摘要
目的探讨孕期咖啡因摄入与流产之间的关系。方法基于2014年1月对5个数据库的检索结果,研究纳入观察孕妇在妊娠期间咖啡因摄入与否与流产之间关系的分析性研究。两名研究者独立进行文献筛选、资料提取及严格评价的过程。对于纳入研究的方法学质量评价采用纽卡斯尔-渥太华量表（NOS量表）。数据分析运用Revman5.2软件,二分类变量的效应值用比值比（OR）及其95%CI（CI）表示,研究间的统计学异质性采用I2检验,对于异质性在容许范围内的研究进行Meta分析。结果研究共纳入了7项病例对照研究和7项队列研究（合计149 474名孕期妇女）,纳入研究的NOS评分均为7-8分（满分9分）,显示方法学质量良好。单个研究的结果对于咖啡因摄入致孕妇流产的结论并不一致,而其中7项研究的Meta分析结果显示孕期咖啡因摄入可能会导致流产的危险,且危险程度随咖啡因摄入量增加（〉300 mg/d）而加大（OR=1.35,95%CI 1.27-1.44,P〈0.00001）。结论流行病学观察性研究的Meta分析及部分单个研究结果均提示孕妇每日饮用含咖啡因饮品,尤其是多〉300 mg/d很可能会使流产率增加。故而,建议妊娠妇女在孕期最好减少或停止饮用咖啡或其他含咖啡因的饮品。
Objective To investigate the relationship between caffeine intake during pregnancy and spontaneous abortion. Methods Based on the searching results of five databases in January 2014, our research included the analytical studies which observed the relationship between caffeine intake during pregnancy and spontaneous abortion. Two researchers independently screened the literature and extract data. The methodological quality of the included studies was evaluated according to Newcastle-Ottawa Scale （NOS scale）. Revman5.2 software was employed for data analysis. Effect value of dichotomous data was represented as odds ratio （OR） and their 95% confidence interval （CI）, statistical heterogeneity between studies were detected using the f test. Meta-analysis was conducted if the heterogeneity among studies was within the permissible range. Results Seven case-control studies and seven cohort studies （a total of 149,474 pregnant women） were included in the review. NOS scores varied from 7 to 8 points. The results of individual studies for caffeine-induced miscarriage were;not uniform;however,the meta-analysis of seven included studies showed the risk of caffeine intake during pregnancy might cause spontaneous abortion, and the degree of risk would increase when the amount of daily caffeine intake increased （〉300 mg/d） （OR = 1.35, 95% CI： 1.27-1.44, P〈0.00001）. Conclusions Findings from this systematic review strongly suggest that drinking caffeinated beverages daily during pregnancy, especially 〉300mg/d,is likely to increase the chance of spontaneous abortion by 35%. Therefore, this review recommends that pregnant women should reduce or stop drinking coffee or other caffeinated beverages during pregnancy.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2014年第12期945-950,共6页
Chinese Journal of Practical Gynecology and Obstetrics
基金
北京中医药大学创新团队(2011-CXTD-09)
关键词
咖啡
流产
系统综述
病例对照研究
队列研究
coffee
spontaneous abortion
systematic review
case-control study
cohort study
