Meta AnalysisID 1764
有宫颈环扎指征的妇女辅助使用17-羟孕酮己酸酯与单纯环扎的比较：一项系统评价与Meta分析
CRD42018094559
In pregnant women with a history-indicated cerclage (population), is 17 hydroxyprogesterone plus cerclage (intervention) more effective than cerclage alone (comparator) for the prevention of preterm birth? (outcome).
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Record Fields
Scalar fields from the final meta_analysis record.
- Meta Analysis Id
- 1764
- Evidence Id
- 10322
- Core Evidence Id
- 10322
- Source Meta Analysis Id
- 1710
- Herb2 Meta Analysis Id
- HBMA001710
- Crd Id
- CRD42018094559
- Title
- Adjuvant administration of 17-hydroxyprogesterone caproate in women with history-indicated cerclage compared to cerclage alone: a systematic review and meta-analysis
- Review Question
- In pregnant women with a history-indicated cerclage (population), is 17 hydroxyprogesterone plus cerclage (intervention) more effective than cerclage alone (comparator) for the prevention of preterm birth? (outcome).
- Study Type Included
- Randomized controlled trials, retrospective cohort, prospective cohort studies.
- Condition Being Studied
- Preterm birth is a major public health problem, and is the leading cause of infant mortality in high and low income countries. Its effects extend beyond birth, as it is a major cause of morbidity in children; moreover, it affects families, healthcare systems and economies. 17 alpha hydroxyprogesterone caproate adjunct in patients with a history-indicated cerclage is thought to increase the efficacy of the cerclage compared to cerclage alone, but this has not been consistently shown in observational studies. Hence, the need to do this review.
- Participant
- Inclusion: Studies of women with a past history of spontaneous preterm birth s/p history indicated cerclage alone, or in combination with 17 hydroxyprogesterone caproate. Exclusion: ultrasound indicated cerclage, exam indicated cerclage.
- Animal
- Human Disease Modelled
- Intervention
- Inclusion: Any combination of 17alpha –hydroxyprogesterone caproate and history-indicated cerclage Exclusion: Rescue (or emergency) cerclage (cervix already dilated with or without membranes bulging through external os); Interventions for secondary prevention of preterm birth in women with contractions (i.e., tocolysis).
- Comparator Control
- History-indicated cerclage alone.
- Main Outcome
- Preterm birth <34 weeks of gestation.
- Outcome Measure
- Additional Outcome
- Maternal secondary outcomes include: preterm birth less than 37 weeks of gestation, preterm birth less than 24 weeks of gestation, maternal mortality, length of inpatient antepartum stay, number of outpatient visits, Caesarean section, preterm premature rupture of membranes (PPROM), chorioamnionitis and intervention side effects (e.g., infection, vaginal discharge, bleeding, fever, repositioning or removal of pessary). Infant secondary outcomes include: preterm birth (any other cut-off week), gestational age at birth, birth weight, low birth weight, small for gestational age, congenital anomalies, masculinization of the female fetus, mortality (i.e., miscarriage, stillbirth/intrauterine demise, neonatal death, perinatal death), low Apgar score at 5 minutes, umbilical cord pH &lt; 7.10, respiratory problems,(Respiratory distress syndrome [RDS], mechanical ventilation, Continuous positive airway pressure (CPAP), Bronchopulmonary dysplasia) intraventricular haemorrhage (Grades III/IV and I-IV), cystic periventricular leukomalacia (injury to the white matter of the brain adjacent to the ventricles that results in cysts/holes), necrotizing enterocolitis (Stages II/III), retinopathy of prematurity (Stages III-V or treatment and I-V or treatment [laser or injection]), sepsis, admission and length of stay in neonatal intensive care unit or special care unit, or any composite outcomes reported by the primary studies. Long term secondary outcomes include: neurological deficits (e.g. cerebral palsy, hearing and/or sight difficulties, seizures), developmental delays (e.g. abnormal Bayley scores [Bayley Scales of Infant Development] and other forms of motor, language and cognitive delays), learning disabilities (behavioural problems (e.g. Attention deficit hyperactivity disorder [ADHD]), problems with physical development (e.g. failure to thrive/poor growth: height, weight or, head circumference).
- Study Method
- Meta-analysis, Systematic review
- Keyword
- 17-alpha-Hydroxyprogesterone; Adjuvants, Immunologic; Adjuvants, Pharmaceutic; Caproates; Female; Humans; Hydroxyprogesterones; hexanoic acid
- Contact
- Ahizechukwu Eke [email protected]
- Organisational Affiliation
- Johns Hopkins University School of Medicine https://www.hopkinsmedicine.org/gynecology_obstetrics/specialty_areas/maternal_fetal_medicine/our_team.html
- Funding Source
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- Country
- United States of America
- Review Stage
- Review Ongoing
- First Submission Date
- 2018-04-22
- Registration Date
- 2018-05-09
- Anticipated Start Date
- 2018-04-24
- Anticipated Completion Date
- 2018-05-24
- Title Cn
- 有宫颈环扎指征的妇女辅助使用17-羟孕酮己酸酯与单纯环扎的比较：一项系统评价与Meta分析
- Title En
- Adjuvant administration of 17-hydroxyprogesterone caproate in women with history-indicated cerclage compared to cerclage alone: a systematic review and meta-analysis
- Bilingual Status
- complete