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Obstetrics and Gynecology Feb 2021To identify and quantify risk factors for atonic postpartum hemorrhage. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To identify and quantify risk factors for atonic postpartum hemorrhage.
DATA SOURCES
PubMed, CINAHL, EMBASE, Web of Science, and and ClinicalTrials.gov databases were searched for English language studies with no restrictions on date or location. Studies included randomized trials, prospective or retrospective cohort studies, and case-control studies of pregnant patients who developed atonic postpartum hemorrhage and reported at least one risk factor.
METHODS OF STUDY SELECTION
Title, abstract, and full-text screening were performed using the Raayan web application. Of 1,239 records screened, 27 studies were included in this review. Adjusted or unadjusted odds ratios (ORs), relative risks, or rate ratios were recorded or calculated. For each risk factor, a qualitative synthesis of low and moderate risk of bias studies classifies the risk factor as definite, likely, unclear, or not a risk factor. For risk factors with sufficiently homogeneous definitions and reference ranges, a quantitative meta-analysis of low and moderate risk of bias studies was implemented to estimate a combined OR.
TABULATION, INTEGRATION, AND RESULTS
Forty-seven potential risk factors for atonic postpartum hemorrhage were identified in this review, of which 15 were judged definite or likely risk factors. The remaining 32 assessed risk factors showed no association with atonic postpartum hemorrhage or had conflicting or unclear evidence.
CONCLUSION
A substantial proportion of postpartum hemorrhage occurs in the absence of recognized risk factors. Many risk factors for atonic hemorrhage included in current risk-assessment tools were confirmed, with the greatest risk conferred by prior postpartum hemorrhage of any etiology, placenta previa, placental abruption, uterine rupture, and multiple gestation. Novel risk factors not currently included in risk-assessment tools included hypertension, diabetes, and ethnicity. Obesity and magnesium were not associated with atonic postpartum hemorrhage in this review.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, CRD42020157521.
Topics: Female; Humans; Postpartum Hemorrhage; Pregnancy; Risk Factors; Uterine Inertia
PubMed: 33417319
DOI: 10.1097/AOG.0000000000004228 -
BMC Public Health Nov 2021Drug abuse is detrimental, and excessive drug usage is a worldwide problem. Drug usage typically begins during adolescence. Factors for drug abuse include a variety of...
BACKGROUND
Drug abuse is detrimental, and excessive drug usage is a worldwide problem. Drug usage typically begins during adolescence. Factors for drug abuse include a variety of protective and risk factors. Hence, this systematic review aimed to determine the risk and protective factors of drug abuse among adolescents worldwide.
METHODS
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was adopted for the review which utilized three main journal databases, namely PubMed, EBSCOhost, and Web of Science. Tobacco addiction and alcohol abuse were excluded in this review. Retrieved citations were screened, and the data were extracted based on strict inclusion and exclusion criteria. Inclusion criteria include the article being full text, published from the year 2016 until 2020 and provided via open access resource or subscribed to by the institution. Quality assessment was done using Mixed Methods Appraisal Tools (MMAT) version 2018 to assess the methodological quality of the included studies. Given the heterogeneity of the included studies, a descriptive synthesis of the included studies was undertaken.
RESULTS
Out of 425 articles identified, 22 quantitative articles and one qualitative article were included in the final review. Both the risk and protective factors obtained were categorized into three main domains: individual, family, and community factors. The individual risk factors identified were traits of high impulsivity; rebelliousness; emotional regulation impairment, low religious, pain catastrophic, homework completeness, total screen time and alexithymia; the experience of maltreatment or a negative upbringing; having psychiatric disorders such as conduct problems and major depressive disorder; previous e-cigarette exposure; behavioral addiction; low-perceived risk; high-perceived drug accessibility; and high-attitude to use synthetic drugs. The familial risk factors were prenatal maternal smoking; poor maternal psychological control; low parental education; negligence; poor supervision; uncontrolled pocket money; and the presence of substance-using family members. One community risk factor reported was having peers who abuse drugs. The protective factors determined were individual traits of optimism; a high level of mindfulness; having social phobia; having strong beliefs against substance abuse; the desire to maintain one's health; high paternal awareness of drug abuse; school connectedness; structured activity and having strong religious beliefs.
CONCLUSION
The outcomes of this review suggest a complex interaction between a multitude of factors influencing adolescent drug abuse. Therefore, successful adolescent drug abuse prevention programs will require extensive work at all levels of domains.
Topics: Adolescent; Depressive Disorder, Major; Electronic Nicotine Delivery Systems; Female; Humans; Pregnancy; Protective Factors; Risk Factors; Schools; Substance-Related Disorders
PubMed: 34774013
DOI: 10.1186/s12889-021-11906-2 -
Diabetes Care Nov 2012Available evidence supports the emerging hypothesis that metabolic syndrome may be associated with the risk of some common cancers. We did a systematic review and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Available evidence supports the emerging hypothesis that metabolic syndrome may be associated with the risk of some common cancers. We did a systematic review and meta-analysis to assess the association between metabolic syndrome and risk of cancer at different sites.
RESEARCH DESIGN AND METHODS
We conducted an electronic search for articles published through October 2011 without restrictions and by reviewing reference lists from retrieved articles. Every included study was to report risk estimates with 95% CIs for the association between metabolic syndrome and cancer.
RESULTS
We analyzed 116 datasets from 43 articles, including 38,940 cases of cancer. In cohort studies in men, the presence of metabolic syndrome was associated with liver (relative risk 1.43, P < 0.0001), colorectal (1.25, P < 0.001), and bladder cancer (1.10, P = 0.013). In cohort studies in women, the presence of metabolic syndrome was associated with endometrial (1.61, P = 0.001), pancreatic (1.58, P < 0.0001), breast postmenopausal (1.56, P = 0.017), rectal (1.52, P = 0.005), and colorectal (1.34, P = 0.006) cancers. Associations with metabolic syndrome were stronger in women than in men for pancreatic (P = 0.01) and rectal (P = 0.01) cancers. Associations were different between ethnic groups: we recorded stronger associations in Asia populations for liver cancer (P = 0.002), in European populations for colorectal cancer in women (P = 0.004), and in U.S. populations (whites) for prostate cancer (P = 0.001).
CONCLUSIONS
Metabolic syndrome is associated with increased risk of common cancers; for some cancers, the risk differs betweens sexes, populations, and definitions of metabolic syndrome.
Topics: Female; Humans; Male; Metabolic Syndrome; Neoplasms; Risk Factors; Sex Factors
PubMed: 23093685
DOI: 10.2337/dc12-0336 -
PloS One 2021Identifying risk factors of depression can provide a better understanding of the disorder in older people. However, to minimize bias due to the influence of confounders...
OBJECTIVES
Identifying risk factors of depression can provide a better understanding of the disorder in older people. However, to minimize bias due to the influence of confounders and to detect reverse influence, a focus on longitudinal studies using multivariate analysis is required.
DESIGN
A systematic literature search was conducted by searching the databases MEDLINE, Cochrane, PsycINFO and Web of Science for all relevant articles published from January 2000 to the end of March 2020. The following inclusion criteria were used: prospective design, nationally or regionally representative sample, published in English or German, analyzed risk factors for depression of individuals 65+ identified by multivariate analysis, and provided validity of diagnostic instrument. All results of multivariate analysis were reported and summarized.
RESULTS
Thirty articles were identified. Heterogeneous results were found for education, female gender, self-rated health, cognitive impairment and older age, although significant in several studies. Findings hinted at a protective quality of physical activity. In terms of physical health, chronic disease and difficulty initiating sleep homogeneously increased risk of depression. Mobility impairment resulted as a risk factor in three studies. IADL impairment and vision impairment were mostly identified as significant risk factors. Alcohol consumption and smoking behavior yielded heterogenous results. Psychosocial factors were assessed similarly in multiple studies and yielded heterogenous results.
LIMITATIONS
Research was limited to articles published in English or German. Length of follow up was not considered for the presentation of results. Adjustments for and inclusion of different variables in the studies may distort results.
CONCLUSION
Our findings demonstrate the necessity of refined, more comparable assessment tools for evaluating potential risk factors.
Topics: Aged; Aged, 80 and over; Depression; Depressive Disorder; Female; Humans; Male; Multivariate Analysis; Prospective Studies; Protective Factors; Risk Factors
PubMed: 33983995
DOI: 10.1371/journal.pone.0251326 -
European Journal of Sport Science Jul 2017Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the... (Review)
Review
Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures of volleyball injuries. To this end, a highly sensitive search strategy was built based on two groups of keywords (and their synonyms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The results showed that ankle, knee and shoulder injuries are the most common injuries sustained while playing volleyball. Results are presented separately for acute and overuse injuries, as well as for contact and non-contact injuries. Measures to prevent musculoskeletal injuries, anterior knee injuries and ankle injuries were identified in the scientific literature. These preventive measures were found to have a significant effect on decreasing the occurrence of volleyball injuries (for instance on ankle injuries with a reduction from 0.9 to 0.5 injuries per 1000 player hours). Our systematic review showed that musculoskeletal injuries are common among volleyball players, while effective preventive measures remain scarce. Further epidemiological studies should focus on other specific injuries besides knee and ankle injuries, and should also report their prevalence and not only the incidence. Additionally, high-quality studies on the aetiology and prevention of shoulder injuries are lacking and should be a focus of future studies.
Topics: Ankle Injuries; Athletic Injuries; Cumulative Trauma Disorders; Humans; Incidence; Knee Injuries; Prevalence; Risk Factors; Shoulder Injuries; Volleyball
PubMed: 28391750
DOI: 10.1080/17461391.2017.1306114 -
Journal of the American College of... Dec 2022Healthy dietary patterns are rich in micronutrients, but their influence on cardiovascular disease (CVD) risks has not been systematically quantified.
BACKGROUND
Healthy dietary patterns are rich in micronutrients, but their influence on cardiovascular disease (CVD) risks has not been systematically quantified.
OBJECTIVES
The goal of this study was to provide a comprehensive and most up-to-date evidence-based map that systematically quantifies the impact of micronutrients on CVD outcomes.
METHODS
This study comprised a systematic review and meta-analysis of randomized controlled intervention trials of micronutrients on CVD risk factors and clinical events.
RESULTS
A total of 884 randomized controlled intervention trials evaluating 27 types of micronutrients among 883,627 participants (4,895,544 person-years) were identified. Supplementation with n-3 fatty acid, n-6 fatty acid, l-arginine, l-citrulline, folic acid, vitamin D, magnesium, zinc, α-lipoic acid, coenzyme Q10, melatonin, catechin, curcumin, flavanol, genistein, and quercetin showed moderate- to high-quality evidence for reducing CVD risk factors. Specifically, n-3 fatty acid supplementation decreased CVD mortality (relative risk [RR]: 0.93; 95% CI: 0.88-0.97), myocardial infarction (RR: 0.85; 95% CI: 0.78-0.92), and coronary heart disease events (RR: 0.86; 95% CI: 0.80-0.93). Folic acid supplementation decreased stroke risk (RR: 0.84; 95% CI: 0.72-0.97), and coenzyme Q10 supplementation decreased all-cause mortality events (RR: 0.68; 95% CI: 0.49-0.94). Vitamin C, vitamin D, vitamin E, and selenium showed no effect on CVD or type 2 diabetes risk. β-carotene supplementation increased all-cause mortality (RR: 1.10; 95% CI: 1.05-1.15), CVD mortality events (RR: 1.12; 95% CI: 1.06-1.18), and stroke risk (RR: 1.09; 95% CI: 1.01-1.17).
CONCLUSIONS
Supplementation of some but not all micronutrients may benefit cardiometabolic health. This study highlights the importance of micronutrient diversity and the balance of benefits and risks to promote and maintain cardiovascular health in diverse populations. (Antioxidant Supplementation in the Prevention and Treatment of Cardiovascular Diseases; CRD42022315165).
Topics: Humans; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Risk Factors; Heart Disease Risk Factors; Vitamin D; Folic Acid; Stroke
PubMed: 36480969
DOI: 10.1016/j.jacc.2022.09.048 -
The Lancet. Planetary Health Jun 2022Heat exposure is an important but underappreciated risk factor contributing to cardiovascular disease. Warming temperatures might therefore pose substantial challenges... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Heat exposure is an important but underappreciated risk factor contributing to cardiovascular disease. Warming temperatures might therefore pose substantial challenges to population health, especially in a rapidly aging population. To address a potential increase in the burden of cardiovascular disease, a better understanding of the effects of ambient heat on different types of cardiovascular disease and factors contributing to vulnerability is required, especially in the context of climate change. This study reviews the current epidemiological evidence linking heat exposures (both high temperatures and heatwaves) with cardiovascular disease outcomes, including mortality and morbidity.
METHODS
In this systematic review and meta-analysis, we searched PubMed, Embase, and Scopus for literature published between Jan 1, 1990, and March 10, 2022, and evaluated the quality of the evidence following the Navigation Guide Criteria. We included original research on independent study populations in which the exposure metric was high temperatures or heatwaves, and observational studies using ecological time series, case crossover, or case series study designs comparing risks over different exposures or time periods. Reviews, commentaries, grey literature, and studies that examined only seasonal effects without explicitly considering temperature were excluded. The risk estimates were derived from included articles and if insufficient data were available we contacted the authors to provide clarification. We did a random-effects meta-analysis to pool the relative risk (RR) of the association between high temperatures and heatwaves and cardiovascular disease outcomes. The study protocol was registered with PROSPERO (CRD42021232601).
FINDINGS
In total, 7360 results were returned from our search of which we included 282 articles in the systematic review, and of which 266 were eligible for the meta-analysis. There was substantial heterogeneity for both mortality (high temperatures: I=93·6%, p<0·0001; heatwaves: I=98·9%, p<0·0001) and morbidity (high temperatures: I=98·8%, p<0·0001; heatwaves: I=83·5%, p<0·0001). Despite the heterogeneity in environmental conditions and population dynamics among the reviewed studies, results showed that a 1°C increase in temperature was positively associated with cardiovascular disease-related mortality across all considered diagnoses. The overall risk of cardiovascular disease-related mortality increased by 2·1% (RR 1·021 [95%CI 1·020-1·023]), with the highest specific disease risk being for stroke and coronary heart disease. A 1°C temperature rise was also associated with a significant increase in morbidity due to arrhythmias and cardiac arrest and coronary heart disease. Our findings suggest heat exposure leads to elevated risk of morbidity and mortality for women, people 65 years and older, individuals living in tropical climates, and those in countries of lower-middle income. Heatwaves were also significantly associated with a 17% increase in risk of mortality (RR 1·117 [95% CI 1·093-1·141]), and increasing heatwave intensity with an increasing risk (RR 1·067 [95% CI 1·056-1·078] for low intensity, 1·088 [1·058-1·119] for middle intensity, and 1·189 [1·109-1·269] for high intensity settings).
INTERPRETATION
This review strengthens the evidence on the increase in cardiovascular disease risk due to ambient heat exposures in different climate zones. The widespread prevalence of exposure to hot temperatures, in conjunction with an increase in the proportion of older people in the population, might result in a rise in poor cardiovascular disease health outcomes associated with a warming climate. Evidence-based prevention measures are needed to attenuate peaks in cardiovascular events during hot spells, thereby lowering the worldwide total heat-related burden of cardiovascular disease-related morbidity and death.
FUNDING
Australian Research Council Discovery Program.
Topics: Aged; Australia; Cardiovascular Diseases; Climate Change; Female; Hot Temperature; Humans; Risk Factors
PubMed: 35709806
DOI: 10.1016/S2542-5196(22)00117-6 -
Critical Care (London, England) Jun 2016Rhabdomyolysis is a clinical syndrome that comprises destruction of skeletal muscle with outflow of intracellular muscle content into the bloodstream. There is a great... (Review)
Review
BACKGROUND
Rhabdomyolysis is a clinical syndrome that comprises destruction of skeletal muscle with outflow of intracellular muscle content into the bloodstream. There is a great heterogeneity in the literature regarding definition, epidemiology, and treatment. The aim of this systematic literature review was to summarize the current state of knowledge regarding the epidemiologic data, definition, and management of rhabdomyolysis.
METHODS
A systematic search was conducted using the keywords "rhabdomyolysis" and "crush syndrome" covering all articles from January 2006 to December 2015 in three databases (MEDLINE, SCOPUS, and ScienceDirect). The search was divided into two steps: first, all articles that included data regarding definition, pathophysiology, and diagnosis were identified, excluding only case reports; then articles of original research with humans that reported epidemiological data (e.g., risk factors, common etiologies, and mortality) or treatment of rhabdomyolysis were identified. Information was summarized and organized based on these topics.
RESULTS
The search generated 5632 articles. After screening titles and abstracts, 164 articles were retrieved and read: 56 articles met the final inclusion criteria; 23 were reviews (narrative or systematic); 16 were original articles containing epidemiological data; and six contained treatment specifications for patients with rhabdomyolysis.
CONCLUSION
Most studies defined rhabdomyolysis based on creatine kinase values five times above the upper limit of normal. Etiologies differ among the adult and pediatric populations and no randomized controlled trials have been done to compare intravenous fluid therapy alone versus intravenous fluid therapy with bicarbonate and/or mannitol.
Topics: Acute Kidney Injury; Crush Injuries; Fluid Therapy; Humans; Ischemia; Muscle, Skeletal; Muscular Diseases; Physical Exertion; Rhabdomyolysis; Risk Factors
PubMed: 27301374
DOI: 10.1186/s13054-016-1314-5 -
Journal of Affective Disorders Feb 2016Pregnancy is a time of increased vulnerability for the development of anxiety and depression. This systematic review aims to identify the main risk factors involved in... (Review)
Review
BACKGROUND
Pregnancy is a time of increased vulnerability for the development of anxiety and depression. This systematic review aims to identify the main risk factors involved in the onset of antenatal anxiety and depression.
METHODS
A systematic literature analysis was conducted, using PubMed, PsychINFO, and the Cochrane Library. Original papers were included if they were written in English and published between 1st January 2003 and 31st August 2015, while literature reviews and meta-analyses were consulted regardless of publication date. A final number of 97 papers were selected.
RESULTS
The most relevant factors associated with antenatal depression or anxiety were: lack of partner or of social support; history of abuse or of domestic violence; personal history of mental illness; unplanned or unwanted pregnancy; adverse events in life and high perceived stress; present/past pregnancy complications; and pregnancy loss.
LIMITATIONS
The review does not include a meta-analysis, which may have added additional information about the differential impact of each risk factor. Moreover, it does not specifically examine factors that may influence different types of anxiety disorders, or the recurrence or persistence of depression or anxiety from pregnancy to the postpartum period.
CONCLUSIONS
The results show the complex aetiology of antenatal depression and anxiety. The administration of a screening tool to identify women at risk of anxiety and depression during pregnancy should be universal practice in order to promote the long-term wellbeing of mothers and babies, and the knowledge of specific risk factors may help creating such screening tool targeting women at higher risk.
Topics: Anxiety; Depression; Female; Humans; Pregnancy; Pregnancy Complications; Risk Factors; Women's Health
PubMed: 26650969
DOI: 10.1016/j.jad.2015.11.014 -
Psychological Medicine Mar 2019Adults with autism spectrum disorder (ASD) are thought to be at disproportionate risk of developing mental health comorbidities, with anxiety and depression being... (Meta-Analysis)
Meta-Analysis
Adults with autism spectrum disorder (ASD) are thought to be at disproportionate risk of developing mental health comorbidities, with anxiety and depression being considered most prominent amongst these. Yet, no systematic review has been carried out to date to examine rates of both anxiety and depression focusing specifically on adults with ASD. This systematic review and meta-analysis examined the rates of anxiety and depression in adults with ASD and the impact of factors such as assessment methods and presence of comorbid intellectual disability (ID) diagnosis on estimated prevalence rates. Electronic database searches for studies published between January 2000 and September 2017 identified a total of 35 studies, including 30 studies measuring anxiety (n = 26 070; mean age = 30.9, s.d. = 6.2 years) and 29 studies measuring depression (n = 26 117; mean age = 31.1, s.d. = 6.8 years). The pooled estimation of current and lifetime prevalence for adults with ASD were 27% and 42% for any anxiety disorder, and 23% and 37% for depressive disorder. Further analyses revealed that the use of questionnaire measures and the presence of ID may significantly influence estimates of prevalence. The current literature suffers from a high degree of heterogeneity in study method and an overreliance on clinical samples. These results highlight the importance of community-based studies and the identification and inclusion of well-characterized samples to reduce heterogeneity and bias in estimates of prevalence for comorbidity in adults with ASD and other populations with complex psychiatric presentations.
Topics: Adult; Anxiety; Autism Spectrum Disorder; Depression; Humans; Risk Factors
PubMed: 30178724
DOI: 10.1017/S0033291718002283