiro, Therese Dowswell, Nagai Shuko, Mori Rintaro

Cochrane Review: Schedules for home visits in the early postpartum period Yonemoto N, Dowswell T, Nagai S, Mori R. Schedules for home visits in the early post-partum period. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD009326. DOI: 10.1002/14651858.CD009326.pub2.

This companion piece to the review, “Schedules for home visits in the early post-partum period,” contains the following pieces:

Yonemoto N, Dowswell T, Nagai S, Mori R.产后早期家访的时间表。Cochrane Database of Systematic Reviews 2013,第7期。艺术。不。: CD009326。cd009326.pub2 DOI: 10.1002/14651858.。这篇评论的配套文章“产后早期家访的时间表”包含以下内容:
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引用次数: 2
Schedules for home visits in the early postpartum period 产后早期家访安排
Pub Date : 2014-03-20 DOI: 10.1002/ebch.1960
Naohiro Yonemoto, Therese Dowswell, Shuko Nagai, Rintaro Mori

Background

Maternal complications including psychological and mental health problems and neonatal morbidity have been commonly observed in the postpartum period. Home visits by health professionals or lay supporters in the weeks following the birth may prevent health problems from becoming chronic with long-term effects on women, their babies, and their families.

Objectives

To assess outcomes for women and babies of different home-visiting schedules during the early postpartum period. The review focuses on the frequency of home visits, the duration (when visits ended) and intensity, and on different types of home-visiting interventions.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 January 2013) and reference lists of retrieved articles.

Selection criteria

Randomised controlled trials (RCTs) (including cluster-RCTs) comparing different types of home-visiting interventions enrolling participants in the early postpartum period (up to 42 days after birth). We excluded studies in which women were enrolled and received an intervention during the antenatal period (even if the intervention continued into the postnatal period) and studies recruiting only women from specific high-risk groups. (e.g. women with alcohol or drug problems).

Data collection and analysis

Study eligibility was assessed by at least two review authors. Data extraction and assessment of risk of bias were carried out independently by at least two review authors. Data were entered into Review Manager software.

Main results

We included data from 12 randomised trials with data for more than 11,000 women. The trials were carried out in countries across the world, and in both high- and low-resource settings. In low-resource settings women receiving usual care may have received no additional postnatal care after early hospital discharge.

The interventions and control conditions varied considerably across studies with trials focusing on three broad types of comparisons: schedules involving more versus fewer postnatal home visits (five studies), schedules involving different models of care (three studies), and home versus hospital clinic postnatal check-ups (four studies). In all but two of the included studies, postnatal ca

婴儿面临与感染、窒息和早产有关的死亡风险。保健专业人员或非专业人员在产后早期进行家访,可以防止健康问题变成长期问题,从而对妇女、她们的婴儿和她们的家庭产生影响。这篇综述研究了分娩后几周不同的家访计划。我们纳入了12项随机试验,数据来自1.1万多名女性。一些试验侧重于母亲和新生儿的身体检查,而另一些试验则为母乳喂养提供支持,一项试验包括提供家务和儿童保育方面的实际支持。这些研究在资源丰富的国家和资源贫乏的环境中进行,在这些国家中,接受常规护理的妇女在早期出院后可能没有接受额外的产后护理。这些试验集中于三大类比较:涉及更多或更少产后家访的时间表(五项研究),涉及不同护理模式的时间表(三项研究),以及家庭与医院门诊产后检查(四项研究)。在所有纳入的研究中,除了两项之外,家中的产后护理都是由医疗保健专业人员提供的。对于我们的大多数结果,只有一两个研究提供了数据,总体结果不一致。没有证据表明家访与减少新生儿死亡或母亲的严重健康问题有关。更密集的家访安排并没有改善妇女的身心健康。总的来说,如果母亲接受更多的产后家访,婴儿接受紧急医疗护理的可能性就会降低。更多的家访可能鼓励了更多的妇女纯母乳喂养婴儿。不同研究中报告的不同结果、测量结果的方式以及不同研究中干预措施和控制条件的显著差异是本综述的局限性。这些研究在偏倚风险方面质量参差不齐。在推荐任何特定的产后护理计划之前,还需要进行更多的研究
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引用次数: 85
期刊
Evidence-based child health : a Cochrane review journal
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