妊娠期母体感染筛查以预防早产：一项系统综述。
完整摘要 · 中文译文
目的：分析妊娠期母体感染筛查以预防早产是否与早产减少相关。 数据来源：进行了一项系统评价。检索了PubMed、Scopus、Cochrane Library和ProQuest数据库中针对孕妇开展的原始研究，并使用与妊娠、感染筛查和早产相关的医学主题词（MeSH）及自由文本关键词。 研究选择：纳入了评估产前母体生殖道或泌尿道感染筛查、将筛查人群与未进行额外针对性感染筛查的常规护理进行比较，并报告早产（<37周）或相关产科结局的随机研究和观察性研究。 数据收集：研究筛选和资料提取由两名审阅者独立完成。 数据综合：在获得的858条记录中，10项研究符合纳入标准。这些研究筛查了多种生殖道和泌尿道感染。针对未选择产前人群的效应估计大多无显著意义。然而，在选定或高危人群中进行母体感染筛查，以及针对未产妇中筛查细菌性阴道病（BV）或沙眼衣原体/淋病奈瑟菌（CT/NG）的亚组分析与早产减少相关。人群、研究地点、目标感染和筛查方案存在显著异质性，限制了研究间的直接比较。 结论：在未选择的孕妇人群中进行产前感染筛查并未显著降低早产率。 如何显著降低早产率。然而，在特定人群或高风险人群中观察到了更有利的结果，尽管总体效果存在异质性。需要在明确界定的目标人群中开展进一步设计良好的研究，以确定常规实践中的最佳筛查策略。PROSPERO注册号：CRD420251244205。
完整摘要 · 英文原文
OBJECTIVE: To analyze whether screening for maternal infections during pregnancy to prevent premature birth is associated with a reduction in premature birth. DATA SOURCES: A systematic review was conducted. PubMed, Scopus, Cochrane Library and ProQuest databases were screened for original studies carried out on pregnant women and used Medical Subject Headings (MeSH) terms and free-text keywords related to pregnancy, infection screening, and preterm birth. SELECTION OF STUDIES: Randomized and observational studies that evaluated antenatal screening for maternal genital or urinary infections, compared screened populations with usual care without additional targeted infection screening, and reported preterm birth (<37 weeks) or related obstetric outcomes were included. DATA COLLECTION: Study selection and extraction were performed independently by two reviewers. DATA SYNTHESIS: Out of 858 records obtained, 10 studies met the inclusion criteria. These studies screened for various genital and urinary infections. The effect estimates for the unselected antenatal populations were mostly not significant. Nevertheless, maternal infection screening in selected or high-risk populations and subgroup analyses among nulliparous women screened for bacterial vaginosis (BV) or Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG) was associated with reduction in preterm birth. Marked heterogeneity in populations, settings, target infections, and screening protocols limited direct comparison across studies. CONCLUSION: Antenatal infection screening in unselected pregnant populations did not show a significant reduction in preterm birth. However, more favourable findings were observed in selected or high-risk populations, although overall effects are heterogeneous. Further well-designed studies in clearly defined target populations are needed to define optimal screening strategies for routine practice.PROSPERO registration number: CRD420251244205.