M Caballero Campo, F Pérez Milán, M Carrera Roig, E Moratalla Bartolomé, J A Domínguez Arroyo, J L Alcázar Zambrano, L Alonso Pacheco, J Carugno
{"title":"先天性子宫畸形对产科和围产期结果的影响：系统回顾和荟萃分析。","authors":"M Caballero Campo, F Pérez Milán, M Carrera Roig, E Moratalla Bartolomé, J A Domínguez Arroyo, J L Alcázar Zambrano, L Alonso Pacheco, J Carugno","doi":"10.52054/FVVO.16.1.004","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Congenital uterine anomalies (CUA) can be associated with impairments of early and late pregnancy events.</p><p><strong>Objective: </strong>To assess the impact of CUA on reproductive outcomes in pregnancies conceived spontaneously or after assisted reproduction.</p><p><strong>Materials and methods: </strong>Systematic review and meta-analysis of cohort studies comparing patients with CUA versus women with normal uterus. A structured literature search was performed in leading scientific databases to identify prospective and retrospective studies. The Newcastle-Ottawa scale, adapted to AHRQ standards, was used to assess the risk of bias. Pooled odds ratios (OR) were calculated. Publication bias and statistical heterogeneity were assessed, and meta-regression was used to analyse the heterogeneity.</p><p><strong>Main outcome measures: </strong>Miscarriage, ectopic pregnancy, placental abruption, term, and premature rupture of membranes (PROM), malpresentation at delivery, preterm delivery prior to 37, 34 and 32 weeks, caesarean delivery, intrauterine growth restriction/small for gestational age, foetal mortality and perinatal mortality.</p><p><strong>Results: </strong>32 studies were included. CUAs increased significantly the risk of first/second trimester miscarriage (OR:1.54;95%CI:1.14-2.07), placental abruption (OR:5.04;3.60-7.04), PROM (OR:1.71;1.34-2.18), foetal malpresentation at delivery (OR:21.04;10.95-40.44), preterm birth (adjusted OR:4.34;3.59-5.21), a caesarean delivery (adjusted OR:7.69;4.17-14.29), intrauterine growth restriction/small for gestational age (adjusted OR:50;6.11-424), foetal mortality (OR:2.07;1.56-2.73) and perinatal mortality (OR:3.28;2.01-5.36).</p><p><strong>Conclusions: </strong>CUA increases the risk of complications during pregnancy, delivery, and postpartum. Complications most frequent in CUA patients were preterm delivery, foetal malpresentation, and caesarean delivery.</p><p><strong>What is new?: </strong>Bicornuate uterus was associated with the highest number of adverse outcomes, followed by didelphys, subseptate and septate uterus.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"16 1","pages":"9-22"},"PeriodicalIF":1.7000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11198883/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of congenital uterine anomalies on obstetric and perinatal outcomes: systematic review and meta-analysis.\",\"authors\":\"M Caballero Campo, F Pérez Milán, M Carrera Roig, E Moratalla Bartolomé, J A Domínguez Arroyo, J L Alcázar Zambrano, L Alonso Pacheco, J Carugno\",\"doi\":\"10.52054/FVVO.16.1.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Congenital uterine anomalies (CUA) can be associated with impairments of early and late pregnancy events.</p><p><strong>Objective: </strong>To assess the impact of CUA on reproductive outcomes in pregnancies conceived spontaneously or after assisted reproduction.</p><p><strong>Materials and methods: </strong>Systematic review and meta-analysis of cohort studies comparing patients with CUA versus women with normal uterus. A structured literature search was performed in leading scientific databases to identify prospective and retrospective studies. The Newcastle-Ottawa scale, adapted to AHRQ standards, was used to assess the risk of bias. Pooled odds ratios (OR) were calculated. Publication bias and statistical heterogeneity were assessed, and meta-regression was used to analyse the heterogeneity.</p><p><strong>Main outcome measures: </strong>Miscarriage, ectopic pregnancy, placental abruption, term, and premature rupture of membranes (PROM), malpresentation at delivery, preterm delivery prior to 37, 34 and 32 weeks, caesarean delivery, intrauterine growth restriction/small for gestational age, foetal mortality and perinatal mortality.</p><p><strong>Results: </strong>32 studies were included. CUAs increased significantly the risk of first/second trimester miscarriage (OR:1.54;95%CI:1.14-2.07), placental abruption (OR:5.04;3.60-7.04), PROM (OR:1.71;1.34-2.18), foetal malpresentation at delivery (OR:21.04;10.95-40.44), preterm birth (adjusted OR:4.34;3.59-5.21), a caesarean delivery (adjusted OR:7.69;4.17-14.29), intrauterine growth restriction/small for gestational age (adjusted OR:50;6.11-424), foetal mortality (OR:2.07;1.56-2.73) and perinatal mortality (OR:3.28;2.01-5.36).</p><p><strong>Conclusions: </strong>CUA increases the risk of complications during pregnancy, delivery, and postpartum. Complications most frequent in CUA patients were preterm delivery, foetal malpresentation, and caesarean delivery.</p><p><strong>What is new?: </strong>Bicornuate uterus was associated with the highest number of adverse outcomes, followed by didelphys, subseptate and septate uterus.</p>\",\"PeriodicalId\":46400,\"journal\":{\"name\":\"Facts Views and Vision in ObGyn\",\"volume\":\"16 1\",\"pages\":\"9-22\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11198883/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Facts Views and Vision in ObGyn\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.52054/FVVO.16.1.004\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Facts Views and Vision in ObGyn","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.52054/FVVO.16.1.004","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Impact of congenital uterine anomalies on obstetric and perinatal outcomes: systematic review and meta-analysis.
Background: Congenital uterine anomalies (CUA) can be associated with impairments of early and late pregnancy events.
Objective: To assess the impact of CUA on reproductive outcomes in pregnancies conceived spontaneously or after assisted reproduction.
Materials and methods: Systematic review and meta-analysis of cohort studies comparing patients with CUA versus women with normal uterus. A structured literature search was performed in leading scientific databases to identify prospective and retrospective studies. The Newcastle-Ottawa scale, adapted to AHRQ standards, was used to assess the risk of bias. Pooled odds ratios (OR) were calculated. Publication bias and statistical heterogeneity were assessed, and meta-regression was used to analyse the heterogeneity.
Main outcome measures: Miscarriage, ectopic pregnancy, placental abruption, term, and premature rupture of membranes (PROM), malpresentation at delivery, preterm delivery prior to 37, 34 and 32 weeks, caesarean delivery, intrauterine growth restriction/small for gestational age, foetal mortality and perinatal mortality.
Results: 32 studies were included. CUAs increased significantly the risk of first/second trimester miscarriage (OR:1.54;95%CI:1.14-2.07), placental abruption (OR:5.04;3.60-7.04), PROM (OR:1.71;1.34-2.18), foetal malpresentation at delivery (OR:21.04;10.95-40.44), preterm birth (adjusted OR:4.34;3.59-5.21), a caesarean delivery (adjusted OR:7.69;4.17-14.29), intrauterine growth restriction/small for gestational age (adjusted OR:50;6.11-424), foetal mortality (OR:2.07;1.56-2.73) and perinatal mortality (OR:3.28;2.01-5.36).
Conclusions: CUA increases the risk of complications during pregnancy, delivery, and postpartum. Complications most frequent in CUA patients were preterm delivery, foetal malpresentation, and caesarean delivery.
What is new?: Bicornuate uterus was associated with the highest number of adverse outcomes, followed by didelphys, subseptate and septate uterus.
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