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目的:探讨单脐动脉与胎儿先天异常的关系,为临床胎儿取舍决策的制定提供依据。方法:利用Meta分析方法综合分析1995年至今有关单脐动脉与胎儿先天异常的分析性研究文献11篇。结果:单脐动脉合并先天畸形的发生率25.6%,对照组先天畸形发生率9.7%,单脐动脉与胎儿发生结构畸形的危险性增加有关〔合并OR=3.59,95%CI(2.77,4.66),Z=9.62,P<0.00 001〕。单脐动脉合并染色体异常的发生率为14.0%,对照组染色体异常率1.3%,单脐动脉与胎儿染色体异常的危险性增加有关〔合并OR=8.89,95%CI(2.88,27.49),Z=3.80,P=0.0 001〕。没有足够证据表明孤立单脐动脉增加小于胎龄儿及新生儿肾脏超声异常发生的危险性(P>0.05)。结论:单脐动脉组胎儿发生先天畸形及染色体异常的危险性高于正常脐带组胎儿,现有资料尚不能证明孤立单脐动脉可以改变胎儿的预后,仍需要大量的研究进行更深入的探索。
Objective: To explore the relationship between single umbilical artery and congenital anomalies of the fetus, and provide the basis for the formulation of clinical fetus decision-making. Methods: Meta-analysis was used to comprehensively analyze 11 analytical literatures about unilateral umbilical artery and fetal congenital anomalies from 1995 to the present. Results: The incidence of congenital malformations in single umbilical artery was 25.6%, and the incidence of congenital malformations in control group was 9.7%. The single umbilical artery was associated with an increased risk of structural deformity (OR = 3.59, 95% CI 2.77, 4.66) , Z = 9.62, P <0.00 001]. The incidence of chromosomal abnormalities was 14.0% in single umbilical artery and 1.3% in control group. The unilateral umbilical artery was associated with increased risk of fetal chromosomal abnormality (OR = 8.89, 95% CI 2.88, 27.49), Z = 3.80, P = 0.0 001]. There is not enough evidence to show that isolated single umbilical artery increases the risk of sonographic abnormalities smaller than gestational age and neonate (P> 0.05). CONCLUSION: There is a higher risk of congenital malformations and chromosomal abnormalities in fetuses with single umbilical artery. Compared with normal umbilical cord fetuses, the existing data can not prove that isolated umbilical arteries can change the prognosis of fetuses. Therefore, a large amount of researches are needed to explore more deeply.