النتائج السلبية للحمل لدى النساء المصابات بمرض الكلى المزمن: مراجعة منهجية محدثة وتحليل تلوي

المؤلفون

  • بسمة ابوصلاح قسم أمراض النساء والتوليد، كلية الطب البشري، جامعة صبراتة، صبراتة، ليبيا
  • سجى أبوصلاح قسم الطب الباطني، مستشفى صبراتة التعليمي، صبراتة، ليبيا.

الكلمات المفتاحية:

التحليل التلوي لمرض الكلى المزمن، الحمل، تسمم الحمل، الولادة المبكرة

الملخص

      يُعد مرض الكلى المزمن (CKD) شائعًا بشكل متزايد لدى النساء في سن الإنجاب، وتأثيره على الحمل يستدعي تقديرًا كميًا محدثًا. تم البحث في قواعد بيانات PubMed، وWeb of Science، وScopus، والسجل المركزي للتجارب المحكمة التابع لمؤسسة كوكرين (Cochrane Central Register of Controlled Trials) منذ 1 يناير 2023، مع توسيع نطاق المراجعة المرجعية السابقة دون قيود لغوية. شملت الدراسة الدراسات الرصدية التي قارنت النتائج الأمومية ونتائج الفترة المحيطة بالولادة بين النساء المصابات بمرض الكلى المزمن والنساء غير المصابات به. قام مراجعان بشكل مستقل بفحص الدراسات واستخلاص البيانات. تم دمج نسب الأرجحية (OR) مع فواصل الثقة بنسبة 95% (CI) باستخدام نماذج التأثيرات العشوائية (DerSimonian and Laird). تم تضمين خمس وعشرين دراسة (ست دراسات جديدة و19 دراسة من المراجعة الأصلية). ارتبط مرض الكلى المزمن بزيادة احتمالية حدوث جميع النتائج السلبية، بما في ذلك تسمم الحمل (OR 5.77، فاصل الثقة 95%: 3.53 إلى 9.44)، والولادة المبكرة قبل 34 أسبوعًا (OR 7.27، 4.83 إلى 10.95)، وارتفاع ضغط الدم الحملي (OR 4.63، 2.78 إلى 7.68)، ودخول حديثي الولادة إلى وحدة العناية المركزة (OR 4.10، 2.50 إلى 6.73)، والولادة المبكرة قبل 37 أسبوعًا (OR 3.46، 2.60 إلى 4.61)، والأطفال صغار الحجم بالنسبة لعمر الحمل (OR 2.48، 1.86 إلى 3.30)، ووفيات الفترة المحيطة بالولادة (OR 2.40، 1.51 إلى 3.81)، والولادة القيصرية (OR 1.75، 1.54 إلى 1.99). وكانت المخاطر أكبر لدى النساء المصابات بمرض الكلى السكري. يزيد مرض الكلى المزمن بشكل كبير من احتمالية حدوث النتائج السلبية لدى الأمهات وحديثي الولادة، ويجب التعامل معه كحالة حمل عالية الخطورة مع تقديم استشارات منظمة قبل الحمل ورعاية متعددة التخصصات.

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التنزيلات

منشور

2026-09-20

كيفية الاقتباس

بسمة ابوصلاح, & سجى أبوصلاح. (2026). النتائج السلبية للحمل لدى النساء المصابات بمرض الكلى المزمن: مراجعة منهجية محدثة وتحليل تلوي. مجلة الأكاديمية الليبية بني وليد (JLABW) , 2(5), 53–75. استرجع في من https://journals.labjournal.ly/index.php/Jlabw/article/view/686

إصدار

القسم

العلوم التطبيقية