Routine Antenatal Anti-D Prophylaxis in Women Who Are Rh(D) Negative Meta-Analyses Adjusted for Differences in Study Design and Quality 英文参考文献.docVIP

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Routine Antenatal Anti-D Prophylaxis in Women Who Are Rh(D) Negative Meta-Analyses Adjusted for Differences in Study Design and Quality 英文参考文献.doc

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Routine Antenatal Anti-D Prophylaxis in Women Who Are Rh(D) Negative Meta-Analyses Adjusted for Differences in Study Design and Quality 英文参考文献

RoutineAntenatalAnti-DProphylaxisinWomenWho AreRh(D)Negative:Meta-AnalysesAdjustedfor DifferencesinStudyDesignandQuality RebeccaM.Turner1*,MyfanwyLloyd-Jones2,DillyO.C.Anumba3,GordonC.S.Smith4,DavidJ. Spiegelhalter1,5,HazelSquires2,JohnW.Stevens6,MichaelJ.Sweeting1,StanislawJ.Urbaniak7 ,Robert Webster8,SimonG.Thompson9 1MedicalResearchCouncilBiostatisticsUnit,InstituteofPublicHealth,Cambridge,UnitedKingdom,2HealthEconomicsandDecisionScience,UniversityofSheffield, Sheffield, United Kingdom, 3Academic Unit of Reproductive and Developmental Medicine, The University of Sheffield Medical School, Sheffield, United Kingdom, 4DepartmentofObstetricsandGynaecology,UniversityofCambridge,Cambridge,UnitedKingdom,5StatisticalLaboratory,UniversityofCambridge,Cambridge,United Kingdom,6CentreforBayesianStatisticsinHealthEconomics,UniversityofSheffield,Sheffield,UnitedKingdom,7AcademicTransfusion MedicineUnit,Universityof Aberdeen, Foresterhill, United Kingdom, 8National Blood Service Sheffield Centre, National Health Service Blood and Transplant, Sheffield, United Kingdom, 9DepartmentofPublicHealthandPrimaryCare,UniversityofCambridge,Cambridge,UnitedKingdom Abstract Background:Toestimatetheeffectivenessofroutineantenatalanti-Dprophylaxisforpreventingsensitisationinpregnant Rhesusnegativewomen,andtoexplorewhetherthisdependsonthetreatmentregimenadopted. Methods: Ten studies identified in a previous systematic literature search were included. Potential sources of bias were systematicallyidentifiedusingbiaschecklists,andtheirimpactanduncertaintywerequantifiedusingexpertopinion.Study resultswereadjustedforbiasesandcombined,firstinarandom-effectsmeta-analysisandtheninarandom-effectsmeta- regressionanalysis. Results:Inaconventionalmeta-analysis,thepooledoddsratioforsensitisationwasestimatedas0.25(95%CI0.18,0.36), comparingroutineantenatalanti-Dprophylaxistocontrol,withsomeheterogeneity(I2=19%).However,thisna?¨veanalysis ignoressubstantialdifferencesinstudyqualityanddesign.Aftera