护理SCI晨读：集中妊娠方案对孕产分娩结局的有效性：系统评价和荟萃分析
世界卫生组织强调了产前保健在实现减少儿童和孕产妇死亡率的千年发展目标中的关键作用。
集中妊娠方案对孕产分娩结局的有效性：系统评价和荟萃分析
分享智慧
共同成长
摘要
背景
世界卫生组织强调了产前保健在实现减少儿童和孕产妇死亡率的千年发展目标中的关键作用。CenteringPregnancy计划是公认的产前护理模式。有几个国家试图在产前保健实践中实施该方案。但是，其对产妇和分娩结局的有效性尚未得到系统的评估和分析。
目标
确定CenteringPregnancy计划对改善孕产妇和分娩结果（包括低出生体重，早产和产后抑郁）的影响。
设计
这项研究通过比较CenteringPregnancy计划与产科领导的产前检查来评估和分析随机对照试验。感兴趣的产妇和分娩结果包括低出生体重，早产和产后抑郁症状。
数据源
该系统评价使用了Embase，PubMed，CINAHL，Web of Science和Cochrane数据库。此外，还补充检索Google Scholar以捕获所有相关文章。
方法
所有数据均由两名训练有素的研究人员独立提取，使用Cochrane随机对照试验偏倚风险评估工具，检查偏倚的风险来评估研究的质量。使用Review Manager对符合条件的随机对照试验进行荟萃分析。使用I 2统计量评估研究的异质性。
结果
在591篇文章中，纳入7项随机对照试验。研究结果表明，CenteringPregnancy计划与早产率较低（0.88 [0.71-1.07]，p = 0.20，I 2 = 0％），低出生体重（0.87 [0.68–1.12]，p = 0.29，I），2 = 0％）或产后12个月的抑郁症状（0.07 [-0.12-0.26]，p = 0.46，I 2 = 69％）无关。但是，CenteringPregnancy程序与6个月的产后抑郁症状发生率降低相关（0.49 [0.40-0.59]，p <0.01，I 2 = 40％）。
结论
现有证据表明，CenteringPregnancy计划和产科领导护理对降低早产和低出生体重的影响相似，但对产后抑郁症状的影响不同。需要更多的研究来检验CenteringPregnancy计划对改善产后抑郁症状的影响
Abstract
Background
The World Health Organization has emphasized the critical role of prenatal care in achieving the Millennium Development Goals to reduce child and maternal mortality. The CenteringPregnancy program is a widely recognized model of prenatal care. Several countries have attempted to implement the program in prenatal care practice; however, its effectiveness on maternal and birth outcomes has not been systematically evaluated and analyzed.
Objectives
To determine the effect of the CenteringPregnancy program on improving maternal and birth outcomes, including low birth weight, preterm birth, and postpartum depression.
Design
This study evaluated and analyzed randomized controlled trials by comparing the CenteringPregnancy program with obstetric led prenatal care. Maternal and birth outcomes of interest included low birthweight, preterm birth, and postpartum depressive symptoms.
Data Sources
Embase, PubMed, CINAHL, Web of Science, and The Cochrane Library were utilized in this systematic review. Additionally, a supplemental Google Scholar search was performed to capture all relevant articles.
Methods
All data were extracted independently by two trained researchers, who evaluated the quality of the study by examining the risk of bias. The biases of selection, allocation, measurement, reporting, and loss of follow-up were assessed using the Cochrane risk of bias for these included randomized controlled trials. A meta-analysis of eligible randomized controlled trials was conducted using Review Manager. Heterogeneity of studies was assessed using the I2 statistic.
Results
Out of 591 articles reviewed, seven randomized controlled trials were included in this study. Findings showed that the CenteringPregnancy program was not associated with lower rates of preterm birth (0.88 [0.71–1.07], p = 0.20, I2 = 0%), low birth weight (0.87 [0.68–1.12], p =0.29, I2 = 0%), or 12-month postpartum depressive symptoms (0.07 [-0.12–0.26], p =0.46, I2 = 69%). However, the CenteringPregnancy program was associated with reduced rates of 6-month postpartum depressive symptoms (0.49 [0.40–0.59], p < 0.01, I2 = 40%).
Conclusions
Existing evidence suggests that the CenteringPregnancy program and obstetric led care have similar effects on reducing the rates of preterm birth and low birth weight but different effects on postpartum depressive symptoms. More studies are needed to examine the effect of the CenteringPregnancy program on the improvement of postpartum depressive symptoms.
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