中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2014年
3期
209-214
,共6页
白血病,双表型,急性%出生顺序%Meta分析
白血病,雙錶型,急性%齣生順序%Meta分析
백혈병,쌍표형,급성%출생순서%Meta분석
Leukemia,biphenotypic,acute%Birth order%Meta-analysis
目的 综合评价患儿出生顺序、孕妇流产史及分娩方式与儿童急性白血病发病风险之间的关系.方法 在PubMed、Google学术搜索、中国知网(CNKI)、万方数据库中以“childhoodleukemia"、“acute lymphoblastic leukemia"、“acute myeloid leukemia"、“birth order"、“abortion”、“miscarriage”、“caesarean”、“birth characteristics”、“prenatal risk factor”或其对应的中文词目为检索词,收集2013年3月前有关患儿出生顺序、孕妇流产史及分娩方式与儿童急性白血病发病风险之间关系的队列研究和病例对照研究,采用Stata软件进行Meta分析.结果 共纳入相关文献23篇.孕妇流产史与急性白血病发病风险相关(自然流产:OR=1.21,95％ CI:1.05 ～ 1.41;人工流产:OR=1.23,95％ CI:1.07～1.43),而患儿出生顺序、孕妇分娩方式与急性白血病发病风险无关(患儿出生顺序依次为2、3、≥4:OR=0.97,95％ CI:0.89 ～ 1.05、OR=1.00,95％ CI:0.91 ～ 1.11、OR=1.02,95％ CI:0.87 ～ 1.20;孕妇分娩方式:OR=1.05,95％CI:0.96 ～ 1.15).亚组分析进一步揭示,孕妇自然流产史和人丁流产史分别与儿童急性髓性白血病(OR=1.71,95％ CI:1.09 ～2.70)、急性淋巴细胞白血病的发病风险存在显著关联(OR=1.23,95％CI:1.05 ～ 1.42).结论 孕妇流产史可能是儿童急性白血病的危险因素,但仍需进一步验证.
目的 綜閤評價患兒齣生順序、孕婦流產史及分娩方式與兒童急性白血病髮病風險之間的關繫.方法 在PubMed、Google學術搜索、中國知網(CNKI)、萬方數據庫中以“childhoodleukemia"、“acute lymphoblastic leukemia"、“acute myeloid leukemia"、“birth order"、“abortion”、“miscarriage”、“caesarean”、“birth characteristics”、“prenatal risk factor”或其對應的中文詞目為檢索詞,收集2013年3月前有關患兒齣生順序、孕婦流產史及分娩方式與兒童急性白血病髮病風險之間關繫的隊列研究和病例對照研究,採用Stata軟件進行Meta分析.結果 共納入相關文獻23篇.孕婦流產史與急性白血病髮病風險相關(自然流產:OR=1.21,95％ CI:1.05 ～ 1.41;人工流產:OR=1.23,95％ CI:1.07～1.43),而患兒齣生順序、孕婦分娩方式與急性白血病髮病風險無關(患兒齣生順序依次為2、3、≥4:OR=0.97,95％ CI:0.89 ～ 1.05、OR=1.00,95％ CI:0.91 ～ 1.11、OR=1.02,95％ CI:0.87 ～ 1.20;孕婦分娩方式:OR=1.05,95％CI:0.96 ～ 1.15).亞組分析進一步揭示,孕婦自然流產史和人丁流產史分彆與兒童急性髓性白血病(OR=1.71,95％ CI:1.09 ～2.70)、急性淋巴細胞白血病的髮病風險存在顯著關聯(OR=1.23,95％CI:1.05 ～ 1.42).結論 孕婦流產史可能是兒童急性白血病的危險因素,但仍需進一步驗證.
목적 종합평개환인출생순서、잉부유산사급분면방식여인동급성백혈병발병풍험지간적관계.방법 재PubMed、Google학술수색、중국지망(CNKI)、만방수거고중이“childhoodleukemia"、“acute lymphoblastic leukemia"、“acute myeloid leukemia"、“birth order"、“abortion”、“miscarriage”、“caesarean”、“birth characteristics”、“prenatal risk factor”혹기대응적중문사목위검색사,수집2013년3월전유관환인출생순서、잉부유산사급분면방식여인동급성백혈병발병풍험지간관계적대렬연구화병례대조연구,채용Stata연건진행Meta분석.결과 공납입상관문헌23편.잉부유산사여급성백혈병발병풍험상관(자연유산:OR=1.21,95％ CI:1.05 ～ 1.41;인공유산:OR=1.23,95％ CI:1.07～1.43),이환인출생순서、잉부분면방식여급성백혈병발병풍험무관(환인출생순서의차위2、3、≥4:OR=0.97,95％ CI:0.89 ～ 1.05、OR=1.00,95％ CI:0.91 ～ 1.11、OR=1.02,95％ CI:0.87 ～ 1.20;잉부분면방식:OR=1.05,95％CI:0.96 ～ 1.15).아조분석진일보게시,잉부자연유산사화인정유산사분별여인동급성수성백혈병(OR=1.71,95％ CI:1.09 ～2.70)、급성림파세포백혈병적발병풍험존재현저관련(OR=1.23,95％CI:1.05 ～ 1.42).결론 잉부유산사가능시인동급성백혈병적위험인소,단잉수진일보험증.
Objective To evaluate the associations between birth order,maternal abortion and mode of delivery and childhood acute leukemia risk.Method Multiple electronic databases were searched to identify relevant studies up to March 2013 using the search terms " childhood leukemia"," acute lymphoblastic leukemia"," acute myeloid leukemia"," birth order"," abortion "," miscarriage ","cesarean","birth characteristics" and "prenatal risk factor".Data from cohort and case-control studies were analyzed using the Stata software.Result Twenty-three studies were included in this meta-analysis according to the selection criteria.No significant associations were identified for birth order and mode of delivery (birth order =2:OR =0.97,95％ CI:0.89-1.05 ; birth order =3:OR =1.00,95％ CI:0.91-1.11 ; birth order ≥4:OR =1.02,95％ CI:0.87-1.20; mode of delivery:OR =1.05,95％ CI:0.96-1.15).However,there was a significant association between maternal abortion and childhood acute leukemia risk (spontaneous abortion:OR =1.21,95％ CI:1.05-1.41 ; induced abortion:OR =1.23,95％ CI:1.07-1.43).Furthermore,the stratified analysis by disease subtypes showed that spontaneous and induced abortions were significantly associated with the risks of childhood acute myeloid leukemia (OR =1.71,95％ CI:1.09-2.70) and acute lymphoblastic leukemia (OR =1.23,95％ CI:1.05-1.42),respectively.Conclusion This meta-analysis revealed that maternal abortion might contribute to the childhood acute leukemia risk.
