-
BMC Pregnancy and Childbirth Oct 2023Women's reproduction requires increased energy demands, which consequently may lead to cellular damage and aging. Hence, Telomere Length (TL), a biomarker of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Women's reproduction requires increased energy demands, which consequently may lead to cellular damage and aging. Hence, Telomere Length (TL), a biomarker of biological aging and health status may possibly serve as a biomarker of reproductive effort. The aim of this systematic review is to evaluate telomere dynamics throughout pregnancy and the association between parity and TL.
METHODS
A systematic search was conducted across seven databases including CINAHL, Cochrane, PsycINFO, Proquest, PubMed; Scopus; and Web of Science, using keywords and MeSH descriptors of parity and TL. Predefined inclusion and exclusion criteria were used to screen abstracts and titles. After the removal of duplicates, 3431 articles were included in the primary screening, narrowed to 194 articles included in the full-text screening. Consensus was reached for the 14 studies that were included in the final review, and the Newcastle-Ottawa scale (NOS) was utilized to assess the quality of the selected studies. A mini meta-analysis utilized JASP 0.17.3 software and included 4 applicable studies, comprising a total of 2564 participants to quantitatively assess the estimated effect size of parity on TL.
RESULTS
Of the 11 studies reviewed on parity and TL, four demonstrated a negative correlation; one - a positive correlation and six -found no correlation. Studies demonstrating a negative correlation encompassed rigorous methodological practices possibly suggesting having more children is associated with enhanced telomere attrition. Of the four longitudinal studies assessing telomere dynamics throughout pregnancy, most found no change in TL from early pregnancy to postpartum suggesting pregnancy does not affect TL from early pregnancy to early postpartum. The meta-analysis revealed a negative, yet, non-significant effect, of the estimated effect size of parity on TL(ES = -0.009, p = 0.126, CI -0.021, 0.03).
CONCLUSIONS
Studies assessing pregnancy, parity and TL yielded mixed results, most likely due to the different research methods utilized in each study. Improvements in study design to better understand the short-term effects of pregnancy on TL and the effect of parity on TL over time, include precise definitions of parity, comparisons of different age groups, inclusion of reproductive lifespan and statistically adjusting for potential confounders in the parity and TL relationship.
Topics: Pregnancy; Child; Humans; Female; Aging; Reproduction; Telomere; Postpartum Period; Biomarkers
PubMed: 37848852
DOI: 10.1186/s12884-023-06011-8 -
BMC Cancer Jul 2023Associations between reproductive factors and breast cancer (BC) risk vary by molecular subtype (i.e., luminal A, luminal B, HER2, and triple negative/basal-like... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Associations between reproductive factors and breast cancer (BC) risk vary by molecular subtype (i.e., luminal A, luminal B, HER2, and triple negative/basal-like [TNBC]). In this systematic review and meta-analysis, we summarized the associations between reproductive factors and BC subtypes.
METHODS
Studies from 2000 to 2021 were included if BC subtype was examined in relation to one of 11 reproductive risk factors: age at menarche, age at menopause, age at first birth, menopausal status, parity, breastfeeding, oral contraceptive (OC) use, hormone replacement therapy (HRT), pregnancy, years since last birth and abortion. For each reproductive risk factor, BC subtype, and study design (case-control/cohort or case-case), random-effects models were used to estimate pooled relative risks and 95% confidence intervals.
RESULTS
A total of 75 studies met the inclusion criteria for systematic review. Among the case-control/cohort studies, later age at menarche and breastfeeding were consistently associated with decreased risk of BC across all subtypes, while later age at menopause, later age of first childbirth, and nulliparity/low parity were associated with increased risk of luminal A, luminal B, and HER2 subtypes. In the case-only analysis, compared to luminal A, postmenopausal status increased the risk of HER2 and TNBC. Associations were less consistent across subtypes for OC and HRT use.
CONCLUSION
Identifying common risk factors across BC subtypes can enhance the tailoring of prevention strategies, and risk stratification models can benefit from subtype specificity. Adding breastfeeding status to current BC risk prediction models can enhance predictive ability, given the consistency of the associations across subtypes.
Topics: Female; Pregnancy; Humans; Triple Negative Breast Neoplasms; Risk Factors; Reproductive History; Parity; Breast
PubMed: 37430191
DOI: 10.1186/s12885-023-11049-0 -
Environmental Science and Pollution... May 2023To evaluate the relationships between maternal particulate matter exposure and offspring birth weight. Studies were categorized into three subgroups: term low birth... (Meta-Analysis)
Meta-Analysis Review
To evaluate the relationships between maternal particulate matter exposure and offspring birth weight. Studies were categorized into three subgroups: term low birth weight (TLBW) among full-term births and all births (regardless of gestational age) and low birth weight (LBW) among all births, based on the search results of MEDLINE and the Web of Science from the inception of the database to April 2022. Subgroup analyses were conducted based on the economic status, region, exposure assessment, risk of bias, and adjustment. Sixty-one studies involving 34,506,975 singleton live births in 15 countries were analyzed. Overall, the risk of bias for most studies (75%) was low. In 39 of 47 term birth studies, the pooled odds ratio of TLBW among term births for per interquartile range (IQR) increases throughout the entire pregnancy was 1.02 (1.01 to 1.03) for PM and 1.03 (1.01 to 1.05) for PM after adjustment for covariates. No significant relevance was detected across each trimester period for PM. A stronger effect was observed during the second trimester (1.03, 1.01 to 1.06) for PM. There was no increased risk of TLBW in all births associated with IQR increases in PM and PM. LBW was associated with PM exposure in 4 of 7 studies, but statistical heterogeneity was considerable. In the TLBW subgroup analysis, the effects of PM and PM were both greater in studies conducted in advanced countries, studies with low bias, and studies that adjusted for maternal age, infant sex, and parity. Stronger effects were present for PM exposure collected from monitoring stations and PM exposure interpolated from the inverse distance weighting model. TLBW may be associated with prenatal exposure to particulate matter, but no critical windows were identified. Stronger associations were observed in advanced countries. Future original study designs need to consider the impact of different exposure assessment modalities and all possible confounding factors.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Particulate Matter; Air Pollutants; Prenatal Exposure Delayed Effects; Infant, Low Birth Weight; Maternal Exposure; Birth Weight; Air Pollution
PubMed: 37059952
DOI: 10.1007/s11356-023-26831-7 -
Fetal Diagnosis and Therapy 2022Although maternal-fetal surgery to treat fetal anomalies such as spina bifida continues to grow more common, potential health disparities in the field remain relatively... (Review)
Review
BACKGROUND/PURPOSE
Although maternal-fetal surgery to treat fetal anomalies such as spina bifida continues to grow more common, potential health disparities in the field remain relatively unexamined. To address this gap, we identified maternal-fetal surgery studies with the highest level of evidence and analyzed the reporting of participant sociodemographic characteristics and representation of racial and ethnic groups.
METHODS
We conducted a systematic review of the scientific literature using biomedical databases. We selected randomized control trials (RCTs) and cohort studies with comparison groups published in English from 1990 to May 5, 2020. We included studies from across the globe that examined the efficacy of fetal surgery for twin-twin transfusion syndrome (TTTS), obstructive uropathy, congenital diaphragmatic hernia (CDH), myelomeningocele (MMC), thoracic lesions, cardiac malformations, or sacrococcygeal teratoma. We determined the frequency of reporting of age, gravidity/parity, race, ethnicity, education level, language spoken, insurance, income level, and relationship status. We identified whether sociodemographic factors were used as inclusion or exclusion criteria. We calculated the racial and ethnic group representation for studies in the USA using the participation-to-prevalence ratio (PPR).
RESULTS
We included 112 studies (10 RCTs, 102 cohort) published from 1990-1999 (8%), 2000-2009 (30%), and 2010-2020 (62%). Most studies were conducted in the USA (47%) or Europe (38%). The median sample size was 58. TTTS was the most common disease group (37% of studies), followed by MMC (23%), and CDH (21%). The most frequently reported sociodemographic variables were maternal age (33%) and gravidity/parity (20%). Race and/or ethnicity was only reported in 12% of studies. Less than 10% of studies reported any other sociodemographic variables. Sociodemographic variables were used as exclusion criteria in 13% of studies. Among studies conducted in the USA, White persons were consistently overrepresented relative to their prevalence in the US disease populations (PPR 1.32-2.11), while Black or African-American, Hispanic or Latino, Asian, American-Indian or Alaska-Native, and Native-Hawaiian or other Pacific Islander persons were consistently underrepresented (PPR 0-0.60).
CONCLUSIONS
Sociodemographic reporting quality in maternal-fetal surgery studies is poor and inhibits examination of potential health disparities. Participants enrolled in studies in the USA do not adequately represent the racial and ethnic diversity of the population across disease groups.
Topics: Black People; Ethnicity; Female; Hispanic or Latino; Humans; Maternal Age; Pregnancy; United States
PubMed: 35272297
DOI: 10.1159/000523867 -
Frontiers in Medicine 2022Epidemiological studies have provided inconsistent evidence of the association between parity and metabolic syndrome (MetS) risk. We conducted this first systematic...
BACKGROUND
Epidemiological studies have provided inconsistent evidence of the association between parity and metabolic syndrome (MetS) risk. We conducted this first systematic review and meta-analysis to comprehensively and precisely quantify this topic.
METHODS
Comprehensive searches of PubMed, Embase, and the Web of Science databases were conducted to identify observational studies of the association between parity and MetS risk up to 30 January 2022. Study inclusion, data extraction, and quality assessment were checked and reviewed by two investigators independently. Random-effects models were applied to estimate pooled odds ratios (ORs) and 95% CIs. This study has been registered with PROSPERO.
RESULTS
Two high-quality cohorts and thirteen medium-quality cross-sectional studies involving 62,095 women were finally included. Compared with the nulliparous, the pooled OR of MetS for the ever parity was 1.31 (95% CI = 0.91-1.88, = 72.6%, = 3). Compared with the lowest parity number, the pooled OR of MetS for the highest parity number was 1.38 (95% CI = 1.22-1.57, = 60.7%, = 12). For the dose-response analysis, the pooled OR of MetS for each increment of one live birth was 1.12 (95% CI = 1.05-1.19, = 78.6%, = 6). These findings were robust across subgroups and sensitivity analyses. No evidence of heterogeneity between subgroups was indicated by meta-regression analyses.
CONCLUSION
The findings suggested that parity was associated with an increased risk of MetS. A sufficient number of large prospective cohort studies are required to fully verify our findings.
SYSTEMATIC REVIEW REGISTRATION
[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022307703].
PubMed: 35903312
DOI: 10.3389/fmed.2022.926944 -
Journal of Public Health (Oxford,... Sep 2016Maternal obesity is emerging as a public health problem, recently highlighted together with maternal under-nutrition as a 'double burden', especially in African... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Maternal obesity is emerging as a public health problem, recently highlighted together with maternal under-nutrition as a 'double burden', especially in African countries undergoing social and economic transition. This systematic review was conducted to investigate the current evidence on maternal obesity in Africa.
METHODS
MEDLINE, EMBASE, Scopus, CINAHL and PsycINFO were searched (up to August 2014) and identified 29 studies. Prevalence, associations with socio-demographic factors, labour, child and maternal consequences of maternal obesity were assessed. Pooled risk ratios comparing obese and non-obese groups were calculated.
RESULTS
Prevalence of maternal obesity across Africa ranged from 6.5 to 50.7%, with older and multiparous mothers more likely to be obese. Obese mothers had increased risks of adverse labour, child and maternal outcomes. However, non-obese mothers were more likely to have low-birthweight babies. The differences in measurement and timing of assessment of maternal obesity were found across studies. No studies were identified either on the knowledge or attitudes of pregnant women towards maternal obesity; or on interventions for obese pregnant women.
CONCLUSIONS
These results show that Africa's levels of maternal obesity are already having significant adverse effects. Culturally adaptable/sensitive interventions should be developed while monitoring to avoid undesired side effects.
Topics: Africa; Age Factors; Female; Humans; Mothers; Obesity; Parity; Prevalence; Risk Factors
PubMed: 26487702
DOI: 10.1093/pubmed/fdv138 -
Nursing Open Sep 2021This study aimed to provide comprehensive information about the core determinants of fertility intentions. (Review)
Review
AIM
This study aimed to provide comprehensive information about the core determinants of fertility intentions.
DESIGN
Systematic review.
METHODS
Ovid, MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science, SCOPUS and GOOGLE SCHOLAR were searched for the relevant articles published from 1946-December 2017. We updated our records by searching three computerized databases (Ovid MEDLINE, SCOPUS and WOS) from 2018-January 2021.
RESULTS
53 studies included in the qualitative synthesis. The results of some studies indicated the impact of demographic factors, physical and psychological health, happiness and child desire. The most frequent variables in a couple's mesosystem were marital status, parity, partnership satisfaction and gender role attitude. The mesosystem of childbearing intention also included family and peers network. The EXEO system of the ECSM includes certain variables, such as job characteristics, urban residence, housing condition. The macrosystem comprises cultural and societal principles with broader influences on the couple's system.
Topics: Child; Female; Fertility; Humans; Intention; Marital Status; Parity; Personal Satisfaction; Pregnancy
PubMed: 33705606
DOI: 10.1002/nop2.849 -
Environmental Health : a Global Access... May 2023Per- and polyfluoroalkyl substances (PFAS) are used for their properties such as stain and water resistance. The substances have been associated with adverse health... (Review)
Review
Per- and polyfluoroalkyl substances (PFAS) are used for their properties such as stain and water resistance. The substances have been associated with adverse health outcomes in both pregnant mothers and infants, including pre-eclampsia and low birthweight. A growing body of research suggests that PFAS are transferred from mother to fetus through the placenta, leading to in utero exposure. A systematic review was performed using the PubMed database to search for studies evaluating determinants of PFAS concentrations in blood matrices of pregnant mothers and neonates shortly after birth. Studies were included in this review if an observational study design was utilized, exposure to at least one PFAS analyte was measured, PFAS were measured in maternal or neonatal matrices, at least one determinant of PFAS concentrations was assessed, and results such as beta estimates were provided. We identified 35 studies for inclusion in the review and evaluated the PFAS and determinant relationships among the factors collected in these studies. Parity, breastfeeding history, maternal race and country of origin, and household income had the strongest and most consistent evidence to support their roles as determinants of certain PFAS concentrations in pregnant mothers. Reported study findings on smoking status, alcohol consumption, and pre-pregnancy body mass index (BMI) suggest that these factors are not important determinants of PFAS concentrations in pregnant mothers or neonates. Further study into informative factors such as consumer product use, detailed dietary information, and consumed water sources as potential determinants of maternal or neonatal PFAS concentrations is needed. Research on determinants of maternal or neonatal PFAS concentrations is critical to estimate past PFAS exposure, build improved exposure models, and further our understanding on dose-response relationships, which can influence epidemiological studies and risk assessment evaluations. Given the potential for adverse outcomes in pregnant mothers and neonates exposed to PFAS, it is important to identify and understand determinants of maternal and neonatal PFAS concentrations to better implement public health interventions in these populations.
Topics: Female; Pregnancy; Infant; Infant, Newborn; Humans; Body Mass Index; Fetus; Mothers; Placenta; Fluorocarbons; Observational Studies as Topic
PubMed: 37161484
DOI: 10.1186/s12940-023-00992-x -
Heliyon Jul 2020Pregnancy-associated malaria (PAM) is a health problem with serious clinical, epidemiological and economic effects. (Review)
Review
INTRODUCTION
Pregnancy-associated malaria (PAM) is a health problem with serious clinical, epidemiological and economic effects.
PURPOSE
To analyze the microeconomic evaluations of PAM reported in the world scientific literature.
METHODS
Systematic review with 15 different search strategies in PubMed, ScienceDirect, Scielo, Google Scholar and Malaria in Pregnancy (MiP) Library. A search, selection and extraction protocol was applied, which guaranteed completeness and reproducibility in accordance with preferred reporting items for systematic reviews and meta-analysis guidelines. The methodological quality was evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guide. The analysis were based on frequencies, costs and average and incremental cost-effectiveness ratios in 2018 US dollars adjusted for purchasing power parity.
RESULTS
Twenty-two evaluations published between 1990 and 2018 were analyzed, of which 82% addressed cost-effectiveness in Africa. Twelve interventions were studied; of these, intermittent preventive treatment in pregnant women with sulfadoxine-pyrimethamine (IPTp-SP) was the most frequent strategy. The main outcomes were low birth weight, anaemia and DALYs avoided. The best average cost-effectiveness ratio was reported in IPTp-SP with a cost of US$ 2 per DALY avoided, followed by the administration of IPTp-SP in pregnant women with HIV (US$ 14.2).
CONCLUSIONS
The studies focus on Africa with a high heterogeneity in the interventions, outcomes, resources and populations studied. All the interventions were highly cost-effective, which demonstrates the importance of including prevention, care and control resources for PAM as a priority in health sector budgets. This is especially true considering the importance of its intervention for social progress and overcoming poverty in endemic areas.
PubMed: 32775727
DOI: 10.1016/j.heliyon.2020.e04558 -
Journal of Animal Science and... Feb 2022Effects of added fat in sow diets on the sows' reproductive performance and offspring growth performance are influenced by multiple factors such as genetics, nutrition,... (Review)
Review
Effects of added fat in sow diets on the sows' reproductive performance and offspring growth performance are influenced by multiple factors such as genetics, nutrition, parity, ambient temperatures, and farm management. Individual studies cannot cover all these factors. With the view to address this challenge, we searched all studies that were published from 1986 to 2020, and performed a systematic review and meta-analysis on the fat effect. In total, 19 papers were collected and analyzed. Fat supplementation in sow diets during late gestation and lactation decreased average daily feed intake (ADFI, P < 0.05) and tended to increase average daily energy intake (ADEI, P = 0.11). It had no impact on litter weights at birth (P = 0.40) or weaning (P = 0.46). It increased total numbers of piglets at birth (P = 0.07), but had no effect on liveborn per litter (P = 0.90) or survival rate (P = 0.48) of piglets to weaning. Fat supplementation had no significant effect on sow body weight loss (P = 0.67) or backfat thickness changes (P = 0.66), but sows fed diets with added fat had increased milk fat concentration (P = 0.03) and shorter wean to estrus intervals (WEI, P = 0.01). In specific circumstances, fat supplementation tended to improve growth performance of piglets with low litter weights at birth (P = 0.14), or when the sows lost large amounts of body weight during lactation (P = 0.11). The level of supplemented fat was 10% and higher would decrease liveborn per litter at neutral temperature (P = 0.10). The meta-analysis revealed that fat supplementation to sows diet during late gestation and lactation can be beneficial for sow reproductive performance and litter growth performance.
PubMed: 35130973
DOI: 10.1186/s40104-021-00662-3