单脐动脉与胎儿先天异常相关性的Meta分析

目的:探讨单脐动脉与胎儿先天异常的关系,为临床胎儿取舍决策的制定提供依据。方法:利用Meta分析方法综合分析1995年至今有关单脐动脉与胎儿先天异常的分析性研究文献11篇。结果:单脐动脉合并先天畸形的发生率25.6%,对照组先天畸形发生率9.7%,单脐动脉与胎儿发生结构畸形的危险性增加有关〔合并OR=3.59,95%CI(2.77,4.66),Z=9.62,P<0.00 001〕。单脐动脉合并染色体异常的发生率为14.0%,对照组染色体异常率1.3%,单脐动脉与胎儿染色体异常的危险性增加有关〔合并OR=8.89,95%CI(2.88,27.49),Z=3.80,P=0.0 001〕。没有足够证据表明孤立单脐动脉增加小于胎龄儿及新生儿肾脏超声异常发生的危险性(P>0.05)。结论:单脐动脉组胎儿发生先天畸形及染色体异常的危险性高于正常脐带组胎儿,现有资料尚不能证明孤立单脐动脉可以改变胎儿的预后,仍需要大量的研究进行更深入的探索。

Correlation between single umbilical artery and fetal congenital abnormality:a Meta analysis

Objective:To explore the relationship between single umbilical artery and fetal congenital abnormality,provide reference for making choice for fetuses in clinic.Methods:Meta analysis was used to analyze 11 literatures about single umbilical artery and fetal congenital abnormality from 1995 to now synthetically.Results:The incidence of single umbilical artery combined with fetal congenital abnormality was 25.6%,the incidence of congenital malformation in control group was 9.7%,single umbilical artery was correlated with the increase of risk of fetal structural abnormality(combined OR=3.59,95%CI(2.77,4.66),Z=9.62,P<0.00 001).The incidence of single umbilical artery combined with chromosomal abnormality was 14.0%,the incidence of chromosomal abnormality in control group was 1.3%,single umbilical artery was correlated with the increase of risk of fetal chromosomal abnormality(combined OR=8.89,95%CI(2.88,27.49),Z=3.80,P=0.0 001).There was no evidence that single umbilical artery could increase the risk of renal ultrasonic abnormality among the small for gestational age infants and neonates(P>0.05).Conclusion:The risk of congenital abnormality and chromosomal abnormality in fetuses of single umbilical artery group is higher than that in fetuses of normal umbilical cord group,current data can′t prove that single umbilical artery can improve the prognosis of fetuses,more further studies are needed.