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Journal of Pediatric Urology Feb 2021A systematic review was conducted to evaluate the relationship between ART and the risk of urogenital tract malformations, especially hypospadias and cryptorchidism.... (Meta-Analysis)
Meta-Analysis Review
A systematic review was conducted to evaluate the relationship between ART and the risk of urogenital tract malformations, especially hypospadias and cryptorchidism. Thirty-three papers were selected. Meta-analysis showed that ART was correlated with an increased risk of urogenital tract malformation in offspring (odds ratio (OR) = 1.61, 95% confidence interval (CI): 1.41-1.85), hypospadias (OR = 1.87, 95% CI: 1.47-2.40) and cryptorchidism (OR = 1.83, 95% CI: 1.54-2.18). Among offspring conceived by ART, multiple pregnancies appeared to result in a higher risk of urogenital tract malformation than singleton pregnancies (OR = 1.42, 95% CI: 0.99-2.04; P = 0.058). No significant difference in the risk of urogenital tract malformation was found between in vitro fertilization and intracytoplasmic sperm injection technologies. A sensitivity analysis showed that the above conclusions were relatively consistent. Conclusion: ART is correlated with an increased risk of urogenital tract malformations in offspring, especially hypospadias and cryptorchidism. Among ART offspring, multiple pregnancies may lead to a higher risk of urogenital tract malformations than singleton pregnancies, but more studies are needed for confirmation.
Topics: Congenital Abnormalities; Female; Fertilization in Vitro; Humans; Hypospadias; Male; Pregnancy; Reproductive Techniques, Assisted; Sperm Injections, Intracytoplasmic; Urogenital Abnormalities
PubMed: 33223458
DOI: 10.1016/j.jpurol.2020.11.005 -
Effects of air pollution on the risk of congenital anomalies: a systematic review and meta-analysis.International Journal of Environmental... Jul 2014Congenital anomalies are the main causes of preterm and neonatal mortality and morbidity. We investigated the association between congenital anomalies and mothers'... (Meta-Analysis)
Meta-Analysis Review
Congenital anomalies are the main causes of preterm and neonatal mortality and morbidity. We investigated the association between congenital anomalies and mothers' exposure to air pollution during pregnancy by combining risk estimates for a variety of air pollutants (SO2, NO2, PM10, PM2.5, CO and O3) and anomaly defect outcomes. Seventeen articles were included in the systematic review and thirteen studies were taken into account in the meta-analysis. Combined estimated were calculated separately according to whether the exposure metric was continuous or categorical. Only one significant combination was; NO2 concentrations were significantly associated with coarctation of the aorta (OR = 1.20 per 10 ppb, 95% CI, (1.02, 1.41)). This finding could stem from strong heterogeneity in study designs. Improved exposure assessment methods, in particular more accurate spatial measurements or modeling, standardized definition of cases and of better control of confounders are highly recommended for future congenital anomalies research in this area.
Topics: Air Pollutants; Air Pollution; Aortic Coarctation; Congenital Abnormalities; Environmental Exposure; Female; Humans; Male; Nitrogen Dioxide; Pregnancy; Prenatal Exposure Delayed Effects; Risk Factors
PubMed: 25089772
DOI: 10.3390/ijerph110807642 -
Reproductive Toxicology (Elmsford, N.Y.) Nov 2006The present systematic review was proposed with the objective of estimating the risk of congenital anomalies and other adverse events in children exposed to misoprostol... (Meta-Analysis)
Meta-Analysis Review
The present systematic review was proposed with the objective of estimating the risk of congenital anomalies and other adverse events in children exposed to misoprostol during fetal life. The data source consisted of case-control studies that analyzed the effect of prenatal exposure to misoprostol on the pregnancy outcome, which were located in electronic databases and published up to June 2005. The outcomes of interest included congenital anomalies, fetal death, low birth weight and prematurity. The odds ratios (OR) for the individual studies were pooled by meta-analysis. Sensitivity tests and heterogeneity analysis were performed. Four studies involving 4899 cases of congenital anomalies and 5742 controls were included in accordance with the selection criteria. None of the studies analyzed other adverse effects from misoprostol on the outcome from gestation. Increased risks of congenital anomalies related to misoprostol use were found for any congenital defect (OR=3.56; 95% CI: 0.98-12.98), Möbius sequence (OR=25.31; 95% CI: 11.11-57.66) and terminal transverse limb defects (OR=11.86; 95% CI: 4.86-28.90). In conclusion, prenatal exposure to misoprostol is associated with an increased risk of Möbius sequence and terminal transverse limb defects.
Topics: Anti-Ulcer Agents; Case-Control Studies; Congenital Abnormalities; Dose-Response Relationship, Drug; Female; Humans; Limb Deformities, Congenital; Misoprostol; Mobius Syndrome; Pregnancy
PubMed: 16750609
DOI: 10.1016/j.reprotox.2006.03.015 -
Interactive Cardiovascular and Thoracic... Jan 2018Complete atrioventricular septal defect with tetralogy of Fallot is a rare congenital heart disease. The combination of these lesions occurs in about 1% of all patients... (Meta-Analysis)
Meta-Analysis Review
Influence of staged repair and primary repair on outcomes in patients with complete atrioventricular septal defect and tetralogy of Fallot: a systematic review and meta-analysis.
OBJECTIVES
Complete atrioventricular septal defect with tetralogy of Fallot is a rare congenital heart disease. The combination of these lesions occurs in about 1% of all patients with atrioventricular canal defects and in 5-6% of patients with tetralogy of Fallot. To assess the influence of surgical strategy on the survival and reintervention rate for the left atrioventricular valve and right ventricular outflow tract.
METHODS
We analyzed all related studies since 1986. Thirty-eight articles were initially retrieved via PubMed/MEDLINE, Cochrane Central Register of Controlled Trials and Google Scholar, from which 18 retrospective studies were included in the systematic review and 8 studies in the meta-analysis.
RESULTS
There was no significant difference in the 6-year survival between staged repair and primary repair [80 patients in the primary group and 81 patients in the staged group; I2 = 0%; time-to-event data Peto odds ratio 0.66, 95% confidence interval (CI) 0.3-1.5, P = 0.31; hazard ratio 0.66, 95% CI 0.3-1.3, P = 0.23]. Both groups had an equal reintervention rate for the left atrioventricular valve [75 patients in the primary group and 71 patients in the staged group; I2 = 0.26%; the Mantel-Haenszel odds ratio 0.60, 95% CI 0.22-1.68, P = 0.33], but patients who received an initial palliation had a higher rate of reoperation on the right ventricular outflow tract [I2 = 0%; the Mantel-Haenszel odds ratio 0.27, 95% CI 0.27-0.9988, P = 0.05].
CONCLUSIONS
Results of this meta-analysis reveal no difference in 6-year survival and reoperation rate for the left atrioventricular valve; however, patients who underwent staged repair had a higher rate of reintervention for the right ventricular outflow tract, which could be related to initially poor pulmonary bed anatomy. Therefore, both the primary repair and the staged repair are acceptable options for repair of complete atrioventricular septal defect with tetralogy of Fallot. The choice of surgical strategy must consider the anatomy of the pulmonary bed, patient condition and associated anomalies, which could affect surgical risk.
Topics: Abnormalities, Multiple; Cardiac Surgical Procedures; Child; Heart Septal Defects; Humans; Palliative Care; Tetralogy of Fallot; Treatment Outcome
PubMed: 29049707
DOI: 10.1093/icvts/ivx267 -
Journal of Thoracic Oncology : Official... Nov 2016The appropriate management of asymptomatic congenital pulmonary malformations (CPMs) remains controversial. Prophylactic surgery is recommended to avoid the risk for... (Review)
Review
INTRODUCTION
The appropriate management of asymptomatic congenital pulmonary malformations (CPMs) remains controversial. Prophylactic surgery is recommended to avoid the risk for development of pulmonary infections and to prevent the highly debated development of malignancy. However, the true risk for development of malignancy remains unknown. A systematic review analyzed all cases in which lung tumors associated with CPMs in both the pediatric and adult populations were described.
METHODS
A comprehensive literature search was carried out; it included all the cases in which an association between CPMs and malignant pulmonary lesions was reported.
RESULTS
In all, 134 publications were eligible for inclusion. In 168 patients CPM was found associated with lung tumor. The diagnosis was made in 76 children at a mean age of 3.68 ± 3.4, whereas in the adult population (n = 92) it was made at a mean age of 44.62 ± 16.09. Cough was the most frequent presenting symptom both in children and in adults. Most of the patients underwent lobectomy. The tumor most often associated with CPM was pleuropulmonary bastoma in children (n = 31) and adenocarcinoma (n = 20) or bronchioloalveolar carcinoma (n = 20) in adults. The CPM most frequenty associated with tumors in children was congenital cystic adenomatoid malformation (n = 37), especially type 1 (n = 21), whereas in adults it was bronchogenic cyst (n = 25), followed by congenital cystic adenomatoid malformation (n = 21).
CONCLUSIONS
CPMs should be followed up and never underestimated because they may conceal a tumor. Apparently, there is no age limit for malignant progression of CPMs and no limit of the interval between first detection of the CPM and appearance of the associated tumor.
Topics: Adenocarcinoma; Adult; Child, Preschool; Congenital Abnormalities; Female; Humans; Lung Neoplasms; Male
PubMed: 27423390
DOI: 10.1016/j.jtho.2016.06.023 -
The Journal of Bone and Joint Surgery.... Dec 2017Radial dysplasia affects 1 in 6,000 to 8,000 births, classically presenting with a shortened, bowed ulna and radially deviated hand. The optimal treatment remains... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Radial dysplasia affects 1 in 6,000 to 8,000 births, classically presenting with a shortened, bowed ulna and radially deviated hand. The optimal treatment remains unclear, with several opposing approaches advocated. This review aims to clarify the long-term outcomes of nonsurgical and surgical treatment of the "wrist" deformity.
METHODS
The Embase, MEDLINE, PubMed, Cochrane Central, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform (ICTRP) databases were searched for published and unpublished studies reporting long-term outcomes of surgical or nonsurgical treatment of children with radial dysplasia. Results were not restricted by date or language. Primary outcomes were hand-forearm angle, ulnar length, and "wrist" active range of motion (ROM). Studies were assessed using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) criteria. Data for the change in hand-forearm angle were pooled using random-effects meta-analysis, and mean differences and 95% confidence intervals were obtained. Primary outcome data at last follow-up were pooled, and means and standard deviations were obtained. The PROSPERO registration of this study was CRD42016036665.
RESULTS
Of 104 studies identified, 12 were included in this review. Five were retrospective cohort studies and 7 were case series. No randomized studies were found. Study quality was low or very low according to the GRADE criteria. The hand-forearm angle of nonsurgically treated patients worsened during childhood, from 66° to 84°, whereas "wrist" active ROM, at 61°, was better than that for most surgically treated patients. Ulnar length with nonsurgical treatment was predicted to be 64% of normal, but was not directly reported. Isolated soft-tissue release provided a modest reduction in hand-forearm angle compared with nonsurgical treatment. Soft-tissue distraction with centralization or radialization achieved the best hand-forearm angle correction (16° radial deviation). Radialization maintained better "wrist" active ROM (46°) and ulnar length than centralization. Microvascular second metatarsophalangeal joint transfer yielded better reported "wrist" active ROM (83°) and good ulnar length compared with other surgical techniques, but a slightly worse hand-forearm angle (28°).
CONCLUSIONS
There was low-quality evidence that soft-tissue distraction plus centralization or radialization achieved the best correction of the hand-forearm angle for children with radial dysplasia.
LEVEL OF EVIDENCE
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Topics: Age Factors; Female; Hand Deformities, Congenital; Humans; Male; Orthopedic Procedures; Radius; Plastic Surgery Procedures; Recovery of Function; Risk Assessment; Treatment Outcome; Wrist Joint
PubMed: 29257019
DOI: 10.2106/JBJS.17.00164 -
Oral Diseases May 2021The aim of systematic review was to describe the phenotypes and molecular profiles of syndromes with gingival fibromatosis (GF). (Review)
Review
OBJECTIVE
The aim of systematic review was to describe the phenotypes and molecular profiles of syndromes with gingival fibromatosis (GF).
METHODS
A comprehensive search of PubMed, LILACS, Livivo, Scopus, and Web of Science was conducted using key terms relevant to the research questions and supplemented by a gray literature search. The Methodological Quality and Synthesis of Case Series and Case Reports in association with the Case Series and Prevalence Studies from the Joanna Briggs Institute critical appraisal tools were used for the risk of bias. We followed the PRISMA checklist guidelines.
RESULTS
Eighty-four studies reporting GF as an oral manifestation of a syndrome were identified in this review. Enamel renal syndrome was the most frequently reported syndrome with GF, represented by 54 individuals in 19 studies, followed by Zimmermann-Laband syndrome with 24 individuals in 15 studies and Costello syndrome, which was presented in a case series study with 41 individuals. Among reported cases, other clinical manifestations such as hypertrichosis, ectopic gingival calcification, and cherubism were described.
CONCLUSIONS
The results emphasize the need of systematic oro-dental-facial phenotyping for future descriptions as well as further molecular analysis in order to better understand the occurrence of syndromic GF.
Topics: Abnormalities, Multiple; Craniofacial Abnormalities; Fibromatosis, Gingival; Hand Deformities, Congenital; Humans; Syndrome
PubMed: 32335995
DOI: 10.1111/odi.13369 -
Obstetrics and Gynecology Mar 2017To assess antenatal, birth, and infant outcomes for pregnant women, fetuses, and infants after antenatal vaccination with any antigen present in combination pertussis... (Review)
Review
OBJECTIVE
To assess antenatal, birth, and infant outcomes for pregnant women, fetuses, and infants after antenatal vaccination with any antigen present in combination pertussis vaccines.
DATA SOURCES
PubMed, EMBASE, Literature in the Health Sciences in Latin America and the Caribbean, ClinicalTrials.gov, Cochrane Library, and World Health Organization (inception to May 5, 2016).
METHODS OF STUDY SELECTION
Studies reporting outcomes for pregnant women, their fetus, or infant after antenatal exposure to either monovalent or combined tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) or inactivated polio vaccines were considered for inclusion.
RESULTS
A total of 21 studies were included in this review. Point estimates ranged from 0.47 to 1.50 for preterm birth (less than 37 weeks of gestation), 0.65-1.00 for small for gestational age (birth weight less than the 10th percentile), 0.36-0.85 for stillbirth, 0.16-1.00 for neonatal death, 0.76-1.20 for low birth weight (less than 2,500 g), and 0.20-0.91 for congenital anomalies. All lower 95% confidence intervals (CIs) were less than 1.0. Of three retrospective studies assessing chorioamnionitis after vaccination, one showed a small but statistically significant increase. Point estimates for all anomalies after antenatal tetanus toxoid vaccination ranged from 1.20 to 1.60 and had 95% CIs that crossed 1.0. There was substantial clinical and methodologic heterogeneity from mainly retrospective observational studies with an overall high risk of bias. Objective rates of fever were low, 3% or below, and more common systemic events observed included headache, malaise, and myalgia.
CONCLUSION
Evidence suggests that antenatal combined Tdap administered during the second or third trimester of pregnancy is not associated with clinically significant harms for the fetus or neonate. Medically attended events in pregnant women are similar between vaccinated and unvaccinated groups.
Topics: Chorioamnionitis; Congenital Abnormalities; Diphtheria Toxoid; Female; Fever; Headache; Humans; Infant, Newborn; Infant, Small for Gestational Age; Myalgia; Perinatal Mortality; Pregnancy; Pregnancy Outcome; Premature Birth; Stillbirth; Vaccination
PubMed: 28178054
DOI: 10.1097/AOG.0000000000001888 -
African Journal of Reproductive Health Sep 2020Nigeria has a large number of congenital disorders (CD). For instance, two out of every hundred children born in Nigeria have sickle cell disorders (SCD). Making Nigeria... (Review)
Review
Nigeria has a large number of congenital disorders (CD). For instance, two out of every hundred children born in Nigeria have sickle cell disorders (SCD). Making Nigeria the country with the highest incidence of SCD. This article reviews the prevalence of CD in Nigeria; with emphasis on those having a heavy statistical burden on the country, the availability of community genetics services in Nigeria and the efforts being made to tackle the challenges of CD. A systematic review of birth prevalence of congenital malformations (CM) in Nigeria was done through a literature search, with no time restriction for publication dates. Only studies that included the birth prevalence of CM were included. Eligible studies with incorrect or missing data were excluded. This revealed a dearth of data on CD in Nigeria, as in most Low- and Middle-Income Countries. A predominance of CM of the musculoskeletal and gastrointestinal systems was found in Nigeria. However, the pattern of CM in the South-South region was more of the central nervous system. There is scarcity of resources to address the challenges of CD in Nigeria with feeble government assistance. Meanwhile, 70% of CD can be prevented and adequately managed by well implemented community genetics services.
Topics: Anemia, Sickle Cell; Central Nervous System; Community Health Services; Congenital Abnormalities; Genetic Counseling; Genetic Diseases, Inborn; Genetic Services; Humans; Infant, Newborn; Musculoskeletal Abnormalities; Nigeria
PubMed: 34077139
DOI: 10.29063/ajrh2020/v24i3.18 -
Current Drug Safety 2016Multiple pregnancies are a recognized adverse effect of assisted reproductive technologies; nevertheless, there is no consensus on the incremental risk associated with... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Multiple pregnancies are a recognized adverse effect of assisted reproductive technologies; nevertheless, there is no consensus on the incremental risk associated with the ovarian stimulation (OS) used alone and intrauterine insemination (IUI). The relationship between OS and IUI and the risk of major congenital malformations (MCM) is unclear.
OBJECTIVE
To summarise the literature and evaluate the risk of multiple pregnancy and MCM associated with OS used alone and IUI used with or without OS compared to natural conception (spontaneously conceived infants without any type of fertility treatments).
METHODS
We carried out a systematic review to identify published papers between 1966 and 2014 in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. We included observational studies and randomized clinical trials related to the risk of multiple pregnancies and MCM conceived following OS alone or IUI compared to natural conception (spontaneously conceived infants without any fertility treatments). The quality of the included studies was evaluated using The Cochrane Collaboration's tool for assessing risk of bias for RCTs and the Newcastle-Ottawa Scale for observational studies.
RESULTS
There were 63 studies included in this review. Our systematic review suggests that the use of any OS alone was associated with an increased risk of multiple pregnancy compared to natural conception (pooled RR 8.80, 95% CI 5.09- 15.20; p= 0.000; 9 studies). Similar increases in the risk of multiple pregnancies were observed following clomiphene citrate used without assisted reproductive technologies. Compared to natural conception, the use of IUI with or without OS was associated with an increased risk of multiple pregnancy (pooled RR 9.73, 95% CI 7.52 -12.60; p= 0.000; 6 studies). Compared to natural conception, the use of any OS alone was associated with an increased risk of any MCM (RR pooled 1.18, 95%CI 1.03-1.36; 11 studies), major musculoskeletal malformations (pooled RR 1.48, 95%CI 1.21-1.81; 7 studies), and malformations of the nervous system (pooled RR 1.73, 95%CI 1.15-2.61; 6 studies). Compared to natural conception, the use of IUI was associated with an increased risk of any MCM (pooled RR 1.23, 95%CI 1.10-1.37; 10 studies), major urogenital (pooled RR 1.52, 95%CI 1.04-2.22; 7 studies), and musculoskeletal malformations (pooled RR 1.54, 95%CI 1.20-1.98; 7 studies). The overall quality of the included studies was acceptable.
CONCLUSIONS
The increased risk of multiple pregnancy and certain types of MCM associated with the use of less invasive fertility treatments, such as OS and IUI, found in this review, highlights the importance of the practice framing. Heterogeneity in OS protocols, the combination with other fertility agents, the limited number of studies and the methodological quality differences reduce our ability to draw conclusions on specific treatment. More observational studies, assessing the risk of multiple pregnancy or MCM, as a primary outcome, using standardized methodologies, in larger and better clinically defined populations are needed.
Topics: Clinical Trials as Topic; Congenital Abnormalities; Female; Fertility Agents, Female; Humans; Insemination; Ovulation Induction; Pregnancy; Pregnancy, Multiple; Risk Factors
PubMed: 27484228
DOI: 10.2174/1574886311666160627094051