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Heliyon Jan 2024Nausea and vomiting, which cause considerable multifaceted effects, are commonly experience in early pregnancy. Various therapeutic strategies are employed, including...
BACKGROUND
Nausea and vomiting, which cause considerable multifaceted effects, are commonly experience in early pregnancy. Various therapeutic strategies are employed, including both conventional agents and complementary medicine. However, the effectiveness of complementary medicine remains controversial. The objective of this meta-analysis is to evaluate efficacy and safety of acupuncture and moxibustion in pregnant women.
METHODS
We conducted a comprehensive search using electronic databases such as PubMed, Embase, ISI Web, Medline, Cochrane, clinicaltrial.gov, and several Chinese databases. A total of 21 randomized controlled trials were included in this study for quantitative analysis. Forest plots were utilized to evaluate the efficacy and safety of acupuncture and moxibustion. Egger's test was employed to assess publication bias.
RESULTS
The pooled analysis revealed that the acupuncture/moxibustion group was more effective than control group in alleviating nausea and vomiting in early pregnant women (RR: 0.28; 95%CI: 0.21, 0.37). Similar results were observed when comparing the acupuncture group to traditional herbs (RR: 0.08; 95 % CI: 0.01, 0.60), conventional therapy (RR: 0.15; 95 % CI: 0.04, 0.57), and the blank control group (RR: 0.33; 95 % CI: 0.22, 0.51). Moxibustion also exhibited the ability to alleviate nausea and vomiting compared with the blank control group (RR: 0.21; 95 % CI: 0.08, 0.52). As for safety, there were no significant differences in severe adverse events between the acupuncture group and the control group (RR: 0.77; 95%CI: 0.52, 1.14), the blank control group (RR: 0.61; 95%CI: 0.34, 1.10), the sham acupuncture group (RR: 1.05; 95%CI: 0.63, 1.73), or the conventional therapy group (RR: 0.32; 95%CI: 0.06, 1.55).
CONCLUSION
Acupuncture and moxibustion might be effective for the management of nausea and vomiting in early pregnant women. Moreover, acupuncture might be a relatively safe treatment for pregnancy.
PubMed: 38298660
DOI: 10.1016/j.heliyon.2024.e24439 -
Environmental Pollution (Barking, Essex... Mar 2024Exposure to toxic metals is a global public health threat. Among other adverse effects, exposure to the heavy metal cadmium has been associated with greater risk of... (Meta-Analysis)
Meta-Analysis Review
Exposure to toxic metals is a global public health threat. Among other adverse effects, exposure to the heavy metal cadmium has been associated with greater risk of cardiovascular disease (CVD). Nonetheless, the shape of the association between cadmium exposure and CVD risk is not clear. This systematic review summarizes data on the association between cadmium exposure and risk of CVD using a dose-response approach. We carried out a literature search in PubMed, Web of Science, and Embase from inception to December 30, 2023. Inclusion criteria were: studies on adult populations, assessment of cadmium exposure, risk of overall CVD and main CVD subgroups as endpoints, and observational study design (cohort, cross-sectional, or case-control). We retrieved 26 eligible studies published during 2005-2023, measuring cadmium exposure mainly in urine and whole blood. In a dose-response meta-analysis using the one-stage method within a random-effects model, we observed a positive association between cadmium exposure and risk of overall CVD. When using whole blood cadmium as a biomarker, the association with overall CVD risk was linear, yielding a risk ratio (RR) of 2.58 (95 % confidence interval-CI 1.78-3.74) at 1 μg/L. When using urinary cadmium as a biomarker, the association was linear until 0.5 μg/g creatinine (RR = 2.79, 95 % CI 1.26-6.16), after which risk plateaued. We found similar patterns of association of cadmium exposure with overall CVD mortality and risks of heart failure, coronary heart disease, and overall stroke, whereas for ischemic stroke there was a positive association with mortality only. Overall, our results suggest that cadmium exposure, whether measured in urine or whole blood, is associated with increased CVD risk, further highlighting the importance of reducing environmental pollution from this heavy metal.
Topics: Adult; Humans; Cardiovascular Diseases; Cadmium; Cross-Sectional Studies; Metals, Heavy; Biomarkers; Observational Studies as Topic
PubMed: 38295933
DOI: 10.1016/j.envpol.2024.123462 -
BMC Pregnancy and Childbirth Jan 2024Early baby bathing has a major negative impact on the newborn's health. Even though early newborn bathing has numerous detrimental effects on neonatal health, evidence... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Early baby bathing has a major negative impact on the newborn's health. Even though early newborn bathing has numerous detrimental effects on neonatal health, evidence has provided little attention on the current level of practice. Furthermore, there is a dearth of data regarding the overall effects of early newborn bathing in Ethiopia, which would be helpful to program and policy designers. This meta-analysis aimed to ascertain the level of early bathing practice and its determinants among postpartum women in Ethiopia.
METHODS
All articles were searched from the Web of Sciences, CINAHL (EBOSCO), Science Direct, MEDLINE, PubMed, Google Scholar, and Google websites from inception to October 10, 2023. The meta-analysis was performed using Stata version 18. The summary estimates with 95% CI were estimated using the random effect model with the Der Simonian Liard method. Heterogeneity was explored using Galbraith plot, Cochrane Q statistics, I2 statistics, and test of theta. To deal with the observed heterogeneity, subgroup analysis, sensitivity analysis, and meta-regression were done.
RESULTS
This meta-analysis included a total of 2787 postpartum women. The pooled level of early newborn bathing practice among postpartum women in Ethiopia was 55% [95% CI: 38-71]. Based on subgroup analysis by region, the highest level of early newborn bathing practice was among studies conducted in the Afar region which was 73% (95% CI: 69-77). There is a significant association between maternal level of education and early newborn bathing practice among postpartum women in Ethiopia (AOR = 0.51, 95% CI: 0.24, 0.78).
CONCLUSIONS
In this meta-analysis, the overall estimate illustrates that more than half of postpartum women practice early newborn bathing in Ethiopia. Maternal level of education was significantly associated with early newborn bathing practice. Thus, both the government and all the concerned stakeholders should take coordinated action to boost information dissemination and awareness creation among postpartum women thereby reducing the practice of early newborn bathing and alleviating consequences of early newborn bathing.
Topics: Female; Humans; Infant, Newborn; Educational Status; Ethiopia; Policy; Postpartum Period; Baths
PubMed: 38281013
DOI: 10.1186/s12884-024-06280-x -
BMC Public Health Jan 2024Self-medication during pregnancy is of great interest. The use of drugs during pregnancy requires a careful reflection on the benefits to the mother and the risks to the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Self-medication during pregnancy is of great interest. The use of drugs during pregnancy requires a careful reflection on the benefits to the mother and the risks to the fetus. Selecting a drug or drugs for treating pregnant women can be difficult for clinicians owing to the various pharmacokinetic and physiological changes encountered during pregnancy. This systematic review and meta-analysis aimed to estimate the pooled prevalence of self-medication and associated factors among women during pregnancy.
METHODS
Searches were carried out at PubMed, Science Direct, Web of Science, and Google Scholar. The quality of the studies and the risk of bias were analyzed using the Joanna Briggs Critical Appraisal Checklist for Analytical Cross-Sectional Studies instrument. The extracted data were tabulated and analyzed qualitatively and quantitatively through meta-analysis.
RESULTS
The overall prevalence of self-medication among pregnant women was 44.50% (95% CI: 38.92-50.23). Subgroup analyses showed differences in self-medication prevalence influenced by region, county income, and study design. The Heterogeneity, assessed by the statistical test I2 varied from 96 to 99% and was statistically significant. The result of this funnel plot showed that the funnel plot was symmetry with p-value = 0.36, and there is no publication bias.
CONCLUSION
The results obtained from this study showed that the prevalence of self-medication among pregnant women is relatively high. This requires effective measures and interventions to reduce self-medication.
TRIAL REGISTRATION
ID = CRD42022312333 .
Topics: Female; Humans; Pregnancy; Cross-Sectional Studies; Pregnant Women; Prevalence; Self Medication; Geography; Socioeconomic Factors
PubMed: 38279083
DOI: 10.1186/s12889-023-17195-1 -
Vaccines Jan 2024During the coronavirus diseases 2019 (COVID-19) pandemic, the safety and efficacy of vaccination during pregnancy, particularly regarding the risk of preterm birth, have... (Review)
Review
During the coronavirus diseases 2019 (COVID-19) pandemic, the safety and efficacy of vaccination during pregnancy, particularly regarding the risk of preterm birth, have been a subject of concern. This systematic review aims to evaluate the impact of COVID-19 vaccination on preterm birth risk and to inform clinical practice and public health policies. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a database search included PubMed, Embase, and Scopus, conducted up until October 2023. Inclusion criteria focused on studies that examined COVID-19 vaccination during pregnancy and its correlation with preterm birth, defined as a birth before 37 weeks of gestation. Six studies met these criteria, encompassing 35,612 patients. A quality assessment was performed using the Newcastle-Ottawa Scale and the Cochrane Collaboration's tool, with the risk of bias evaluated via a funnel plot analysis and an Egger's regression test. The studies demonstrated geographical diversity, mainly from Israel, Romania, and the United States, with a blend of prospective and retrospective designs. The patient cohort's mean age was 31.2 years, with common comorbidities such as gestational diabetes and obesity affecting 9.85% of the total population. The vaccination types varied across the studies, with BNT162b2 being the most used. The results indicated a low heterogeneity among the included studies, evidenced by a Cochran's Q statistic of 2.10 and an I statistic of 13%. The meta-analysis yielded a pooled odds ratio (OR) for a preterm birth risk post-vaccination of approximately 1.03 (95% CI: 0.82-1.30), suggesting no significant increase in preterm birth risk was associated with COVID-19 vaccination. Notable findings included a low preterm birth rate (as low as 0.6% and up to 6.1%) with minimal differences in neonatal outcomes, such as birth weight and APGAR (appearance, pulse, grimace, activity, and respiration) scores between vaccinated and unvaccinated groups. This study concludes that a COVID-19 vaccination during pregnancy does not significantly increase the risk of preterm birth. These findings are crucial for reassuring healthcare providers and pregnant women about the safety of COVID-19 vaccines and supporting their use in public health strategies during the pandemic.
PubMed: 38276674
DOI: 10.3390/vaccines12010102 -
Pregnancy Hypertension Mar 2024To evaluate the diagnostic accuracy of point-of-care (POC) tests for detecting proteinuria in pregnant women. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To evaluate the diagnostic accuracy of point-of-care (POC) tests for detecting proteinuria in pregnant women.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
MEDLINE and EMBASE databases were searched from inception to 13 November 2020.
ELIGIBILITY CRITERIA AND DATA ANALYSIS
Included studies measured the sensitivity and specificity ofPOC proteinuria testing compared to laboratory reference standards (protein-creatinine ratio (PCR), 24-hour urine collection). Bivariate meta-analyses determined pooled sensitivity and specificity. Random-effects inverse-variance model determinedheterogeneity.
MAIN OUTCOME MEASURES
The primary outcome was overall sensitivity and specificity, stratified by method of POC testing and reference standard. Secondary outcomes were sensitivity and specificity within thesubgroupstest brand, reference standard, and hypertension status.
RESULTS
1078 studies were identified, 17 studies comprising 23 comparisons were included. The meta-analysis included 13 studies with 19 comparisons. Pooled sensitivity and specificity of visual dipsticks against PCR was 72 % (95 % CI: 56 % to 84 %) and 92 % (95 % CI: 76 % to 98 %), respectively. Pooled sensitivity and specificity of visual dipsticks against 24-hour collection was 69 % (55 % to 80 %) and 70 % (51 % to 84 %), respectively. Pooled sensitivity and specificity for automated readers against PCR was 73 % (53 % to 86 %) and 91 % (83 % to 95 %), respectively. Pooled sensitivity and specificity of automated readers against 24-hour collection was 65 % (42 % to 83 %) and 82 % (46 % to 96 %), respectively.
CONCLUSION
Visual dipsticks have comparable accuracy to automated readers, yet are notadequate as a rule-out test for proteinuria. Proteinuria POC testing maybe beneficial inantenatal care when repeatfollow-up tests are performed. PROSPERO Registration Number: CRD42021231914.
Topics: Humans; Female; Pregnancy; Pre-Eclampsia; Proteinuria; Sensitivity and Specificity; Point-of-Care Testing
PubMed: 38262144
DOI: 10.1016/j.preghy.2024.01.133 -
Journal of Clinical Medicine Jan 2024Women have classically been excluded from the development of normal data and reference ranges, with pregnant women experiencing further neglect. The incidence of... (Review)
Review
BACKGROUND
Women have classically been excluded from the development of normal data and reference ranges, with pregnant women experiencing further neglect. The incidence of Caesarean section in pregnant women, and of general operative management in young women (both pregnant and non-pregnant), necessitates the formal development of healthy baseline data in these cohorts to optimise their perioperative management. This systematic review assesses the representation of young women in existing reference ranges for several functional exercise tests in common use to facilitate functional assessment in this cohort.
METHODS
Existing reference range data for the exercise tests the Six Minute Walk Test (6MWT), the Incremental Shuttle Walk Test (ISWT) and Cardiopulmonary Exercise Testing (CPET) in young women of reproductive age were assessed using the MEDLINE (Ovid) database, last searched December 2023. Results were comparatively tabulated but not statistically analysed given underlying variances in data.
RESULTS
The role of exercise testing in the perioperative period as an assessment tool, as well as its safety during pregnancy, was evaluated using 65 studies which met inclusion criteria.
CONCLUSION
There is a significant lack of baseline data regarding these tests in this population, especially amongst the pregnant cohort, which limits the application of exercise testing clinically.
PubMed: 38256550
DOI: 10.3390/jcm13020416 -
Indian Journal of Community Medicine :... 2023Asymptomatic bacteriuria is prevalent during pregnancy. If it goes undetected, it can lead to urinary tract infection with severe maternal and neonatal complications....
BACKGROUND
Asymptomatic bacteriuria is prevalent during pregnancy. If it goes undetected, it can lead to urinary tract infection with severe maternal and neonatal complications. Until date, India does not have any guidelines to test for ASB during pregnancy.
OBJECTIVE
To estimate the pooled prevalence of asymptomatic bacteriuria in pregnant women at national level in India.
MATERIAL AND METHODS
We searched Medline, Embase, Web of Science, and Google Scholar using search strategy with keyword. Two authors independently assessed the eligibility of study. The checklist of the JBI was used for evaluating the quality of reporting. The extracted data were analyzed, and the results were reported using a random-effects model with 95% confidence interval (CI). Subgroup analysis was conducted for zones of India, parity and trimester. Publication bias is reported as funnel plot.
RESULT
Pooled prevalence of asymptomatic bacteriuria among pregnant women in India is 13.5% [CI 11.1; 15.8]. Subgroup analysis based on the various geographic zones of the country the pooled prevalence ranged from 9.2% in central zone to 14.8% in south zone. Distribution of prevalence of ASB as per parity was approximately identical. The prevalence of ASB was found to be high in third (21.8%).
CONCLUSION
The prevalence of ASB is found to be high among Indian pregnant women, especially in third trimester. It is therefore recommended for guideline to screen and treat every pregnant woman for ASB to prevent further complications.
PubMed: 38249695
DOI: 10.4103/ijcm.ijcm_795_22 -
PloS One 2024Postpartum sexual health is indicated by a resumption of sexual activity as well as arousal, desire, orgasm, and sexual satisfaction. The issue of resuming sexual... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Postpartum sexual health is indicated by a resumption of sexual activity as well as arousal, desire, orgasm, and sexual satisfaction. The issue of resuming sexual intercourse after childbirth has received limited attention because healthcare professionals rarely provide adequate care to postnatal women. The present study aimed to ascertain the overall prevalence of early resumption of sexual intercourse among most women.
METHODS
Searches were conducted in PubMed, Web of Science, Science Direct, Google Scholar, African Journals Online, and the Cochrane Library. Data were extracted using Microsoft Excel, and STATA version 14 was used for analysis. Publication bias was checked by funnel plot, Egger, and Begg regression tests. A p-value of 0.05 was regarded to indicate potential publication bias. Using I2 statistics, the heterogeneity of the studies was evaluated. By country, a subgroup analysis was conducted. A sensitivity analysis was carried out to determine the effect of each study's findings on the overall estimate. The random effects model was used to assess the overall effect of the study and then measured using prevalence rates and odds ratio with 95% CI.
RESULTS
Twenty-one studies with 4,482 postpartum women participants were included in the study. The pooled prevalence of early resumption sexual intercourse among post-partum women was 57.26% (95% CI 50.14, 64.39) with significant heterogeneity between studies (I2 = 99.2%; P-value ≤ 0.000) observed. Current contraceptive use (AOR = 1.48, 95%CI = 1.03, 6.21), primipara (AOR = 2.88, 95%CI = 1.41, 5.89), and no history of severe genital injury on the last delivery (AOR = 2.27, 95%CI = 1.05, 4.93) were significantly associated with early resumption of sexual intercourse.
CONCLUSION
This study found that more than half of women resumed sexual intercourse early after giving birth. This suggests that a significant number of women may be at higher risk of unwanted pregnancies, short birth intervals, and postpartum sepsis. Thus, stakeholders should improve the integration of postpartum sexual education with maternal health services to reduce the resumption of postpartum sexual intercourse.
Topics: Female; Humans; Pregnancy; Coitus; Family Planning Services; Postpartum Period; Sexual Behavior
PubMed: 38232099
DOI: 10.1371/journal.pone.0288536 -
BMC Psychiatry Jan 2024Globally, sleep disturbance is the foremost public health issue among pregnant women which might have undesirable birth outcome including neurocognitive impairment,... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Globally, sleep disturbance is the foremost public health issue among pregnant women which might have undesirable birth outcome including neurocognitive impairment, preterm birth, low birth weight, and neonatal morbidity and mortality. In Ethiopia, inconsistent findings have been reported on the prevalence of sleep disturbance among pregnant women. Therefore, this review aims to estimate the pooled prevalence sleep disturbance and its associated factors among pregnant women in Ethiopia.
METHODS
This systematic review and meta-analysis of observational studies was designed according to the PRISMA guideline. A systematic search of literature was conducted in PubMed, Scopus, Web of science, and Google Scholar using relevant searching key terms. The Newcastle-Ottawa scale was used to evaluate the quality of all selected articles. Data were analyzed using STATA Version 14 software. Publication bias was checked using Egger's test and funnel plot. Cochran's chi-squared test and I values were used to assess heterogeneity. A fixed-effects model was applied during meta-analysis.
RESULTS
In this review, six studies were included after reviewing 17,100 articles. The pooled prevalence of sleep disturbance among pregnant women in Ethiopia was 50.43% (95%CI: 39.34-61.52). Third trimester pregnancy AOR = 4.03; 95% CI: 2.84,5.71), multigravidity (AOR = 1.99; 95% CI: 1.54, 2.59), unplanned pregnancy (AOR = 2.56; 95% CI: 1.52,4.31), depression (AOR = 3.57; 95% CI: 2.04, 6.27), stress (AOR = 2.77; 95% CI: 1.57, 4.88), anxiety (AOR = 3.69; 95% CI: 1.42, 9.59) and poor sleep hygiene (AOR = 2.49; 95% CI: 1.56, 3.99) and were statistically associated with sleep disturbance among pregnant women.
CONCLUSION
This review revealed that the magnitude of sleep disturbance among pregnant woman in Ethiopia was relatively high and multiple factors determined the likelihood of having a disturbed sleep-awake pattern. Thus, the implementation of interventions for sleep disturbance after screening pregnant women is needed. Moreover, public health interventions targeted on the prevention of unintended pregnancy and depression during pregnancy should be implemented.
Topics: Female; Pregnancy; Infant, Newborn; Humans; Pregnant Women; Ethiopia; Premature Birth; Pregnancy Trimester, Third; Prevalence; Observational Studies as Topic
PubMed: 38225632
DOI: 10.1186/s12888-023-05456-7