| Objective:to systematically evaluate the effects of environmental endocrine disrupting chemicals(EEDs)on recurrent spontaneous abortion.Methods:Pubmed,Webof Science,Google retrieval,academic Chinese HowNet and VIP and Wanfang database using computer,supplemented by manual retrieval,the retrieval time for the January 1,2000-2017 year in May 1st,included in the patients with unexplained recurrent spontaneous abortion:and the occupation exposure of patients,analysis of the impact of environmental endocrine disruptors on recurrent spontaneous abortion.According to the Meta analysis of the previous report,the selected papers were collated and analyzed,using Revmam5.3 software for statistical analysis.The selected article data will statistics with heterogeneity test,12 test was used for qualitative and quantitative evaluation of the heterogeneity between different studies;on the numerical data using standardized mean difference with statistics,select the fixed effects model,the value of OR and 95%CI were calculated by the inverse variance method for two classification;variable with fixed effect model to analyze and calculate the value of OR and 95%CI by Mantel-Haenszel,and the forest plot.Publicationbias funnel plot was used to determine the sensitivity analysis by changing the type of research into the standard,excluding design department strict research judgment,can use different statistical methods to analysis the data.Result:1.through the retrieval of the database,a total of 1422 key words were retrieved,of which 911 were Chinese and 511 were english.Then,through reading the literature summary method,the above documents were screened out,and the 903 literatures were excluded,which were not in accordance with the inclusion criteria,the literature was repeated,and the data were cross referenced.Then,the remaining literature was re screened,read the full text,excluding incomplete data,and 509 articles that met the exclusion criteria.At last,10 remaining literatures met the requirements of this study and were included in the study.Among them,there are 5 Chinese literature and 5 English literature.2.10 literatures were evaluated by NOS quality evaluation scale,and the scores were over 5 points,which met the requirements of Meta analysis standard.According to the PRISMA specification,the level of evidence for this study was III.The results of the literature bias assessment showed that none of the references mentioned these reports and did not report any sources of bias.Literature quality evaluation:the diagnosis and definition of case group in the control group were correct and definite.All the literatures in the study were comparable between the case group and the control group.The average age of the subjects was less than 40 years old,and the quality of the documents was relatively high.Among them,URSA group and EEDs exposure level research 5,see Table 1,EEDs occupational exposure and spontaneous abortion situation 5,see table 2.3 a total of 5 articles reporting the relationship between the exposure of URSA group and EEDs URSA group,a total of 357 cases,a total of 519 cases of the control group,the results are the same(P=0.41),Meta analysis of the literature using fixed effect model,URSA group EEDs exposure was significantly higher than the normal pregnancy group,and the difference was statistically significant(Z=7.50,OR=0.54,95%CI0.40-0.68,P<0.001).A total of 5 articles were reported on the relationship between EEDs occupational exposure group and spontaneous abortion.The total number of pregnancies in the exposed group was 3323,while the unexposed group was not 5469 times pregnant.Have the homogeneity between(P=0.09),Meta analysis of the literature using fixed effect model,EEDs occupation exposure associated with spontaneous abortion,EEDs occupation exposure is a risk factor for spontaneous abortion(Z=5.04,OR=1.77,95%CI1.42-2.21,P<0.001)4.funnel plots were used to analyze bias between EEDs and URSA correlations(Figure 3)and EEDs occupational exposures to spontaneous abortions(Figure 4),and the funnel plots were basically symmetric.Conclusion:1.EEDs is closely related to the pathogenesis of URSA and is an important pathogenic factor of URSA.It can lead to an increase in the incidence of URSA.2.Fertility groups should avoid contact with EEDs during pregnancy and during pregnancy to reduce adverse effects. |
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