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BJOG : An International Journal of... Nov 2020Interpregnancy interval (IPI) <6 months is a potentially modifiable risk factor for adverse perinatal health outcomes. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Interpregnancy interval (IPI) <6 months is a potentially modifiable risk factor for adverse perinatal health outcomes.
OBJECTIVE
This systematic review evaluated the international literature on the risk of perinatal death associated with IPI.
SEARCH STRATEGY
Two independent reviewers screened titles and abstracts identified in MEDLINE, EMBASE and Scopus from inception to 4 April 2019 (Prospero Registration #CRD42018092792).
SELECTION CRITERIA
Studies were included if they provided a description of IPI measurement and perinatal death, including stillbirth and neonatal death.
DATA COLLECTION AND ANALYSIS
A narrative review was performed for all included studies. Random effects meta-analysis was used to compare unadjusted odds of perinatal death associated with IPI <6 months and IPI ≥6 months. Analyses were performed by outcome of the preceding pregnancy and study location.
MAIN RESULTS
Of the 624 unique articles identified, 26 met the inclusion criteria. The pooled unadjusted odds ratio of perinatal death for IPI <6 months was 1.34 (95% CI 1.17-1.53) following a previous live birth, 0.85 (95% CI 0.73-0.99) following a previous miscarriage and 1.07 (95% CI 0.84-1.36) following a previous stillbirth compared with IPI ≥6 months. However, few high-income country studies reported an association after adjustment. Fewer studies evaluated the impact of long IPI on perinatal death and what evidence was available showed mixed results.
CONCLUSIONS
Results suggest a possible association between short IPI and risk of perinatal death following a live birth, particularly in low- to middle-income countries.
TWEETABLE ABSTRACT
Short IPI <6 months after a live birth was associated with greater risk of perinatal death than IPI ≥6 months.
Topics: Birth Intervals; Female; Humans; Infant, Newborn; Perinatal Death; Pregnancy; Risk Assessment; Risk Factors
PubMed: 32378279
DOI: 10.1111/1471-0528.16303 -
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 -
The Journal of Dermatological Treatment May 2021Topical steroids have been previously associated with potential for hyperglycemia and glucosuria, and thought to have a relatively safe side effect profile. In prolonged... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Topical steroids have been previously associated with potential for hyperglycemia and glucosuria, and thought to have a relatively safe side effect profile. In prolonged use, there is the potential for steroids to be absorbed through the skin and eventually reach systemic circulation. We aimed to investigate the potential association between topical corticosteroid use and development of diabetes, we performed a systematic review and meta-analysis of available case-control data in the literature.
METHODS
Electronic database searches was performed to identify studies comparing the proportion of patients with diabetes in cases using topical corticosteroids compared to those without. The odds ratio (OR) was used as a summary statistic.
RESULTS
Four case-control studies were pooled for meta-analysis. Overall, we found a significant association between topical corticosteroid use and development of type 2 diabetes mellitus, even after adjustment for confounding factors (OR 1.24, 95% CI 1.15-1.34, I2 = 91%, < .00001). There was no potency-dependent effect noted, with no significant difference noted between the subgroups.
CONCLUSIONS
We demonstrate a potential association between topical corticosteroid use and risk of developing diabetes mellitus. This risk does not appear to be dependent on potency of the topical medication, but rather the cumulative dose and cumulative duration of use.
Topics: Administration, Topical; Adrenal Cortex Hormones; Databases, Factual; Diabetes Mellitus, Type 2; Humans; Odds Ratio; Steroids
PubMed: 31418613
DOI: 10.1080/09546634.2019.1657224 -
Psychotherapy and Psychosomatics 2023People living with chronic diseases are at an increased risk of anxiety and depression, which are associated with poorer medical and psychosocial outcomes. Many studies... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
People living with chronic diseases are at an increased risk of anxiety and depression, which are associated with poorer medical and psychosocial outcomes. Many studies have examined the trajectories of depression and anxiety in people with specific diseases, including the predictors of these trajectories. This is valuable for understanding the process of adjustment to diseases and informing treatment planning. However, no review has yet synthesised this information across chronic diseases.
METHODS
Electronic databases were searched for studies reporting trajectories of depression or anxiety in chronic disease samples. Data extracted included sample characteristics, results from trajectory analyses, and predictors of trajectories. Meta-analysis of the overall pooled prevalence of depression and anxiety trajectories was conducted, and qualitative synthesis of disease severity predictors was undertaken.
RESULTS
Following search and screening, 67 studies were included (N = 61,201 participants). Most participants followed a stable nonclinical trajectory for depression (69.0% [95% CI: 65.6, 72.2]) and anxiety (73.4% [95% CI: 66.3, 79.5]). Smaller but meaningful subsamples followed a trajectory of depression and anxiety symptoms consistently in the clinical range (11.8% [95% CI: 9.2, 14.8] and 13.7% [95% CI: 9.3, 19.7], respectively). Several clinical and methodological moderators emerged, and qualitative synthesis suggested that few aspects of disease severity were associated with participants' trajectories.
CONCLUSION
Most people with chronic disease follow a trajectory of distress that is low and stable, suggesting that most people psychologically adjust to living with chronic disease. Evidence also suggests that the nature and severity of the disease are not meaningful predictors of psychological distress.
Topics: Humans; Depression; Anxiety; Anxiety Disorders; Chronic Disease; Psychological Distress
PubMed: 37607505
DOI: 10.1159/000533263 -
Vaccines Nov 2022Foodborne enteritis is a major disease burden globally. Two of the most common causative bacterial enteropathogens in humans are Campylobacter and Salmonella species... (Review)
Review
Foodborne enteritis is a major disease burden globally. Two of the most common causative bacterial enteropathogens in humans are Campylobacter and Salmonella species which are strongly associated with the consumption of raw or contaminated chicken. The poultry industry has approached this issue by use of a multi-hurdle method across the production chain to reduce or eliminate this risk. The use of poultry vaccines is one of these control methods. A systematic review and meta-analysis of vaccination effects against caecal Campylobacter and Salmonella were performed on primary research published between 2009 and 2022. Screening was conducted by three reviewers with one reviewer performing subsequent data extraction and one reviewer performing the risk of bias assessment. The confidence in cumulative evidence was evaluated based on the GRADE method. Meta-analyses were performed using standardised mean differences (SMDs) with additional analyses and random effects regression models on intervention effects grouped by the vaccine type. A total of 13 Campylobacter and 19 Salmonella studies satisfied the eligibility criteria for this review. Many studies included multi-arm interventions, resulting in a total of 25 Campylobacter and 34 Salmonella comparators which were synthesised. The analyses revealed a large reduction in pathogen levels; however, many effects required statistical adjustment due to unit of analysis errors. There was a moderate level of confidence in the reduction of Campylobacter by 0.93 SMD units (95% CI: −1.275 to −0.585; p value < 0.001) and a very low level of confidence in the reduction of Salmonella by 1.10 SMD units (95% CI: −1.419 to −0.776; p value < 0.001). The Chi2 test for heterogeneity (p value 0.001 and <0.001 for Campylobacter and Salmonella, respectively) and the I2 statistic (52.4% and 77.5% for Campylobacter and Salmonella, respectively) indicated high levels of heterogeneity in the SMDs across the comparators. The certainty of gathered evidence was also affected by a high risk of study bias mostly due to a lack of detailed reporting and, additionally for Salmonella, the presence of publication bias. Further research is recommended to source areas of heterogeneity, and a conscious effort to follow reporting guidelines and consider units of analysis can improve the strength of evidence gathered to provide recommendations to the industry.
PubMed: 36423031
DOI: 10.3390/vaccines10111936 -
European Journal of Epidemiology Jun 2022Several case-control and prospective cohort studies have examined the association between the consumption of nuts and legumes and the risk of colorectal cancer. For the... (Meta-Analysis)
Meta-Analysis
Several case-control and prospective cohort studies have examined the association between the consumption of nuts and legumes and the risk of colorectal cancer. For the quantitative assessment of this association, we conducted a meta-analysis of observational studies. We searched PubMed and Web of Science databases along with hand searches for eligible studies published up to January 2022. A total of 13 studies (8 cohort studies and 5 case-control studies) on nuts consumption and 29 studies (16 cohort studies and 13 case-control studies) on legumes consumption were included in the meta-analysis. The pooled relative risks (RRs) of colorectal cancer for the highest versus lowest categories of nuts consumption and legumes consumption were 0.84 (95% CI: 0.71-0.99) and 0.90 (95% CI: 0.83-0.98), respectively. Based on the dose-response analysis, a 28 g/day (1 serving/day) increment of nut consumption was associated with a 33% lower risk of colorectal cancer, and 100 g/day (1 serving/day) increment of legumes consumption was associated with a 21% lower risk of colorectal cancer. By geographic region for nuts consumption, however, the inverse association for the highest versus lowest categories was only observed in Asia (RR = 0.44; 95% CI: 0.29-0.68) from 3 studies, and no association was found in America (RR = 1.01; 95% CI: 0.92-1.11) (P = 0.003) or Europe (RR = 1.02; 95% CI: 0.84-1.25) (P = 0.003). In addition, the associations tended to be weak when stratified by adjustment for confounders. Our findings suggest that the evidence for an association is currently weak, and thus further well-designed prospective studies are needed.
Topics: Colorectal Neoplasms; Diet; Fabaceae; Humans; Nuts; Observational Studies as Topic; Prospective Studies; Risk Factors; Vegetables
PubMed: 35622305
DOI: 10.1007/s10654-022-00881-6 -
Annals of Intensive Care Dec 2022The literature is unresolved on whether female receive advanced cardiac life support less than do male and on whether female have a survival advantage over male after... (Review)
Review
BACKGROUND
The literature is unresolved on whether female receive advanced cardiac life support less than do male and on whether female have a survival advantage over male after cardiopulmonary resuscitation.
METHODS
We systematically searched PubMed, Embase and Web of Science databases (from inception to 23-April-2022) for papers reporting outcomes in adult male and female after out-of-hospital cardiac arrest. The main study outcome was the rate of adjusted survival to hospital discharge or 30 days. Secondary outcomes included unadjusted survival to hospital discharge and favourable neurological outcome.
RESULTS
A total of 28 studies were included, involving 1,931,123 patients. Female were older than male, their cardiac arrests were less likely to be witnessed and less likely to present with a shockable rhythm. Unadjusted analysis showed that females had a lower likelihood of survival than males (OR 0.68 [0.62-0.74], I = 97%). After adjustment, no significant difference was identified between male and female in survival at hospital discharge/30 days (OR 1.01 [0.93-1.11], I = 87%). Data showed that male had a significantly higher likelihood of favorable neurological outcome in unadjusted analysis but this trend disappeared after adjustment. Both the primary outcome (adjusted for several variables) and the secondary outcomes were associated with substantial heterogeneity. The variables examined using meta-regression, subgroup and sensitivity analyses (i.e., study type, location, years, population, quality of adjustment, risk of bias) did not reduce heterogeneity.
CONCLUSIONS
The adjusted rate of survival to hospital discharge/30 days was similar for male and female despite an initial seeming survival advantage for male. The validity of this finding is limited by substantial heterogeneity despite in-depth investigation of its causes, which raises concerns regarding latent inequalities in some reports nonetheless. Further study on this topic may require inclusion of factors not reported in the Utstein template and in-depth analysis of decision-making processes.
PubMed: 36534195
DOI: 10.1186/s13613-022-01091-9 -
Obstetrics and Gynecology Aug 2023To review and perform a meta-analysis of observational studies that examined associations between prenatal cannabis exposure and major structural birth defects. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To review and perform a meta-analysis of observational studies that examined associations between prenatal cannabis exposure and major structural birth defects.
DATA SOURCES
Information sources included Google Scholar, BIOSIS, PubMed/MEDLINE, EMBASE CINAHL, and ClinicalTrials.gov.
METHODS OF STUDY SELECTION
Study titles and abstracts were reviewed with Abstrackr software. We included observational studies that examined the risk of major structural birth defects in people who used cannabis during pregnancy compared with those who had not used cannabis. We excluded case reports, ecologic studies, conference abstracts, manuscript preprints, studies designed to examine effects of cannabis used concurrently with other drugs, and studies that included synthetic cannabinoids. This process yielded 23 studies that analyzed data from birth years 1968-2021.
TABULATION, INTEGRATION, AND RESULTS
We clustered and meta-analyzed measures of association for birth defects by anatomic group. Eleven articles reported an association between cannabis use and the risk of a nonspecific outcome (eg, congenital anomaly). We estimated a pooled odds ratio of 1.33 (95% CI 1.14-1.56) and a pooled adjusted odds ratio (aOR) of 1.22 (95% CI 1.00-1.50). Anatomic groups examined were cardiac (nine studies), oral cleft (three studies), digestive (four studies), genitourinary (three studies), musculoskeletal (seven studies), and nervous system (five studies). Across most outcomes, we reported positive pooled unadjusted associations that were usually attenuated after the inclusion of only adjusted estimates. Two specific anomalies, with limited data, had pooled effect estimates that did not attenuate to the null after adjustment: Ebstein anomaly (two studies, aOR 2.19, 95% CI 1.25-3.82) and gastroschisis (five studies, aOR 2.50, 95% CI 1.09-5.740).
CONCLUSION
Studies examining associations between prenatal exposure to cannabis and major structural birth defects were heterogeneous. Most published effect estimates were unadjusted and scored low on our risk-of-bias assessment. Overall, we found inconsistent evidence to suggest that prenatal cannabis exposure is associated with birth defects. However, findings related to specific anomalies should be considered in further research.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, CRD42022319041.
Topics: Pregnancy; Female; Humans; Cannabis; Prenatal Exposure Delayed Effects; Odds Ratio; Bias
PubMed: 37473409
DOI: 10.1097/AOG.0000000000005252 -
Clinical Microbiology and Infection :... Jul 2023Therapeutic drug monitoring and Model-informed precision dosing allow dose individualization to increase drug effectivity and reduce toxicity. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Therapeutic drug monitoring and Model-informed precision dosing allow dose individualization to increase drug effectivity and reduce toxicity.
OBJECTIVES
To evaluate the available evidence on the clinical efficacy of individualized antimicrobial dosing optimization.
METHODS
Data sources: PubMed, Embase, Web of Science, and Cochrane Library databases from database inception to 11 November 2022.
STUDY ELIGIBILITY CRITERIA
Published peer-reviewed randomized controlled trials.
PARTICIPANTS
Human subjects aged ≥18 years receiving an antibiotic or antifungal drug.
INTERVENTIONS
Patients receiving individualized antimicrobial dose adjustment.
ASSESSMENT OF RISK OF BIAS
Cochrane risk-of-bias tool for randomized trials.
METHODS OF DATA SYNTHESIS
The primary outcome was the risk of mortality. Secondary outcomes included target attainment, treatment failure, clinical and microbiological cure, length of stay, treatment duration, and adverse events. Effect sizes were pooled using a random-effects model. Statistical heterogeneity was assessed by inconsistency testing (I).
RESULTS
Ten randomized controlled trials were included in the meta-analysis (1241 participants; n = 624 in the individualized antimicrobial dosing group and n = 617 in the control group). Individualized antimicrobial dose optimization was associated with a numerical decrease in mortality (risk ratio [RR] = 0.86; 95% CI, 0.71-1.05), without reaching statistical significance. Moreover, it was associated with significantly higher target attainment rates (RR = 1.41; 95% CI, 1.13-1.76) and a significant decrease in treatment failure (RR = 0.70; 95% CI, 0.54-0.92). Individualized antimicrobial dose optimization was associated with improvement, but not significant in clinical cure (RR = 1.33; 95% CI, 0.94-1.33) and microbiological outcome (RR = 1.25; CI, 1.00-1.57), as well as with a significant decrease in the risk of nephrotoxicity (RR = 0.55; 95% CI, 0.31-0.97).
CONCLUSIONS
This meta-analysis demonstrated that target attainment, treatment failure, and nephrotoxicity were significantly improved in patients who underwent individualized antimicrobial dose optimization. It showed an improvement in mortality, clinical cure or microbiological outcome, although not significant.
Topics: Humans; Adolescent; Adult; Randomized Controlled Trials as Topic; Anti-Bacterial Agents; Treatment Outcome; Treatment Failure; Duration of Therapy; Renal Insufficiency
PubMed: 36965694
DOI: 10.1016/j.cmi.2023.03.018 -
Scandinavian Journal of Work,... Jan 2020Objectives Evidence on the effect of smoking on sickness absence could guide workplace smoking cessation interventions and encourage employers to promote smoking... (Meta-Analysis)
Meta-Analysis
Objectives Evidence on the effect of smoking on sickness absence could guide workplace smoking cessation interventions and encourage employers to promote smoking cessation among their employees. This systematic review and meta-analysis aimed to summarize evidence on the association between smoking and sickness absence and determine whether there are differences in this association for study design, methodology, and sample characteristics. Methods We searched for studies that reported on smoking status and sickness absence, used empirical data, were published in a peer-reviewed journal in the last 25 years, and written in English. We conducted pooled analyses in which uni- and multivariate generalized linear regression models were applied. Results After screening 2551 unique records, 46 articles from 43 studies were included, of which 33 studies (with 1 240 723 participants) could be included in the pooled analyses. Smoking was associated with an 31% increase in risk of sickness absence compared to non-smoking (95% confidence interval (CI) 1.24-39). We did not find statistically significant different effect sizes for study location, gender, age, occupational class, study design, assessment of sickness absence, short- versus long-term sickness absence, and adjustment for relevant confounders. Furthermore, smoking was associated with 2.89 more sickness absence days per year compared to non-smoking (95% CI 2.08-3.70). Conclusions We found robust evidence showing that smoking increases both the risk and number of sickness absence days in working populations, regardless of study location, gender, age, and occupational class. Encouraging smoking cessation at the workplace could therefore be beneficial for employers and employees.
Topics: Absenteeism; Humans; Smoking; Workplace
PubMed: 31478055
DOI: 10.5271/sjweh.3848