ارتباط بین آلودگی هوا و پرهاکلامپسی با فشار خون بارداری: یک مطالعه مرور سیستماتیک

نوع مقاله : مروری

نویسندگان

1 دانشجوی کارشناسی ارشد مامایی، کارگروه دانشجویی مرکز تحقیقات توسعه اجتماعی و ارتقاء سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی گناباد، گناباد، ایران.

2 دانشجوی کارشناسی تغذیه، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران.

3 استادیار گروه مامایی، مرکز تحقیقات توسعه اجتماعی و ارتقاء سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی گناباد، گناباد، ایران.

چکیده

مقدمه: تأثیر آلودگی هوا بر فشارخون بارداری و پره­اکلامپسی در تعدادی از مطالعات بیان شده است. قرار گرفتن در معرض آلاینده‌های هوا با پیامدهای نامطلوب مادری و جنینی همراه است. مطالعه مروری حاضر با هدف تعیین ارتباط بین آلودگی هوا و فشارخون بارداری با پره­اکلامپسی انجام شد.
روش‌کار: در این مطالعه مرور سیستماتیک جهت دستیابی به مطالعات مرتبط پایگاه‌های اطلاعاتی انگلیسی Pubmed، Scopus، Embase، Cochrane library و Web of science از ابتدای 2014 تا 31 دسامبر 2019 با کلیدواژه‌های انگلیسی آلودگی هوا و فشارخون بارداری و پره‌اکلامپسی با همه ترکیبات احتمالی مورد جستجو قرار گرفتند. معیارهای ورود به مطالعه شامل: مقالات کوهورت یا مورد شاهدی، جامعه هدف زنان باردار، در نظر گرفتن یکی از آلاینده‌های هوا و ارتباط آن با پره‌اکلامپسی یا فشار خون بارداری و معیارهای خروج از مطالعه شامل: مطالعات مروری و متاآنالیز، بررسی حیوانی و ژنی بود. ارزیابی کیفیت مقالات با استفاده از چک‌لیست استروب صورت گرفت.
یافته‌ها: از مجموع 581 مقاله، 21 مقاله که دارای معیار ورود به مطالعه بودند، مورد بررسی قرار گرفتند. 8 مطالعه فقط فشارخون بارداری و 5 مطالعه پره­اکلامپسی و 8 مطالعه هر دو را به‌عنوان پیامد در نظر گرفته‌اند. هر یک از این مطالعات طیفی از آلاینده‌ها را به‌عنوان در معرض قرار گرفتن در نظر گرفته و ارتباط آنها را با فشارخون بارداری و یا پره­اکلامپسی سنجیده بودند که 18 مقاله کیفیت خوب و عالی و 3 مقاله کیفیت ضعیف داشت. 8 مطالعه فشارخون بارداری را تنها به‌عنوان پیامد و 4 مطالعه تنها پره‌‌اکلامپسی را به‌عنوان پیامد گزارش کرده و 9 مطالعه هر دو پیامد را بررسی نموده‌اند.
نتیجه‌گیری: اکثر مطالعات حاکی از ارتباط آلودگی هوا با فشارخون بارداری یا پره‌اکلامپسی بودند. تعدادی از مطالعات نتایج ضدونقیضی در مورد اثر برخی آلاینده‌های هوا با پره‌اکلامپسی یا فشارخون بارداری گزارش کردند، از این رو پیشنهاد می‌شود که مطالعات کوهورت یا مورد شاهدی بیشتری در این زمینه در کشورهای مختلف جهان، بالاخص ایران انجام شود.

کلیدواژه‌ها

عنوان مقاله [English]

The relationship between air pollution and preeclampsia with gestational hypertension; A systematic review

نویسندگان [English]

  • Masuomeh fayazi 1
  • Rasol Rahmani 2
  • Roghaieh rahmany bilandi 3
1 M.Sc. student of midwifery, Student workgroup of Social Determinants of Health Research Center, Faculty of medicine, Gonabad University of Medical Sciences, Gonabad, Iran.
2 B.Sc. student of nutrition, Student Research Committee, Faculty of medicine, Zahdan University of Medical Sciences, Zahdan, Iran.
3 Assistant professor, Department of Midwifery, Social Development and Health Promotion Research Center, Faculty of medicine, Gonabad University of Medical Sciences, Gonabad, Iran.
چکیده [English]

Introduction: The effects of air pollution on gestational hypertension and preeclampsia have been reported in a number of studies. Exposure to air pollutants is associated with adverse maternal and fetal consequences. In the present study, we conducted a systematic review on the relevant studies with the aim of determining the relationship between air pollution and gestational hypertension or preeclampsia.
Methods: In this study, a review systematic was conducted to obtain relevant studies from the English databases Pubmed, Scopus, Web of science, , Cochrane library, Embase from the beginning of 2014 to the end of31 december 2019 with English keywords air pollution,hypertension during pregnancy and preeclampsia with all possible search combinations. Inclusion criteria: Cohort or case control articles, the target population of pregnant women, is considered one of the air pollutants and its relationship with preeclampsia or gestational hypertension. Exclusion criteria: review and meta-analysis, animal and genetic studies The quality of the articles was evaluated using the Strobe checklist.
Results: out of 581 articles, 21 articles that had inclusion criteria were examined. 8 studies considered gestational hypertension only, 5 studies considered preeclampsia, and 8 studies both considered outcome. Each of these studies has considered a range of pollutants to be exposed and their relationship to pregnancy inducted hypertension or preeclampsia were investigated. Which had 18 articles good and excellent quality and 3 articles poor quality.8 studies reported gestational hypertension as outcome, 4 studies reported preeclampsia alone, and nine studies examined both outcomes.
Conclusion: The results ofmost studies showned association between gestational hypertension or preeclampsia. While a number of studies have reported conflicting results on the effect of some air pollutants with preeclampsia or hypertension during pregnancy(HDP).Therefore, it is suggested that further cohort or case control studies be conducted in this area, in different countries around the world.

کلیدواژه‌ها [English]

  • peragnancy
  • air pollution
  • hypertension during pregnancy
  • preeclampsia
  • systematic review

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مجله زنان، مامایی و نازایی ایران
دوره 23، شماره 9
آذر 1399
صفحه 95-107

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