[1]蒋 林,代 丹,尹琳琳,等.基于蒙特勒标准的新生儿急性呼吸窘迫综合征危险因素的Meta分析[J].医学信息,2025,38(03):39-45.[doi:10.3969/j.issn.1006-1959.2025.03.007]
　JIANG Lin,DAI Dan,YIN Linlin,et al.Meta-analysis of Risk Factors for Neonatal Acute Respiratory Distress Syndrome Based on Montreux Criteria[J].Journal of Medical Information,2025,38(03):39-45.[doi:10.3969/j.issn.1006-1959.2025.03.007]
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基于蒙特勒标准的新生儿急性呼吸窘迫综合征危险因素的Meta分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
38卷
期数:
2025年03期
页码:
39-45
栏目:
医学数据科学
出版日期:
2025-02-01

文章信息/Info

Title:
Meta-analysis of Risk Factors for Neonatal Acute Respiratory Distress Syndrome Based on Montreux Criteria
文章编号:
1006-1959（2025）03-0039-07
作者:
蒋 林; 代 丹; 尹琳琳; 赵 婧
川北医学院附属医院儿科，四川 南充 637000
Author(s):
JIANG Lin;  DAI Dan;  YIN Linlin;  ZHAO Jing
Department of Pediatrics, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan, China
关键词:
蒙特勒标准; 急性呼吸窘迫综合征; 危险因素; Meta分析
Keywords:
Montreux criteria;  Acute respiratory distress syndrome;  Risk factors;  Meta-analysis
分类号:
R722.1
DOI:
10.3969/j.issn.1006-1959.2025.03.007
文献标志码:
A
摘要:
目的 系统评价基于蒙特勒标准的新生儿急性呼吸窘迫综合征危险因素。方法 通过计算机检索万方数据库、VIP、中国生物医学文献数据库、CNKI、PubMed、EMBASE、Web of Science、Cochrane Library等从2017年8月-2023年8月1日收录的关于基于蒙特勒标准的新生儿急性呼吸窘迫综合征危险因素的病例对照研究。由2名研究者根据纳入与排除标准对文献进行筛选、数据提取、质量评价后，采用RevMan 5.4软件进行Meta分析。结果 共纳入研究文献9篇，累积病例组797例，对照组2001例，包括20个相关因素，有统计学意义的危险因素包括剖宫产（OR=2.76，95%CI：1.91~3.98，P＜0.001）、出生窒息（OR=8.01，95%CI：5.18~12.40，P＜0.001）、宫内窘迫（OR=3.55，95%CI：2.41~5.22，P＜0.001）、羊水/胎粪吸入（OR=3.93，95%CI：2.39~6.48，P＜0.001）、母亲妊娠期糖尿病（OR=3.36，95%CI：1.95~5.78，P＜0.001）、母亲妊娠期高血压（OR=4.76，95%CI：2.45~9.28，P＜0.001）是基于蒙特勒标准的新生儿急性呼吸窘迫综合征的独立危险因素。结论 剖宫产、出生窒息、宫内窘迫、羊水/胎粪吸入、母亲妊娠期糖尿病、母亲妊娠期高血压的新生儿，更易发生新生儿急性呼吸窘迫综合征。临床中，应针对上述危险因素制定预防管理措施，以降低新生儿急性呼吸窘迫综合征的发生率。
Abstract:
Objective To systematically evaluate the risk factors of neonatal acute respiratory distress syndrome based on Montreux criteria. Methods A case-control study on the risk factors of neonatal acute respiratory distress syndrome based on Montreux criteria was retrieved from Wanfang database, VIP, Chinese biomedical literature database, CNKI, PubMed, EMBASE, Web of Science, Cochrane Library from August 2017 to August 1,2023. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted data, and evaluated the quality of the included studies. Meta-analysis was performed using RevMan 5.4 software. Results A total of 9 studies were included, including 797 cases in the case group and 2001 cases in the control group, with 20 related factors, and the statistically significant risk factors included cesarean section (OR=2.76, 95%CI: 1.91-3.98, P<0.001), birth asphyxia (OR=8.01, 95%CI: 5.18-12.40, P<0.001), intrauterine distress (OR=3.55, 95%CI: 2.41-5.22, P<0.001), amniotic fluid/meconium aspiration (OR=3.93, 95%CI: 2.39-6.48, P<0.001), maternal gestational diabetes mellitus (OR=3.36, 95%CI: 1.95-5.78, P<0.001), maternal gestational hypertension (OR=4.76, 95%CI: 2.45-9.28, P<0.001) were independent risk factors for neonatal acute respiratory distress syndrome based on Montreux criteria. Conclusion Newborns with cesarean section, birth asphyxia, intrauterine distress, amniotic fluid/meconium aspiration, maternal gestational diabetes, and maternal gestational hypertension are more likely to develop neonatal acute respiratory distress syndrome. In clinical practice, preventive management measures should be formulated for the above risk factors to reduce the incidence of neonatal acute respiratory distress syndrome.

参考文献/References:

[1]郭静雨,陈龙,史源.2017年新生儿急性呼吸窘迫综合征蒙特勒诊断标准解读[J].中华儿科杂志,2018,56(8):571-574.[2]牛蓉.ARDS定义的演进与新生儿ARDS诊断标准的建立[J].国际儿科学杂志,2019,46(4):246-250.[3]Ranieri VM,Rubenfeld GD,Thompson BT,et al.Acute Respiratory Distress Syndrome:The Berlin Definition[J].JAMA,2012,307(23):2526-2533.[4]De Luca D,van Kaam AH,Tingay DG,et al.The Montreux definition of neonatal ARDS: biological and clinical background behind the description of a new entity[J].Lancet Respir Med,2017,5(8):657-666.[5]张永芳,于新桥,廖建华,等.鄂西南地区新生儿急性呼吸窘迫综合征临床流行病学调查[J].中国当代儿科杂志,2020,22(9):942-947.[6]唐烁,包蕾.新生儿急性呼吸窘迫综合征临床特征与预后相关因素分析[J].第三军医大学学报,2019,41(9):898-902.[7]江苏省新生儿ARDS研究协作组.基于“柏林定义”的新生儿急性呼吸窘迫综合征临床流行病学调查研究[J].中华新生儿科杂志(中英文),2018,33(5):339-343.[8]Stang A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J].European Journal of Epidemiology,2010,25(9):603-605.[9]努尔加玛丽·则敏.新生儿急性呼吸窘迫综合征临床特点及影响因素分析[D].乌鲁木齐:新疆医科大学,2021.[10]李小霞.新生儿急性呼吸窘迫综合征高危因素及并发症的临床分析[D].银川:宁夏医科大学,2021.[11]Hu Y,Chen X,Wang F,et al.Risk Factors of Neonatal Acute Respiratory Distress Syndrome Based on the Montreux Definition in Neonates with Sepsis: A Retrospective Case–Control Study[J].Am J Perinatol,2024,41(8):1019-1026.[12]Liu H,Li J,Guo J,et al.A prediction nomogram for neonatal acute respiratory distress syndrome in late-preterm infants and full-term infants: A retrospective study[J].eClinicalMedicine,2022,50:101523.[13]You T,Zhou Y,Liu X,et al.Risk Factors and Clinical Characteristics of Neonatal Acute Respiratory Distress Syndrome Caused by Early Onset Sepsis[J].Front Pediatr,2022,10:847827.[14]刘云,朱云龙.分娩方式对足月新生儿急性呼吸窘迫综合征的影响[J].蚌埠医学院学报,2019,44(10):1370-1372.[15]李春亮,王茜,李雅玲.新生儿急性呼吸窘迫综合征危险因素病例对照研究[J].中国现代医生,2021,59(16):87-90.[16]殷剑秋,叶一帆,刘婷婷.新生儿急性呼吸窘迫综合征相关影响因素分析[J].重庆医学,2019,48(19):3318-3320.[17]刘慧,伍莉,吴芳,等.新生儿急性呼吸窘迫综合征的母孕期高危因素分析[J].重庆医学,2021,50(1):54-57.[18]Beydoun H,Yunis KA,Khogali M,et al.Caesarean route of delivery and hyaline membrane disease: a hospital-based case-control study in Greater Beirut[J].Paediatr Perinat Epidemiol, 2003,17(4):363-368.[19]Zanardo V,Simbi AK,Franzoi M,et al.Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesarean delivery[J].Acta Paediatr,2004,93(5):643-647.[20]新生儿窒息多器官损害临床诊断多中心研究协作组.新生儿窒息多器官损害发生率、高危因素和转归的多中心研究[J].中华围产医学杂志,2016,19(1):23-28.[21]Tse BC,Block B,Figueroa H,et al.Adverse neonatal outcomes associated with pregestational diabetes mellitus in infants born preterm[J].American Journal of Obstetrics & Gynecology MFM,2020,2(4):100213.[22]McGillick EV,Orgeig S,Morrison JL.Regulation of lung maturation by prolyl hydroxylase domain inhibition in the lungof the normally grown and placentally restricted fetus in late gestation[J].Am J Physiol Regul Integr Comp Physiol,2016,310(11):R1226-R1243.[23]Polnaszek B,López JD,Clark R,et al.Marked variability in intrapartum electronic fetal heart rate patterns: association with neonatal morbidity and abnormal arterial cord gas[J].Journal of Perinatology,2020,40(1):56-62.[24]Battarbee AN,Venkatesh KK,Aliaga S,et al.The association of pregestational and gestational diabetes with severe neonatal morbidity and mortality[J].Journal of Perinatology,2020,40(2):232-239.[25]Kleiner I,Ram S,Kovo M,et al.Pregnancy outcomes in association with placental histopathology in pregnancies complicated by macrosomia in diabetic vs. non-diabetic women[J].European Journal of Obstetrics & Gynecology and Reproductive Biology,2020,248:24-29.[26]Benzouina S,Boubkraoui M,Mrabet M,et al.Fetal outcome in emergency versus elective cesarean sections at Souissi Maternity Hospital, Rabat, Morocco[J].Pan Afr Med J,2016,23:197.

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更新日期/Last Update: 1900-01-01