{"title":"妊娠期免疫性血小板减少性紫癜与孕产妇和新生儿结局:系统回顾和元分析》。","authors":"Hong Zhang, Lixia Shi, Hui Shang, Huili Yang","doi":"10.1111/aji.70008","DOIUrl":null,"url":null,"abstract":"<div>\n \n <p>Immune thrombocytopenic purpura (ITP) affects 1–3 out of every 10 000 pregnancies, posing significant risks to both mothers and newborns. The condition often requires careful management to prevent severe hemorrhagic events. PubMed, Embase, Scopus, and Web of Science searched for relevant literature until June 2024. A meta-analysis was performed to evaluate the effect of ITP on maternal and fetal outcomes. The results showed that antepartum hemorrhage occurred in 0.17 (95% CI = 0.12–0.25) of patients and postpartum hemorrhage occurred in 0.11 (95% CI = 0.07–0.16) of pregnant women with ITP. About 0.63 (95% CI = 0.50–0.74) of pregnant women needed treatment for ITP. The cesarean section (CS) rate was 0.48 (95% CI = 0.34–0.61), and the occurrence of preterm labor was 0.14 (95% CI = 0.07–0.24). A total of 0.32 of neonates had thrombocytopenia (95% CI = 0.18–0.52). The difference between the platelet count of those diagnosed with ITP before pregnancy and those diagnosed after pregnancy was significant (MD = –31.50, 95% CI = 51.29–11.72, <i>p</i> < 0.01). This meta-analysis highlights the significant impact of ITP on pregnancy, estimating risks of bleeding, CS, gestational diabetes, preterm labor, and neonatal thrombocytopenia. These findings underscore the need for vigilant monitoring and tailored management of pregnant women with ITP.</p>\n </div>","PeriodicalId":7665,"journal":{"name":"American Journal of Reproductive Immunology","volume":"92 5","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Immune Thrombocytopenic Purpura and Maternal and Neonatal Outcomes During Pregnancy: A Systematic Review and Meta-Analysis\",\"authors\":\"Hong Zhang, Lixia Shi, Hui Shang, Huili Yang\",\"doi\":\"10.1111/aji.70008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <p>Immune thrombocytopenic purpura (ITP) affects 1–3 out of every 10 000 pregnancies, posing significant risks to both mothers and newborns. The condition often requires careful management to prevent severe hemorrhagic events. PubMed, Embase, Scopus, and Web of Science searched for relevant literature until June 2024. A meta-analysis was performed to evaluate the effect of ITP on maternal and fetal outcomes. The results showed that antepartum hemorrhage occurred in 0.17 (95% CI = 0.12–0.25) of patients and postpartum hemorrhage occurred in 0.11 (95% CI = 0.07–0.16) of pregnant women with ITP. About 0.63 (95% CI = 0.50–0.74) of pregnant women needed treatment for ITP. The cesarean section (CS) rate was 0.48 (95% CI = 0.34–0.61), and the occurrence of preterm labor was 0.14 (95% CI = 0.07–0.24). A total of 0.32 of neonates had thrombocytopenia (95% CI = 0.18–0.52). The difference between the platelet count of those diagnosed with ITP before pregnancy and those diagnosed after pregnancy was significant (MD = –31.50, 95% CI = 51.29–11.72, <i>p</i> < 0.01). This meta-analysis highlights the significant impact of ITP on pregnancy, estimating risks of bleeding, CS, gestational diabetes, preterm labor, and neonatal thrombocytopenia. These findings underscore the need for vigilant monitoring and tailored management of pregnant women with ITP.</p>\\n </div>\",\"PeriodicalId\":7665,\"journal\":{\"name\":\"American Journal of Reproductive Immunology\",\"volume\":\"92 5\",\"pages\":\"\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-11-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Reproductive Immunology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/aji.70008\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Reproductive Immunology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/aji.70008","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
免疫性血小板减少性紫癜(ITP)每 10 000 名孕妇中就有 1-3 人患病,对母亲和新生儿都有很大风险。这种疾病通常需要精心治疗,以防止严重出血事件的发生。PubMed、Embase、Scopus和Web of Science检索了截至2024年6月的相关文献。我们进行了一项荟萃分析,以评估 ITP 对产妇和胎儿预后的影响。结果显示,在ITP孕妇中,0.17(95% CI = 0.12-0.25)的患者会发生产前出血,0.11(95% CI = 0.07-0.16)的患者会发生产后出血。约有 0.63(95% CI = 0.50-0.74)名孕妇需要治疗 ITP。剖宫产率为 0.48(95% CI = 0.34-0.61),早产率为 0.14(95% CI = 0.07-0.24)。共有 0.32 名新生儿患有血小板减少症(95% CI = 0.18-0.52)。孕前诊断为 ITP 的新生儿和孕后诊断为 ITP 的新生儿的血小板计数差异显著(MD = -31.50,95% CI = 51.29-11.72,p<0.05)。
Immune Thrombocytopenic Purpura and Maternal and Neonatal Outcomes During Pregnancy: A Systematic Review and Meta-Analysis
Immune thrombocytopenic purpura (ITP) affects 1–3 out of every 10 000 pregnancies, posing significant risks to both mothers and newborns. The condition often requires careful management to prevent severe hemorrhagic events. PubMed, Embase, Scopus, and Web of Science searched for relevant literature until June 2024. A meta-analysis was performed to evaluate the effect of ITP on maternal and fetal outcomes. The results showed that antepartum hemorrhage occurred in 0.17 (95% CI = 0.12–0.25) of patients and postpartum hemorrhage occurred in 0.11 (95% CI = 0.07–0.16) of pregnant women with ITP. About 0.63 (95% CI = 0.50–0.74) of pregnant women needed treatment for ITP. The cesarean section (CS) rate was 0.48 (95% CI = 0.34–0.61), and the occurrence of preterm labor was 0.14 (95% CI = 0.07–0.24). A total of 0.32 of neonates had thrombocytopenia (95% CI = 0.18–0.52). The difference between the platelet count of those diagnosed with ITP before pregnancy and those diagnosed after pregnancy was significant (MD = –31.50, 95% CI = 51.29–11.72, p < 0.01). This meta-analysis highlights the significant impact of ITP on pregnancy, estimating risks of bleeding, CS, gestational diabetes, preterm labor, and neonatal thrombocytopenia. These findings underscore the need for vigilant monitoring and tailored management of pregnant women with ITP.
期刊介绍:
The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.