Tae Hyeon Kim, Hyeri Lee, Selin Woo, Hayeon Lee, Jaeyu Park, Guillaume Fond, Laurent Boyer, Jong Woo Hahn, Jiseung Kang, Dong Keon Yon
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引用次数: 0
摘要
背景目前还缺乏有关婴儿猝死综合症（SIDS）影响的风险和保护因素的全面定量证据。方法我们对评估婴儿猝死综合症相关因素的观察性和干预性研究的荟萃分析进行了综述。从开始到 2023 年 1 月 18 日，我们检索了 PubMed/MEDLINE、Embase、EBSCO 和 Google Scholar。数据提取、质量评估和证据的确定性均按照 PRISMA 指南使用系统性综述评估测量工具 2 进行评估。根据观察证据，可信度按等级和证据质量（CE；有说服力、高度提示性、提示性、弱或无意义）进行分级和分类。我们的研究方案已在 PROSPERO 注册（CRD42023458696）。与婴儿猝死综合症相关的风险因素和保护因素以等效几率比（eORs）表示。结果我们发现了 8 项原创荟萃分析，包括 152 篇原创文章，涉及婴儿猝死综合症的 12 个独特风险因素和保护因素，遍及 21 个国家/地区和五大洲。一些风险因素，包括产前药物暴露[eOR = 7.84 (95% CI = 4.81-12.79)，CE =高度提示性]、产前阿片类药物暴露[9.55 (95% CI = 4.87-18.72)，CE =提示性]、产前美沙酮暴露[9.52 (95% CI = 3.34-27.10)，CE =弱]、产前可卡因暴露[4.38 (95% CI = 1.95-9.86)，CE =弱]、产前鸦片类药物暴露[9.52 (95% CI = 3.34-27.10)，CE =弱]。4.38 (95% CI = 1.95-9.86), CE = 弱]、产前母亲吸烟[2.25 (95% CI = 1.95-2.60), CE = 高度提示性]、产后母亲吸烟[1.97 (95% CI = 1.75-2.22), CE = 弱]、同床[2.89 (95% CI = 1.81-4.60), CE = 弱]以及最后一次睡眠后发现婴儿头部被床单覆盖[11.01 (95% CI = 5.40-22.45), CE = 提示性]。另一方面，还确定了三个保护因素，即母乳喂养[0.57 (95% CI = 0.39-0.83)，CE = 非显著]、仰卧位[0.48 (95% CI = 0.37-0.63)，CE = 提示性]和使用安抚奶嘴[0.44 (95% CI = 0.30-0.65)，CE = 弱]。本研究表明，有必要对可信度弱、无关联或缺乏充分研究的婴儿猝死综合症相关因素进行进一步研究。
Prenatal and postnatal factors associated with sudden infant death syndrome: an umbrella review of meta-analyses
Background
Comprehensive quantitative evidence on the risk and protective factors for sudden infant death syndrome (SIDS) effects is lacking. We investigated the risk and protective factors related to SIDS.
Methods
We conducted an umbrella review of meta-analyses of observational and interventional studies assessing SIDS-related factors. PubMed/MEDLINE, Embase, EBSCO, and Google Scholar were searched from inception until January 18, 2023. Data extraction, quality assessment, and certainty of evidence were assessed by using A Measurement Tool Assessment Systematic Reviews 2 following PRISMA guidelines. According to observational evidence, credibility was graded and classified by class and quality of evidence (CE; convincing, highly suggestive, suggestive, weak, or not significant). Our study protocol was registered with PROSPERO (CRD42023458696). The risk and protective factors related to SIDS are presented as equivalent odds ratios (eORs).
Results
We identified eight original meta-analyses, including 152 original articles, covering 12 unique risk and protective factors for SIDS across 21 countries/regions and five continents. Several risk factors, including prenatal drug exposure [eOR = 7.84 (95% CI = 4.81–12.79), CE = highly suggestive], prenatal opioid exposure [9.55 (95% CI = 4.87–18.72), CE = suggestive], prenatal methadone exposure [9.52 (95% CI = 3.34–27.10), CE = weak], prenatal cocaine exposure [4.38 (95% CI = 1.95–9.86), CE = weak], prenatal maternal smoking [2.25 (95% CI = 1.95–2.60), CE = highly suggestive], postnatal maternal smoking [1.97 (95% CI = 1.75–2.22), CE = weak], bed sharing [2.89 (95% CI = 1.81–4.60), CE = weak], and infants found with heads covered by bedclothes after last sleep [11.01 (95% CI = 5.40–22.45), CE = suggestive], were identified. On the other hand, three protective factors, namely, breastfeeding [0.57 (95% CI = 0.39–0.83), CE = non-significant], supine sleeping position [0.48 (95% CI = 0.37–0.63), CE = suggestive], and pacifier use [0.44 (95% CI = 0.30–0.65), CE = weak], were also identified.
Conclusions
Based on the evidence, we propose several risk and protective factors for SIDS. This study suggests the need for further studies on SIDS-related factors supported by weak credibility, no association, or a lack of adequate research.
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The World Journal of Pediatrics, a monthly publication, is dedicated to disseminating peer-reviewed original papers, reviews, and special reports focusing on clinical practice and research in pediatrics.
We welcome contributions from pediatricians worldwide on new developments across all areas of pediatrics, including pediatric surgery, preventive healthcare, pharmacology, stomatology, and biomedicine. The journal also covers basic sciences and experimental work, serving as a comprehensive academic platform for the international exchange of medical findings.
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