-
Frontiers in Endocrinology 2023This study aimed to evaluate the association between blood heavy metal (zinc (Zn), copper (Cu), lead (Pb), and cadmium (Cd)) concentrations and spontaneous abortion (SA)... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study aimed to evaluate the association between blood heavy metal (zinc (Zn), copper (Cu), lead (Pb), and cadmium (Cd)) concentrations and spontaneous abortion (SA) and recurrent pregnancy loss (RPL) and explore the possible endocrine dysfunction associated with it.
METHODS
A literature search was performed in the PubMed, Embase, Cochrane Library, and Web of Science databases up to April 2023. The overall effects were expressed as the standard mean difference (SMD). Subgroup analysis was performed according to the type of abortion (SA or RPL). Stata 16.0 was utilized for data analysis.
RESULTS
Based on the integrated findings, abortion women showed significantly lower Zn (SMD = -1.05, 95% CI: -1.74 to -0.36, = 0.003) and Cu concentrations (SMD = -1.42, 95% CI: -1.97 to -0.87, 0.001) and higher Pb (SMD = 1.47, 95% CI: 0.89-2.05, 0.001) and Cd concentrations (SMD = 1.15, 95% CI: 0.45-1.85, = 0.001) than normal pregnant women. Subgroup analysis showed that Zn and Cu deficiency and Cd and Pb exposure were significantly (0.05) associated with RPL, whereas Cu deficiency and Cd and Pb exposure were significantly (0.05) associated with SA.
CONCLUSION
Zn and Cu deficiencies and Pb and Cd exposure were associated with abortion. Endocrine dysfunction, such as insulin resistance, vitamin D insufficiency, and abnormal thyroid and sex hormone concentrations, is thought to be involved in heavy metal-related abortion.
Topics: Pregnancy; Female; Humans; Abortion, Spontaneous; Cadmium; Lead; Metals, Heavy; Zinc
PubMed: 37711903
DOI: 10.3389/fendo.2023.1216507 -
Canadian Journal of Dietetic Practice... Mar 2024Previous systematic reviews have reported on the relationship between eating disorders (EDs) and birth outcomes, but there are no existing meta-analyses on this topic.... (Meta-Analysis)
Meta-Analysis Review
Previous systematic reviews have reported on the relationship between eating disorders (EDs) and birth outcomes, but there are no existing meta-analyses on this topic. This systematic review and meta-analysis examines the association between lifetime maternal EDs, including anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) with low birth weight (LBW), preterm birth (PTB), small for gestational age (SGA), large for gestational age (LGA), and miscarriage. Four databases were systematically searched for quantitative literature on maternal EDs that preceded birth outcomes. Eighteen studies met the inclusion criteria and were included in the review. The meta-analyses included 6 studies on miscarriage, 11 on PTB, 4 on LBW, 9 on SGA, and 4 on LGA. The Mantel-Haenszel random effects model was used to test the associations between EDs and birth outcomes. The results showed significant positive associations between AN and LBW (OR 1.74, 95% confidence interval (CI) 1.49, 2.03), AN and SGA (OR 1.39, 95% CI 1.17, 1.65), BN and PTB (OR 1.19, 95% CI 1.04, 1.36), and BED and LGA (OR 1.43 95% CI 1.18, 1.72). EDs were not significantly correlated with miscarriage. These findings reveal the importance of screening for and treating EDs in pregnant women.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Abortion, Spontaneous; Premature Birth; Feeding and Eating Disorders; Infant, Low Birth Weight; Infant, Small for Gestational Age
PubMed: 38032141
DOI: 10.3148/cjdpr-2023-019 -
BMJ Open Jan 2024Literature surrounding the association between antidepressant use during pregnancy and miscarriage is conflicting. We aimed to conduct a systematic review and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Literature surrounding the association between antidepressant use during pregnancy and miscarriage is conflicting. We aimed to conduct a systematic review and meta-analysis of studies among pregnant women regarding the association between exposure to antidepressants during pregnancy and the risk of miscarriage, compared with pregnant women not exposed to antidepressants.
DESIGN
We conducted a systematic review and meta-analysis of non-randomised studies.
DATA SOURCES
We searched Medline, Embase and PsychINFO up to 6 August 2023.
ELIGIBILITY CRITERIA AND OUTCOMES
Case-control, cohort and cross-sectional study designs were selected if they compared individuals exposed to any antidepressant class during pregnancy to comparator groups of either no antidepressant use or an alternate antidepressant.
DATA EXTRACTION AND SYNTHESIS
Effect estimates were extracted from selected studies and pooled using a random-effects meta-analysis. Risk of bias (RoB) was assessed using the Risk of Bias in Non-Randomised Studies of Interventions (ROBINS-I) tool, and heterogeneity assessed using the I statistic. Subgroup analyses were used to explore antidepressant classes and the impact of confounding by indication.
RESULTS
1800 records were identified from the search, of which 29 were included in the systematic review and meta-analysis. The total sample included 5 671 135 individuals. Antidepressant users initially appeared to have a higher risk of miscarriage compared with unexposed individuals from the general population (summary effect estimate: 1.24, 95% CI 1.18 to 1.31, I=69.2%; number of studies (n)=29). However, the summary estimate decreased when comparing against unexposed individuals with maternal depression (1.16, 1.04 to 1.31; I=58.6%; n=6), suggesting confounding by indication may be driving the association. 22 studies suffered from serious RoB, and only two of the 29 studies were deemed at moderate RoB.
CONCLUSIONS
After accounting for maternal depression, there is little evidence of any association between antidepressant use during pregnancy and miscarriage. Instead, the results indicate the biasing impact of confounding by indication.
Topics: Humans; Female; Pregnancy; Abortion, Spontaneous; Cross-Sectional Studies; Antidepressive Agents
PubMed: 38272551
DOI: 10.1136/bmjopen-2023-074600 -
Acta Obstetricia Et Gynecologica... Jul 2024Postpartum depression (PPD) is a growing mental health concern worldwide and has detrimental effects on the social and cognitive health of both mothers and infants. This... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Postpartum depression (PPD) is a growing mental health concern worldwide and has detrimental effects on the social and cognitive health of both mothers and infants. This review was performed to assess the risk of PPD in women with postpartum hemorrhage (PPH) and to identify potential moderators.
MATERIAL AND METHODS
The review protocol was registered in the PROSPERO database on June 17, 2023 (registration number: CRD42023432955). Two researchers independently performed a literature search of the PubMed, Embase, and Web of Science databases for articles published before May 25, 2023, with no filters and no language or location restrictions. Study quality was evaluated using the Newcastle-Ottawa Scale. The primary outcome was the odds ratio (OR) and 95% confidence interval (CI) of PPD in women with vs. without PPH. We performed sensitivity analyses and meta-regression analyses to resolve heterogeneity. Meta-regression analyses included the effects of age, maternal smoking, marital status, preterm labor, maternal education level, preeclampsia, anemia during pregnancy, and cesarean section.
RESULTS
In total, seven studies involving 540 558 participants met the eligibility criteria and were included in the meta-analysis. Women with PPH were at increased risk of PPD compared with women without PPH (OR 1.10; 95% CI 1.03-1.16), and heterogeneity was low (I = 23%; τ = 0.0007; p = 0.25). Moreover, the results of the sensitivity analyses showed that the I value decreased from 23% to 0% after excluding one particular study, which may have been a source of heterogeneity. In the meta-regression analyses, the OR of PPD was greatly affected by maternal smoking (OR -0.26; 95% CI -0.30 to -0.22; p < 0.001). However, we did not observe any effects for maternal age, marital status, preterm labor, maternal education level, preeclampsia, anemia during pregnancy, or cesarean section.
CONCLUSIONS
Women with PPH must be closely monitored because they have a higher risk of PPD than women without PPH. Early recognition and management of these patients will improve treatment outcomes, maternal health, and newborn development.
Topics: Humans; Female; Depression, Postpartum; Postpartum Hemorrhage; Pregnancy; Risk Factors
PubMed: 38475881
DOI: 10.1111/aogs.14795 -
EBioMedicine Aug 2023Chlamydia trachomatis (CT) infection has an increased risk for fertility-related and pregnancy adverse outcomes partly due to mechanisms related to a pro-inflammatory... (Meta-Analysis)
Meta-Analysis
Associations of Chlamydia trachomatis serology with fertility-related and pregnancy adverse outcomes in women: a systematic review and meta-analysis of observational studies.
BACKGROUND
Chlamydia trachomatis (CT) infection has an increased risk for fertility-related and pregnancy adverse outcomes partly due to mechanisms related to a pro-inflammatory response to CT-, or cHSP60-induced delayed hypersensitivity. This study aimed to assess the evidence on the association between CT serology and adverse outcomes.
METHODS
PubMed/Medline, Embase and Web of Science databases were searched for observational studies on the association of CT-specific antibodies (e. g. IgG, IgA, IgM, etc.) with infertility, tubal factor infertility (TFIF), ectopic pregnancy (EP), spontaneous abortion (SA), or preterm labor (PL) that were published from database inception to 31 August 2022. Pooled adjusted odds ratios or relative risks with corresponding 95% confidence intervals were calculated using a random effects model. This study was registered with PROSPERO (CRD42022368366).
FINDINGS
We identified 128 studies that met the inclusion criteria, comprising 87 case-control, 34 cross-sectional and 7 cohort studies, for a total of 167 records involving 128,625 women participants included into the meta-analyses. Based on the adjusted estimates, it was found that CT-specific IgG was significantly associated with TFIF (pooled adjusted OR = 2.09, 95% CI 1.33-3.27, I = 63.8%) or EP (pooled adjusted OR = 3.00, 95% CI 1.66-5.40, I = 93.0%). Analyses of the unadjusted estimates indicated significant associations between CT-specific IgG and infertility, TFIF, EP or SA (four pooled unadjusted ORs ranging between 1.60 and 5.14, I ranging between 40% and 83%); IgA and infertility, TFIF, EP (three pooled unadjusted ORs ranging between 3.64 and 4.91, I ranging between 0% and 74%); IgM and TFIF (pooled unadjusted OR = 5.70, 95% CI 1.58-20.56, I = 56%); or cHSP60 and TFIF (pooled unadjusted OR = 7.83, 95% CI 5.42-11.31, I = 49%).
INTERPRETATION
A broad range of CT-specific antibodies have been studied in association with fertility-related and pregnancy adverse outcomes. However, our study identified a low- or moderate-quality evidence for an association of CT serology with the outcomes. There are substantial research gaps in relation to the clinical implications of CT serological biomarkers.
FUNDING
The work was supported by the Chinese Academy of Medical Sciences Initiative for Innovative Medicine (2016-I2M-3-021).
Topics: Pregnancy; Infant, Newborn; Female; Humans; Chlamydia trachomatis; Cross-Sectional Studies; Pregnancy, Ectopic; Fertility; Chlamydia Infections; Abortion, Spontaneous; Infertility; Immunoglobulin G; Immunoglobulin A; Immunoglobulin M
PubMed: 37413889
DOI: 10.1016/j.ebiom.2023.104696 -
BMC Pregnancy and Childbirth Aug 2023Bipolar disorder (BD) is a mental disorder characterized by mood shifts from severe depression to mania. Pregnant women with BD may experience manic or depressive...
BACKGROUND
Bipolar disorder (BD) is a mental disorder characterized by mood shifts from severe depression to mania. Pregnant women with BD may experience manic or depressive episodes, so they are usually concerned about the effects of BD on their pregnancy. The aim of this systematic review is to determine the effects of BD on maternal health and fetal health, weight, and development. It also addresses how BD affects the probability of incidence of pregnancy complications in women with bipolar compared with healthy controls.
METHODS
Seven electronic databases (Ovid MEDLINE, Embase, MIDRIS, APA PsychINFO, Scopus, Web of Science, and ScienceOpen) were searched, and 1728 eligible studies were identified. After deduplication, screening, and manual search processes, we included only 15 studies. Descriptive analysis, and calculation of the probability of incidence for each pregnancy outcome were used to analyze the results.
RESULTS
The findings of the included studies suggest that BD during pregnancy may affect both fetal growth and maternal health by increasing the risk of giving birth to an infant with some birth defects such as microcephaly, CNS problems, small for gestational age, and other congenital anomalies, in addition to causing some obstetric complications such as gestational hypertension, preterm labor, need for assisted delivery, hospital readmission, and others.
CONCLUSION
Bipolar disorder during pregnancy negatively affects mothers and their fetuses and increases the probability of incidence of obstetrics complications.
Topics: Infant; Infant, Newborn; Female; Pregnancy; Humans; Bipolar Disorder; Prenatal Care; Fetus; Psychotic Disorders; Parturition
PubMed: 37641006
DOI: 10.1186/s12884-023-05924-8 -
International Journal of Molecular... Mar 2024This systematic review delves into the connections between microRNAs and preterm labor, with a focus on identifying diagnostic and prognostic markers for this crucial... (Review)
Review
This systematic review delves into the connections between microRNAs and preterm labor, with a focus on identifying diagnostic and prognostic markers for this crucial pregnancy complication. Covering studies disseminated from 2018 to 2023, the review integrates discoveries from diverse pregnancy-related scenarios, encompassing gestational diabetes, hypertensive disorders and pregnancy loss. Through meticulous search strategies and rigorous quality assessments, 47 relevant studies were incorporated. The synthesis highlights the transformative potential of microRNAs as valuable diagnostic tools, offering promising avenues for early intervention. Notably, specific miRNAs demonstrate robust predictive capabilities. In conclusion, this comprehensive analysis lays the foundation for subsequent research, intervention strategies and improved outcomes in the realm of preterm labor.
Topics: Female; Pregnancy; Infant, Newborn; Humans; Obstetric Labor, Premature; Abortion, Spontaneous; Diabetes, Gestational; Hypertension
PubMed: 38612564
DOI: 10.3390/ijms25073755 -
The Journal of Maternal-fetal &... Dec 2023In 2017, China proposed to achieve the goal that 50% of infants aged 0-6 months should be exclusively breastfed by 2025 proposed by the World Health Assembly in 2012.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
In 2017, China proposed to achieve the goal that 50% of infants aged 0-6 months should be exclusively breastfed by 2025 proposed by the World Health Assembly in 2012. However, delayed onset lactogenesis II has adverse effects on breastfeeding and thus on neonatal health. There has been no meta-analysis of the prevalence and risk factors of delayed onset lactogenesis II among parturient women in China. To provide best practices, updated evidence-based evidence is needed to supplement reviews on this topic.
OBJECTIVE
The purpose of this systematic review and meta-analysis was to quantitatively analyze the prevalence and risk factors of delayed onset lactogenesis II in China.
METHODS
We identified relevant studies by searching literature published prior to October 2022 in PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang, and VIP databases for all available observational studies. Stata 16.0 were used for performing the systematic review and meta-analysis.
RESULTS
The researchers examined data from 14 observational studies involving 17610 females. The prevalence of delayed onset lactogenesis II from these studies was 31% (95% CI = 25.0%-38.0%, < .001), and the prevalence showed a significant increasing trend in China over the past decade. The frequency of breastfeeding was >2 times per day at 24-48 h after delivery was one protective factor against delayed onset lactogenesis II (OR = 0.41). The significant risk factors for delayed onset lactogenesis II were breastfeeding initiation > 30min after birth (OR = 1.31), maternal age > 35 years (OR = 2.19), primiparous women (OR = 2.38), maternal overweight/obesity (OR = 2.22), cesarean section (OR = 1.33), anxiety (OR = 3.23), depression (OR = 3.21) and gestational hypertension (OR = 3.43).
CONCLUSIONS
There is a high incidence of delayed onset lactogenesis II in Chinese parturient women. We identified eight risk factors and one protective factor for DOL II. These findings suggest health care professionals should pay attention to these risk parturients so as to better provide early preventive interventions to increase the breastfeeding rate.
Topics: Infant; Infant, Newborn; Female; Pregnancy; Humans; Lactation; Cesarean Section; Prevalence; Breast Feeding; Risk Factors; China; Obesity, Maternal
PubMed: 37258287
DOI: 10.1080/14767058.2023.2214833 -
Epilepsia Open Dec 2023Several reports have described the autoimmune encephalitis' (AE) possible onset during pregnancy. In this systematic review, we summarize the available data on the... (Review)
Review
Several reports have described the autoimmune encephalitis' (AE) possible onset during pregnancy. In this systematic review, we summarize the available data on the diagnostic and therapeutic approach to AE during pregnancy, highlighting the associated maternal and fetal clinical outcomes. A systematic search of the literature was performed. The following databases were used: PubMed, Google Scholar, EMBASE, and CrossRef. The revision was registered on the PROSPERO platform (CRD42022336357). Forty-nine patients were included. AE onset was mainly observed during the first and the second trimester of pregnancy with psychiatric manifestations and seizures as main onset symptoms. CSF analysis showed AE-specific autoantibody positivity in 33 patients (anti-NMDA receptor as the most frequent). EEG generally showed normal findings. MRI revealed pathological findings in less than half of patients. Tumor screening was positive in 14 cases. First-line immunotherapy (single or combined) was generally employed while second line was administered in a minority of patients. Levetiracetam was the most used antiseizure medication. Cesarean section was performed in 18 women. Most of the women had an excellent early outcome after delivery but 22 showed persistent neurological deficits in long-term follow-up. Fetal outcome was positive in 33 cases, whereas 12 cases of fetal death were reported. A logistic regression showed that no variable significantly influenced the odds of good/bad maternal and fetal clinical outcome. Diagnosis and treatment of AE during pregnancy is challenging. The rate of miscarriage in women with AE seems to be higher than the general population. In addition, mothers may show long-term neurological deficits.
Topics: Humans; Pregnancy; Female; Cesarean Section; Encephalitis; Abortion, Spontaneous; Autoimmune Diseases of the Nervous System
PubMed: 37562964
DOI: 10.1002/epi4.12806 -
Frontiers in Endocrinology 2023There is no clear evidence of clinical significance of endometrial compaction, which can be measured by a reduction in endometrial thickness (EMT) during the... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
There is no clear evidence of clinical significance of endometrial compaction, which can be measured by a reduction in endometrial thickness (EMT) during the follicular-luteal transition before the day of embryo transfer. In this study, we aim to determine whether endometrial compaction has an effect on fertilization (IVF) success.
METHODS
We searched PubMed, Cochrane, Embase, and Web of Science electronic databases for studies published in English up to March 2023. Heterogeneity between studies was assessed using the I statistic. The random effects model and fixed effects model was used to pool the risk ratio (RR) with a corresponding 95% confidence interval (CI). A subgroup analysis was performed based on different methods of ultrasonic measurement and different endometrial compaction rates (ECR). Stata 17.0 software was used for meta-analysis. Pregnancy outcomes, which included clinical pregnancy rate, ongoing pregnancy rate, live birth rate, and spontaneous abortion rate, were evaluated.
RESULTS
In this study, 18 cohort studies were included, involving 16,164 embryo transfer cycles. Pooled results indicated that there was no significant difference between the endometrial compaction group and the non-compaction group in terms of clinical pregnancy rate (RR [95% CI]=0.98 [0.90,1.08]; I69.76%), ongoing pregnancy rate (RR [95% CI]=1.18 [0.95,1.47]; I78.77%), live birth rate (RR [95% CI]= 0.97 [0.92,1.02]; I0.00%) or spontaneous abortion rate (RR [95% CI]= 1.07[0.97,1.26]; I0.00%). According to the subgroup analysis of ultrasonic measurement methods, in the transvaginal ultrasound (TVUS) combined with abdominal ultrasonography (AUS) cycles of the endometrial compaction group, the rate of ongoing pregnancy (RR [95% CI] = 1.69 [1.26, 2.26]; I29.27%) and live birth (RR [95% CI] = 1.27 [1.00,1.61]; I62.28%) was significantly higher than that of the non-compaction group. Additionally, subgroup analysis based on ECR revealed a significantly higher rate of ongoing pregnancy when ECR ≥ 15% (RR [95% CI] = 1.99 [1.61, 2.47]; I0.00%).
CONCLUSION
Endometrial compaction has no adverse effect on clinical pregnancy rate, ongoing pregnancy rate, live birth rate, or spontaneous abortion rate. A possible explanation for the contradictory findings of previous studies lies in the method by which the EMT is measured.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023430511, identifier CRD42023430511.
Topics: Pregnancy; Female; Humans; Pregnancy Outcome; Abortion, Spontaneous; Embryo Transfer; Fertilization in Vitro; Pregnancy Rate
PubMed: 38034000
DOI: 10.3389/fendo.2023.1264608