-
Galen Medical Journal 2019Female genital mutilation (FGM) is a general health concern. The World Health Organization has recognized it as a condition that endangers women's health. This review... (Review)
Review
Female genital mutilation (FGM) is a general health concern. The World Health Organization has recognized it as a condition that endangers women's health. This review study aimed to identify the types of health outcomes of FGM. Therefore, a systematic review was conducted to create a critical view of the current evidence on the effect of Female genital on girls and women's health. In this study, we focused on the health risks of female Female genital. Academic databases such as PubMed, Science Direct, Scopus, Google Scholar, Cochrane Database of Systematic Reviews, SID, IranMedex, Irandoc, and Magiran were searched with regard to the health consequences of FGM from January 1990 until 2018. Eleven review studies met the criteria and contained 288 relevant studies on the risks of FGM. It was suggested that FGM had various physical, obstetric, sexual, and psychological consequences. Women with FGM experienced mental disturbances (e.g., psychiatric diagnoses, anxiety, somatization, phobia, and low self-esteem) than other women. Our study can provide evidence on improving, changing behaviors, and making decisions on the quality of services offered to women suffering from FGM.
PubMed: 34466496
DOI: 10.22086/gmj.v8i0.1336 -
BMC Public Health May 2023Exclusive breastfeeding is a public health priority in sub-Saharan Africa. However, systematic reviews on its determinants in Ghana remain scarce. Therefore, we... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Exclusive breastfeeding is a public health priority in sub-Saharan Africa. However, systematic reviews on its determinants in Ghana remain scarce. Therefore, we systematically reviewed the prevalence and determinants of exclusive breastfeeding in children 0-6 months in Ghana.
METHODS
We conducted systematic searches in Embase, Medline, and Africa-Wide Information from the databases' inception until February 2021 for studies that assessed the prevalence and determinants of exclusive breastfeeding in children 0-6 months in Ghana. Random-effects meta-analysis was used to estimate the pooled prevalence of exclusive breastfeeding and narrative synthesis to summarise the determinants. We calculated the proportion of total variability that was due to between study heterogeneity using I² statistics, and Egger's test assessed publication bias. The review is registered with PROSPERO, CRD42021278019.
RESULTS
Out of the 258 articles identified, 24 met the inclusion criteria. Most of the included studies were cross-sectional and were published between 2005 and 2021. The pooled prevalence of exclusive breastfeeding (EBF) among children 0-6 months in Ghana was 50% (95%CI 41.0-60.0%). The prevalence was higher in rural areas (54%) than in urban areas (44%). Several factors were identified as facilitators of EBF, including older maternal age, self-employment, unemployment, living in a large house, being a house owner, giving birth in a health facility, non-caesarean delivery, adequate antenatal attendance, counselling services, participation in support groups, adequate knowledge about EBF, positive attitude towards EBF, and higher maternal education among rural dwellers. Additionally, having an average birthweight facilitated EBF. Barriers to EBF were also identified, including higher maternal education among urban dwellers, less than three months of maternity leave, maternal HIV-positive status, the experience of partner violence, lack of access to radio, inadequate breastmilk production, lack of family support, having a partner who wants more children, counselling on complementary feeding, healthcare worker recommendation of complementary feed, single marital status, and infant admission to neonatal intensive care units.
CONCLUSION
In Ghana, EBF rates are low, with only about half of all children aged 0-6 months breastfed exclusively. A multi-dimensional approach is required to tackle the diverse sociodemographic, obstetric, and infant-related issues that hinder EBF practice in Ghana.
Topics: Infant; Infant, Newborn; Child; Female; Humans; Pregnancy; Breast Feeding; Ghana; Prevalence; Mothers; Infant Nutritional Physiological Phenomena
PubMed: 37208682
DOI: 10.1186/s12889-023-15758-w -
BioMed Research International 2022This is the first meta-analysis that assessed the association between maternal smoking and the risk of placenta accreta spectrum (PAS), so this study was aimed at... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This is the first meta-analysis that assessed the association between maternal smoking and the risk of placenta accreta spectrum (PAS), so this study was aimed at investigating the association between maternal smoking and PAS based on observational studies. PAS is defined as a severe obstetric complication due to the abnormal invasion of the chorionic villi into the myometrium and uterine serosa.
METHODS
We searched electronic bibliographic databases including PubMed, Web of Science, Scopus, Science Direct, and Google Scholar until January 2022. The results were reported using a random effect model. The chi-square test and the statistic were used to assess heterogeneity. Egger's and Begg's tests were used to examine the probability of publication bias. All statistical analyses were performed at a significance level of 0.05 using Stata software, version 11.
RESULTS
Based on the random effect model, the estimated OR of the risk of PAS associated with smoking was 1.21 (95% CI: 1.02, 1.41; = 4.7%). Subgroup analysis was conducted based on study design, and the result showed that the association between smoking and PAS among cohort studies was significant 1.35 (95% CI: 1.15, 1.55; = 0.0%).
CONCLUSION
Our results suggested that maternal smoking is a risk factor for the PAS. There was no heterogeneity among studies that reported an association between smoking and the PAS. The Newcastle-Ottawa Scale (NOS) was used to measure study quality.
Topics: Chi-Square Distribution; Cohort Studies; Female; Humans; Observational Studies as Topic; Placenta Accreta; Pregnancy; Risk Factors; Smoking
PubMed: 35860796
DOI: 10.1155/2022/2399888 -
PloS One 2023Homebirth preference is the intention/plan to give birth outside health facilities with the help of unskilled birth attendants. The preference to give birth at home... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Homebirth preference is the intention/plan to give birth outside health facilities with the help of unskilled birth attendants. The preference to give birth at home without a skilled birth attendant leads to care-seeking delays, intrapartum mortality, multiple stillbirths, and postpartum morbidities and mortality. Therefore, this study aimed to estimate the pooled prevalence of homebirth preference and associated factors among pregnant women in Ethiopia.
METHODS
Search of Google Scholar, Medline, PubMed, Cochrane Library and Web of Science were done for this study from 20th August 2022 to 6th November 2022. For data extraction and analysis, the standardized data extraction checklist and Stata version 14 were used respectively. Sentence as "Cochrane Q test statistics and I2 statistics were used to check heterogeneity of the studies. The pooled prevalence of homebirth preference was estimated using a random-effects model. The association between homebirth preference and independent variables was determined using an odd ratio with a 95% confidence interval. A funnel plot and Egger's test were used to assess publication bias.
RESULTS
A total of 976 research articles were identified. Seven studies that fulfilled eligibility criteria were included in this systematic review and meta-analysis. The pooled prevalence of homebirth preference in Ethiopia was 39.62% (95% CI 27.98, 51.26). The current meta-analysis revealed that average monthly income <1800 ETB (OR = 2.66, 95% CI 1.44, 4.90) lack of ANC follow-up (OR = 2.57, 95%CI 1.32, 5.01), being multipara (OR = 1.77, 95%CI 1.39, 2.25), poor knowledge about obstetric danger sign (OR = 5.75, 95%CI 1.o2, 32.42), and not discussing the place of delivery with a partner (OR = 5.89 (95%CI 1.1, 31.63) were significantly associated with homebirth preference.
CONCLUSION
This systematic review and meta-analysis examined the substantial prevalence of homebirth preference in Ethiopia which may contribute maternal and child health crisis. The homebirth preference was associated with low average monthly income (<1800 ETB), lack of ANC follow-up, multipara, poor knowledge about obstetric danger signs, and not discussing with their partner the place of delivery. Improving knowledge of pregnant women about the benefit of health facility delivery and obstetric danger signs is necessary to decrease the prevalence of homebirth preference; for these can reduce negative outcomes occurred during delivery.
Topics: Child; Pregnancy; Female; Humans; Pregnant Women; Prevalence; Ethiopia; Parturition; Postpartum Period
PubMed: 37967092
DOI: 10.1371/journal.pone.0291394 -
Nursing Open Sep 2021This study aimed to evaluate the effect of prenatal aerobic exercises on maternal and neonatal outcomes. (Meta-Analysis)
Meta-Analysis Review
AIM
This study aimed to evaluate the effect of prenatal aerobic exercises on maternal and neonatal outcomes.
DESIGN
A systematic review and meta-analysis.
METHOD
A search was carried out in databases including PubMed, ProQuest, EMBASE, Cochrane Library, Scopus, Web of Science, Magiran and SID until 30 September 2020. Two reviewers independently assessed the articles for quality and risk of bias using the Cochrane handbook. The statistical heterogeneity was determined using the Cochran's Q test and Higgins' I coefficient.
RESULTS
Of the 2,790 extracted articles, 16 were included in this review. The results of the meta-analysis showed that prenatal exercise can increase the frequency of vaginal delivery significantly (RR: 1.24; 95% CI: 1.08-1.43), but had no statistically significant effect on other maternal and neonatal outcomes, such as first, second and third stages of labour, gestational age at birth, first and fifth-minute Apgar score, umbilical cord pH, neonatal weight, height and head circumference (p > .05).
CONCLUSIONS
The meta-analysis results suggested that prenatal exercise can reduce the frequency of caesarean section.
Topics: Cesarean Section; Delivery, Obstetric; Exercise; Female; Humans; Labor, Obstetric; Parturition; Pregnancy
PubMed: 33683833
DOI: 10.1002/nop2.838 -
Annals of Palliative Medicine Jul 2021The Plan-Do-Check-Act cycle (PDCA) (also known as the Daiming cycle) is widely used in surgical management and can standardize nursing management and improve nursing... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The Plan-Do-Check-Act cycle (PDCA) (also known as the Daiming cycle) is widely used in surgical management and can standardize nursing management and improve nursing quality. This meta-analysis evaluated the application of the PDCA cycle during nursing management following gynecological surgery.
METHODS
PubMed, Web of Science, Embase, CNKI, Wanfang, and other databases were searched for studies on applying the PDCA cycle in nursing management following gynecological and obstetric surgery. Articles published between 2013 to 2020 in English and Chinese were included. The obtained data are subjected to meta-analysis using Stata16.0 analysis software. Reported outcomes included: satisfaction with care, nursing quality evaluation, and assessments using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS).
RESULTS
A total of 14 articles were included, with a total of 1,629 participants. Meta-analysis showed that satisfaction with gynecological surgery nursing using PDCA cycle management in the intervention groups was higher than in the control groups, OR =6.57 (95% CI, 4.01, 10.76), P<0.001. The perception of nursing quality was higher in the intervention groups than in the control groups, SMD =4.98 (95% CI, 3.32, 6.64, P<0.001. SAS scores of the intervention groups were lower than that of the control groups, SMD =-2.22 (95% CI, -2.80, -1.65), P<0.001. SDS scores of the intervention groups were lower than that of the control groups, SMD =-2.37 (95% CI, -3.15, -1.60), P<0.001.
DISCUSSION
The application of PDCA cycle nursing management for gynecological surgery can significantly improve patients' satisfaction with nursing, including the quality of nursing. At the same time, it can effectively reduce the anxiety and depression of surgical patients, which benefits the surgery process. Given these benefits, it has a high likelihood of being incorporated into clinical practice.
Topics: Anxiety; Female; Gynecologic Surgical Procedures; Humans; Nursing Care; Patient Satisfaction
PubMed: 34353092
DOI: 10.21037/apm-21-1590 -
American Journal of Obstetrics &... Mar 2023Reduced fetal movement, defined as a decrease in the frequency or strength of fetal movements as perceived by the mother, is a common reason for presentation to... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Reduced fetal movement, defined as a decrease in the frequency or strength of fetal movements as perceived by the mother, is a common reason for presentation to maternity care. Observational studies have demonstrated an association between reduced fetal movement and stillbirth and fetal growth restriction related to placental insufficiency. However, individual intervention studies have described varying results. This systematic review and meta-analysis aimed to determine whether interventions aimed at encouraging awareness of reduced fetal movement and/or improving its subsequent clinical management reduce the frequency of stillbirth or other important secondary outcomes.
DATA SOURCES
Searches were conducted in MEDLINE, Embase, CINAHL, The Cochrane Library, Web of Science, and Google Scholar. Guidelines, trial registries, and gray literature were also searched. Databases were searched from inception to January 20, 2022.
STUDY ELIGIBILITY CRITERIA
Randomized controlled trials and controlled nonrandomized studies were eligible if they assessed interventions aimed at encouraging awareness of fetal movement or fetal movement counting and/or improving the subsequent clinical management of reduced fetal movement. Eligible populations were singleton pregnancies after 24 completed weeks of gestation. The primary review outcome was stillbirth; a number of secondary maternal and neonatal outcomes were specified in the review.
METHODS
Risk of bias was assessed using the Cochrane Risk of Bias 2 and Risk of Bias in Non-Randomized Studies I tools for randomized controlled trials and nonrandomized studies, respectively. Variation caused by heterogeneity was assessed using I. Data from studies employing similar interventions were combined using random effects meta-analysis.
RESULTS
A total of 1609 citations were identified; 190 full-text articles were evaluated against the inclusion criteria, 18 studies (16 randomized controlled trials and 2 nonrandomized studies) were included. The evidence is uncertain about the effect of encouraging awareness of fetal movement on stillbirth when compared with standard care (2 studies, n=330,084) with a pooled adjusted odds ratio of 1.19 (95% confidence interval, 0.96-1.47). Interventions for encouraging awareness of fetal movement may be associated with a reduction in neonatal intensive care unit admissions and Apgar scores of <7 at 5 minutes of age and may not be associated with increases in cesarean deliveries or induction of labor. The evidence is uncertain about the effect of encouraging fetal movement counting on stillbirth when compared with standard care with a pooled odds ratio of 0.69 (95% confidence interval, 0.18-2.65) based on data from 3 randomized controlled trials (n=70,584). Counting fetal movements may increase maternal-fetal attachment and decrease anxiety when compared with standard care. When comparing combined interventions of fetal movement awareness and subsequent clinical management with standard care (1 study, n=393,857), the evidence is uncertain about the effect on stillbirth (adjusted odds ratio, 0.86; 95% confidence interval, 0.70-1.05).
CONCLUSION
The effect of interventions for encouraging awareness of reduced fetal movement alone or in combination with subsequent clinical management on stillbirth is uncertain. Encouraging awareness of fetal movement may be associated with reduced adverse neonatal outcomes without an increase in interventions in labor. The meta-analysis was hampered by variations in interventions, outcome reporting, and definitions. Individual studies are frequently underpowered to detect a reduction in severe, rare outcomes and no studies were included from high-burden settings. Studies from such settings are needed to determine whether interventions can reduce stillbirth.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Stillbirth; Fetal Movement; Placenta; Maternal Health Services; Labor, Obstetric
PubMed: 36481411
DOI: 10.1016/j.ajogmf.2022.100821 -
Obstetrics and Gynecology International 2023We systematically identified the prevalence of triplex infections (combined human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV)) in... (Review)
Review
A Systematic Review and Meta-Analysis of the Prevalence of Triplex Infections (Combined Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus) among Pregnant Women in Nigeria.
OBJECTIVE
We systematically identified the prevalence of triplex infections (combined human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV)) in pregnancy.
METHODS
To gather information on the frequency of triplex infections, we searched the databases of PubMed, CINAHL, and Google Scholar. Without regard to language, we utilized search terms that covered HIV, HBV, HCV, and pregnancy. Pregnant women with triplex infections of HIV, HBV, and HCV were included in studies that also examined the prevalence of triplex infections. Review Manager 5.4.1 was employed to conduct the meta-analysis. Critical appraisal and bias tool risk data were provided as percentages with 95% confidence intervals (95% CIs), and was used as the statistical measure of heterogeneity. The checklist was created by Hoy and colleagues. The study protocol was registered on PROSPERO, under the registration number CRD42020202583.
RESULTS
Eight studies involving 5314 women were included. We identified one ongoing study. Pooled prevalence of triplex infections was 0.03% (95% CI: 0.02-0.04%) according to meta-analysis. Subgroup analysis demonstrated a significantly high prevalence of 0.08% (95% CI: 0.06-0.10%; 3863 women) in HIV-positive population than 0.00% (95% CI:-0.00-0.00; 1451 women; < 0.001) in general obstetric population. Moreover, there was a significant difference in the pooled prevalence between studies published between 2001 and 2010 and between 2011 and 2021 (0.14% (95% CI: 0.12 to 0.16 versus 0.03% (95% CI: 0.02 to 0.04%; < 0.001))) and participants recruited in the period between 2001 and 2011 and between 2012 and 2021 (0.13% (95% CI: 0.05 to 0.21; =0.002 versus 0.00% (95% CI: -0.00 to 0.00%; =1.00))), respectively.
CONCLUSION
The combined prevalence of prenatal triplex infections was 0.03%, with rates notably higher among the group of pregnant women who were HIV-positive and during the recruitment period that took place before 2012. This prevalence still necessitates screening for these infections as necessary.
PubMed: 37492627
DOI: 10.1155/2023/3551297 -
PloS One 2022Obstructed labor is one of the five major causes of maternal mortality and morbidity in developing countries. In Ethiopia, it accounts for 19.1% of maternal death. The... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Obstructed labor is one of the five major causes of maternal mortality and morbidity in developing countries. In Ethiopia, it accounts for 19.1% of maternal death. The current review aimed to assess maternal and perinatal outcomes of obstructed labor in Ethiopia.
METHODS
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. A literature search was made using PubMed/MEDLINE, CINAHL, Summon country-specific search, and Cochrane Libraries' online databases. Search terms were adverse outcome, obstructed labor, maternal outcome, fetal outcome, and Ethiopia. The Newcastle-Ottawa scale (NOS), based on a star scoring system, was used to assess the quality of the included studies. The meta-analysis was conducted using STATA 16 software. The pooled prevalence of an adverse maternal outcome, fetal outcome, and association between adverse outcome and obstructed labor was calculated using a random-effects model. Egger's test and funnel plot were used to evaluate publication bias.
RESULT
Eighty-seven studies were included in this review, with an overall sample size of 104259 women and 4952 newborns. The pooled incidence of maternal death was estimated to be 14.4% [14.14 (6.91-21.37). The pooled prevalence of uterine rupture and maternal near-miss was 41.18% (95% CI: 19.83, 62.54) and 30.5% [30.5 (11.40, 49.59) respectively. Other complications such as postpartum hemorrhage, sepsis, obstetric fistula, hysterectomy, bladder injury, cesarean section, and labor abnormalities were also reported. The pooled prevalence of perinatal death was 26.4% (26.4 (95% CI 15.18, 37.7). In addition, the association of obstructed labor with stillbirth, perinatal asphyxia, and meconium-stained amniotic fluid was also demonstrated.
CONCLUSIONS
In Ethiopia, the incidence of perinatal and maternal mortality among pregnant women with obstructed labor was high. The rate of maternal death and maternal near miss reported in this review was higher than incidences reported from high-income and most low and middle-income countries. Uterine rupture, postpartum hemorrhage, sepsis, fistula, hysterectomy, and bladder injury were also commonly reported. To improve the health outcomes of obstructed labor, it is recommended to address the three delay models: enhancing communities' health-seeking behavior, enhancing transportation for an obstetric emergency with different stakeholders, and strengthening the capacity of health facilities to handle obstetric emergencies.
Topics: Cesarean Section; Dystocia; Ethiopia; Female; Humans; Infant, Newborn; Maternal Death; Postpartum Hemorrhage; Pregnancy; Sepsis; Uterine Rupture
PubMed: 36178921
DOI: 10.1371/journal.pone.0275400 -
Ontario Health Technology Assessment... 2015In 2007, caesarean deliveries comprised 28% of all hospital deliveries in Ontario. Provincial caesarean delivery rates increased with maternal age and varied by Local... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
In 2007, caesarean deliveries comprised 28% of all hospital deliveries in Ontario. Provincial caesarean delivery rates increased with maternal age and varied by Local Health Integration Network. However, the accepted rate of caesarean delivery in a low-risk maternal population remains unclear.
OBJECTIVES
To review the literature to assess factors that affect the likelihood of experiencing a caesarean delivery, and to examine Ontario caesarean delivery rates to determine whether there is rate variation across the province.
DATA SOURCES
Data sources included publications from OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID Embase, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), and EBM Reviews, as well as data from the Canadian Institute for Health Information Discharge Abstracts Database and the Better Outcomes and Registry Network.
REVIEW METHODS
A mixed-methods approach was used, which included a systematic review of the literature to delineate factors associated with the likelihood of caesarean delivery and an analysis of administrative and clinical data on hospital deliveries in Ontario to determine provincial caesarean delivery rates, variation in rates, and reasons for variation.
RESULTS
Fourteen systematic reviews assessed 14 factors affecting the likelihood of caesarean delivery; 7 factors were associated with an increased likelihood of caesarean delivery, and 2 factors were associated with a decreased likelihood. Five factors had no influence. One factor provided moderate-quality evidence supporting elective induction policies in low-risk women. The overall Ontario caesarean delivery rate in a very-low-risk population was 17%, but varied significantly across Ontario hospitals.
LIMITATIONS
The literature review included a 5-year period and used only systematic reviews. The determination of Robson class for women is based on care received in hospital only, and the low-risk population may have included data from women with obstetrical conditions that warranted a caesarean delivery.
CONCLUSIONS
There is moderate-quality evidence that-compared with expectant management-an induction policy is associated with a decrease in caesarean delivery rates in low-risk women. There is significant caesarean delivery rate variation among Ontario hospitals.
Topics: Adult; Cesarean Section; Evidence-Based Medicine; Female; Humans; Infant, Newborn; Obstetric Labor Complications; Obstetrics; Obstetrics and Gynecology Department, Hospital; Ontario; Pregnancy; Pregnancy Outcome; Pregnancy, High-Risk; Unnecessary Procedures; Young Adult
PubMed: 26366243
DOI: No ID Found