关于产前诊断胼胝体发育不全患儿预后的Meta分析

目的 对国内外有关胎儿胼胝体发育不全预后情况的文献进行系统综述,探讨该病的临床结局及对比分析单纯性胼胝体发育不全与伴发其他畸形的发育不全预后情况,为该病产前咨询提供依据。方法 运用Meta分析的方法综合分析国内外1990~2012年关于胼胝体发育不全患儿预后情况的文献报道。结果 经筛选并纳入本次Meta分析的文献共15篇,累计病例565例。产前诊断胎儿胼胝体发育不全,引产率达65%;男性发病率大于女性,合并RR=1.29,95%CI=1.04~1.59,P<0.05,差异有统计学意义。单纯性胼胝体发育不全预后良好达70%;伴发其他畸形的胼胝体发育不全患儿预后良好者仅仅16%;伴发其他畸形的胼胝体发育不全明显比单纯性发育不全的患儿预后差,合并OR=0.07,95%CI=0.02~0.24,P<0.05,差异有统计学意义。结论 产前影像学诊断胎儿胼胝体发育不全,其引产率较高。胼胝体发育不全中男性比例大于女性。单纯性较伴发畸形的胼胝体发育不全患儿预后较好,但是伴发其他畸形的胼胝体发育不全患儿预后不容乐观。

Meta-analysis of the prognosis of prenatally-diagnosed fetal agenesis of corpus callosum

Objective To explore the outcomes of agenesis of corpus callosum (ACC), and to compare the prognosis of isolated ACC with ACC complicated with other abnormalities. Methods Literature about the prognosis of ACC during 1990 to 2012 were retrieved and Meta-analysis was conducted. Results A total of 15 studies involving 565 cases were included. The overall rate of terminations was 65%. There was a higher incidence of ACC in males than in females, with the pooled RR=1.29, 95%CI=1.04-1.59, P<0.05. The overall rate of favorable prognosis for simple ACC was up to 70%, while that of ACC complicated with structural anomalies was 16%. There was statistical difference between the two values, the pooled OR=0.07, 95%CI=0.02-0.24, P<0.05. Conclusion There is a high rate of terminations due to prenatal diagnosis of fetal agenesis of corpus callosum. The incidence of ACC is higher in males than in females. The prognosis of isolated ACC is favorable, while the prognosis of ACC complicated with other anomalies is poor.