scholarly journals Association between Oral Contraceptives and cutaneous melanoma: a systematic review and metanalysis

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Giacchetta ◽  
M Chiavarini ◽  
G Naldini ◽  
R Fabiani
Keyword(s):  
Systematic Review ◽  
Malignant Melanoma ◽  
Publication Bias ◽  
Oral Contraceptives ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cutaneous Malignant Melanoma ◽  
Hormonal Factors ◽  
Increased Risk

Abstract Background The probability of developing invasive cutaneous malignant melanoma (CMM) is higher in women than in men up until the age of 49. Several studies investigated the association between hormonal factors and CMM. The aim of this systematic review and meta-analysis is to summarize the evidence on the association between Oral Contraceptives (OC) and the risk of CMM. Methods This review and meta-analysis follow the PRISMA guidelines. A systematic literature search was conducted on Medline and Web of Science until December 2019. Studies were eligible if reported a risk estimate for the association between OC and CMM. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger's test and Begg's test. Meta-analysis was performed using random effect model. Results The results of the pooled analysis of all 32 studies showed no significant association between OC and the risk of CMM (OR 1.02; 95% CI 0.94-1.11; I2=39.32%, p = 0.013). The stratified analyses by study design found no significant association between OC and the risk of CMM neither in the 18 case-control studies (OR 1.02; 95% CI 0.87-1.21; I2=56.91%, p = 0.002) nor in the 14 cohort studies (OR 1.04; 95% CI 0.98-1.11; I2=0.00%, p = 0.557). No significant publication bias could be detected by Egger's test or Begg's test. Conclusions This meta-analysis of available literature suggests no significant association between OC and the risk of developing CMM. Further investigations are needed to evaluate the possible relationship of OC use and other hormonal factors potentially contributing to the increased risk of CMM in women during their reproductive years. Key messages Oral contraceptives (OC) do not significantly contribute to the risk of Cutaneous Malignant Melanoma (CMM). Further studies are needed to investigate the potential role of other hormonal factors in the increased probability of developing CMM in women during their reproductive years.

Association between menopausal hormone therapy and melanoma: a systematic review and meta-analysis

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Naldini ◽  
M Chiavarini ◽  
I Giacchetta ◽  
R Fabiani
Keyword(s):  
Systematic Review ◽  
Malignant Melanoma ◽  
Hormone Therapy ◽  
Publication Bias ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Case Control ◽  
Menopausal Hormone Therapy ◽  
Rate Of Increase ◽  
Increased Risk

Abstract Background Age-specific incidence rates of cutaneous Malignant Melanoma (MM) are higher in women during their reproductive years, while the rate of increase slows after menopause, supporting the speculation that hormones might influence the risk of developing cutaneous MM. The aim of our systematic review and meta-analysis is to summarize the evidence on the association between Menopausal Hormone Therapy (MHT) and the risk of MM. Methods Medline and Web of Science were systematically searched for eligible publications until December 2019. Our review and meta-analysis follow the PRISMA guidelines. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger's test and Begg's test. Meta-analysis was performed using a random effect model. Results The pooled analysis of all 19 studies (9 cohort and 10 case-control) showed a significant positive association of MHT with risk of MM (OR 1.19; 95% CI 1.13-1.26; I2=41.93%, p = 0.029). Excluding Uveal and intraocular MM (3 studies), MHT increased the risk of cutaneous MM (OR 1.19; 95% CI 1.13-1.26; I2=35.73%, p = 0.077). No significant publication bias could be detected. Stratifying by study design, MHT significantly increased the risk of cutaneous MM (OR 1.19; 95% CI 1.12-1.27; I2=42.52%, p = 0.107) in the cohort studies; no significant association was found in case-control studies. Conclusions This meta-analysis of available literature resulted in an increased risk of MM in women used MHT. Further investigations are necessary to increase the reliability of the results and estimate the relationship of other characteristics of MHT, such as type (opposed and unopposed estrogens) and route of administration, with MM. Key messages Menopausal Hormone Therapy (MHT) significantly increases the risk of Malignant Melanoma (MM). Further awareness of clinical practitioners should be raised on the potential association of MHT with MM.

scholarly journals Is Routine Preoperative Esophagogastroduodenoscopy Prior to Bariatric Surgery Mandatory? Systematic Review and Meta-analysis of 10,685 Patients

2020 ◽  
Vol 30 (8) ◽  
pp. 3073-3083 ◽  
Author(s):  
Walid El Ansari ◽  
Ayman El-Menyar ◽  
Brijesh Sathian ◽  
Hassan Al-Thani ◽  
Mohammed Al-Kuwari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Publication Bias ◽  
Surgical Approach ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background This systematic review and meta-analysis searched, retrieved and synthesized the evidence as to whether preoperative esophagogastroduodenoscopy (p-EGD) should be routine before bariatric surgery (BS). Methods Databases searched for retrospective, prospective, and randomized (RCT) or quasi-RCT studies (01 January 2000–30 April 2019) of outcomes of routine p-EGD before BS. STROBE checklist assessed the quality of the studies. P-EGD findings were categorized: Group 0 (no abnormal findings); Group 1 (abnormal findings that do not necessitate changing the surgical approach or postponing surgery); Group 2 (abnormal findings that change the surgical approach or postpone surgery); and Group 3 (findings that signify absolute contraindications to surgery). We assessed data heterogeneity and publication bias. Random effect model was used. Results Twenty-five eligible studies were included (10,685 patients). Studies were heterogeneous, and there was publication bias. Group 0 comprised 5424 patients (56%, 95% CI: 45–67%); Group 1, 2064 patients (26%, 95% CI: 23–50%); Group 2, 1351 patients (16%, 95% CI: 11–21%); and Group 3 included 31 patients (0.4%, 95% CI: 0–1%). Conclusion For 82% of patients, routine p-EGD did not change surgical plan/ postpone surgery. For 16% of patients, p-EGD findings necessitated changing the surgical approach/ postponing surgery, but the proportion of postponements due to medical treatment of H Pylori as opposed to “necessary” substantial change in surgical approach is unclear. For 0.4% patients, p-EGD findings signified absolute contraindication to surgery. These findings invite a revisit to whether p-EGD should be routine before BS, and whether it is judicious to expose many obese patients to an invasive procedure that has potential risk and insufficient evidence of effectiveness. Further justification is required.

scholarly journals Association of human papilloma Virus infection other than cervical cancer: Systematic Review and Meta Analysis

2021 ◽  
Vol 44 (1) ◽  
pp. 119-128
Author(s):  
Habtamu Molla ◽  
Habtamu Temesgen ◽  
Dereje Beyene
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Human Papilloma Virus ◽  
Publication Bias ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Hpv Infection ◽  
Papilloma Virus ◽  
Pooled Prevalence

Human Papilloma Virus (hpv) infection causes different cancer diseases. Cervical cancer is the most common hpv related disease. hpv infection also causes cancer of anus, vulva, vagina, penis, skin, bladder, prostate, breast, oral and others because the hpv virus is epithelium-tropic. But the association of hpv infection other than cervical cancer, for example breast cancer, bladder cancer, prostate cancer etc is still inconclusive. Thus, the objective of this review was to collect published information on hpv infection other than cervix to explore the pooled prevalence of hpv infection as well as related types of cancers.  Publish research articles of hpv infection and cancer risks other than cervical cancer were systematically searched through Internet. The preferred reporting items for systematic review and meta-analysis guidelines were followed. Joanna Brigg’s Institute Meta-Analysis of Statistics Assessment and Review Instrument (jbi-mastari) adapted for cross sectional/case control study design was used for quality assessment of each individual study. A total of 22 studies were extracted and analyzed using stata 14. The random effect model was used to estimate the pooled prevalence; whereas subgroup analysis and meta-regression was performed to identify the probable source of heterogeneity. Both Egger’s and Begg’s tests were used to check publication bias.  The totals of 486 studies were retrieved and 22 studies were included in this meta- analysis. The meta-analysis result showed that the pooled prevalence of hpv infection other than cervix was 34.36% (95% CI: 23.75, 44.97) with severe heterogeneity (I2 = 99.5%; p<0.001) with no publication bias. The highest pooled prevalence of hpv infection other than cervix was related to genital cancer which is 58.63% (95% CI: 51.86, 65.39), followed by oral cancer (47.15% with 95% CI: 19.67, 74.63). Although cervical cancer is primarily hpv induced cancer which well articulated with so many researches, other cancer types (based on the location of the hpv infection) are also increasing across the world based on this systematic and meta-analysis study. hpv infection increases the risk of developing cancers other than cervical cancer.

scholarly journals Prevalence, awareness and control of hypertension in Malaysia 1980 – 2017: A Systematic Review and Meta-Analysis

2019 ◽  
Author(s):  
Zhen Yee Chow ◽  
Soo Man Jun ◽  
Siew Mooi Ching ◽  
Chun Han Tan ◽  
Kai Wei Lee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Public Health Problem ◽  
High Morbidity ◽  
Hypertension Status ◽  
Increased Risk ◽  
And Control

AbstractBackgroundHypertension is a common public health problem worldwide and is a well-known risk factor for increased risk of cardiovascular diseases, contributing to high morbidity and mortality. However, there is no systematic review and meta-analysis that has been done in a multi-ethnic population like Malaysia. This systematic review aims to determine the trend in prevalence, awareness and control of hypertension in Malaysia.MethodsSystematic searches were conducted in PubMed, Scopus, Ovid, Cumulative Index to Nursing and Allied Health Literature, Malaysian Medical Repository and Malaysia Citation Index published between 1980 and 2017. All original articles in English were included. Studies included were those on adults aged 18 years and above. Studies of prevalence in children and adolescents and pregnancy related hypertension were excluded. Two authors independently reviewed the studies, carried out data extraction and performed quality assessment. Heterogeneity between studies and publication bias was assessed and effect size was pooled by the random effect model.ResultsFifty-six studies with a total of 241,796 subjects were included. The prevalence of hypertension throughout Malaysia varied (I2= 99.3%). The overall pooled prevalence of hypertension over the past 4 decades was 28.2% in adults aged 18 years and older (95% CI: 26.1 – 33.3) and the prevalence in those 30 years and older was 40.0% (95% CI: 35.3-44.8).For subgroup analysis, the prevalence of hypertension in male aged 18 and above was 31.4% (95% CI: 26.5 - 36.2) and 27.8% in female (95% CI: 20.7 – 34.9). The prevalence of hypertension among the ethnic groups aged 18 years and above were 37.3% in Malays (95% CI: 32.9 – 41.7); 36.4% in Chinese (95% CI 31.6 - 41.2) and 34.8% in Indians (95% CI: 31.2-38.4). The prevalence of hypertension was the lowest in the 1980s (16.2%, 95% CI: 13.4-19.0%), increases up to 36.8% in the 1990s (95% CI: 6.1-67.5), then came down to 28.7% (95% CI: 21.7-35.8) in the 2000s and 29.2% (95% CI: 24.0-34.4) in the 2010s. The prevalence of awareness was 38.7% (95% CI: 31.7 – 45.8) whereas the control of hypertension of those on treatment was 33.3% (95% CI: 28.4 – 38.2).ConclusionThree in 10 adults aged 18 years old and above have hypertension, whereas four in 10 adults aged 30 years old and above have hypertension. Four out of 10 are aware of their hypertension status and only one-third of them who were under treatment achieved control of their hypertension. Concerted efforts by policymakers and healthcare professionals to improve the awareness and control of hypertension should be of high priority.

Abstract 16310: Association Between the Use of Antithrombotics and Cardiac Implantable Electronic Device Infections: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Chol Techorueangwiwat ◽  
Chanavuth Kanitsoraphan ◽  
Jakrin Kewcharoen
Keyword(s):  
Systematic Review ◽  
Effect Size ◽  
Electronic Device ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Systemic Infection ◽  
Cardiac Implantable Electronic Device ◽  
Inverse Variance ◽  
Increased Risk

Introduction: Studies have shown that the use of antiplatelet and anticoagulant increases the risk of cardiac implantable electronic device (CIED) infection following the implantation. However, results were contradicting. In this study, we performed a systematic review and meta-analysis to explore the effect of antiplatelets and anticoagulants and the risk of CIED infection following the implantation. Methods: We searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were published studies of patients undergoing CIED implantations which reported effect size of the use of either antiplatelet or anticoagulant, or both, on the risk of CIED infections. CIED infection was defined as either device-related local or systemic infection. Data from each study were combined using the random-effects, generic inverse variance method of Der Simonian and Laird to calculate effect size and 95% confidence intervals (CI). Results: Fifteen studies from 2008-2019 involving a total of 72,028 patients were included. In random-effect model, we found that the use of antiplatelet was not associated with an increased risk of CIED infections (risk ratio (RR) =1.13, 95% CI: 0.89-1.44, p=0.314, I 2 =51.3%), while the use of anticoagulant was associated with increased risk of CIED infections (RR =1.50, 95%CI: 1.02-2.21, p=0.038, I 2 =75%). There was no publication bias observed in the funnel plot as well as no small-study effect observed in Egger’s test. Conclusions: Our meta-analysis demonstrated that the use of anticoagulant significantly increases the risk of CIED infection following the implantation by up to 1.50-fold, however, this effect was not observed with antiplatelet use. Our study suggested that patients on anticoagulation considering CIED implantations should proceed with caution.

scholarly journals Association between Anemia and Risk of Parkinson Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yao-Chin Wang ◽  
Abel Po-Hao Huang ◽  
Sheng-Po Yuan ◽  
Chu-Ya Huang ◽  
Chieh-Chen Wu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson Disease ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Epidemiological Studies ◽  
Effect Model ◽  
Increased Risk ◽  
Male Patients ◽  
Risk Ratios

Background and Objective. People with anemia have higher rates of developing Parkinson disease (PD) than the general population. Previous epidemiological studies have invested the risk of PD in patients with anemia. However, the findings are still inconclusive. Therefore, we did a systematic review with meta-analysis to clarify the association between anemia and risk of PD. Methods. We systematically searched articles on electronic databases such as PubMed, Embase, Scopus, and Google Scholar between January 1, 2000 and July 30, 2020. Articles were independently evaluated by two authors. We included observational studies (case-control and cohort) and calculated the risk ratios (RRs) for associated with anemia and PD. Heterogeneity among the studies was assessed using the Q and I 2 statistic. We utilized the random-effect model to calculate the overall RR with 95% CI. Results. A total of 342 articles were identified in the initial searches, and 7 full-text articles were evaluated for eligibility. Three articles were further excluded for prespecified reasons including insufficient data and duplications, and 4 articles were included in our systematic review and meta-analysis. A random effect model meta-analysis of all 4 studies showed no increased risk of PD in patients with anemia ( N = 4 , R R adjusted = 1.17 (95% CI: 0.94-1.45, p = 0.15 ). However, heterogeneity among the studies was significant ( I 2 = 92.60 , p = < 0.0001 ). The pooled relative risk of PD in female patients with anemia was higher ( N = 3 , R R adjusted = 1.14 (95% CI: 0.83-1.57, p = 0.40 ) as compared to male patients with anemia ( N = 3 , R R adjusted = 1.09 (95% CI: 0.83-1.42, p = 0.51 ). Conclusion. This is the first meta-analysis that shows that anemia is associated with higher risk of PD when compared with patients without anemia. However, more studies are warranted to evaluate the risk of PD among patients with anemia.

scholarly journals Effects of underlying morbidities on the occurrence of deaths in COVID-19 patients: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Mostaured Khan ◽  
Md Nuruzzaman Khan ◽  
Md. Golam Mustagir ◽  
Juwel Rana ◽  
Md Saiful Islam ◽  
...  
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
English Language ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Healthcare Providers ◽  
Cerebrovascular Diseases ◽  
Reference List ◽  
Trim And Fill

Abstract Background: Coronavirus disease 2019 (COVID-19), the most hectic pandemic of the era, is increasing exponentially and taking thousands of lives worldwide. This study aimed to assess the prevalence of pre-existing morbidities among COVID-19 infected patients and their mortality risks against each type of pre-existing morbidity category. Methods: To conduct this systematic review and meta-analysis, Medline, Web of Science, Scopus, and CINAHL databases were searched using specified relavent keywords. Further searches were conducted using the reference list of the selected studies, renowned pre-print servers (e.g., medRxiv, bioRixv, SSRN), and relevant journal websites. Studies written in the English language included if those were conducted among COVID-19 patients with and without comorbidities and presented survivor vs. non-survivor counts or hazard/odds of deaths or survivors against types of pre-existing morbidities. Comorbidities reported in the selected studies were grouped into eight categories. The pooled likelihoods of deaths in each category were estimated using a fixed or random-effect model, based on the heterogeneity assessment. Publication bias was assessed by visual inspection of the funnel plot asymmetry and Eggers regression test. Trim and Fill method was used if there any publication bias was found. Results: A total of 42 studies included in this study comprised of 39,398 samples. The most common pre-existing morbidities in COVID-19 infected patients were hypertension (36.5%), cardiovascular disease (11.9%), and diabetes (22.0%). The higher likelihood of deaths was found among COVID-19 patients who had pre-existing cardiovascular diseases (OR: 3.32, 95% CI: 2.79-3.95), immune and metabolic disorders (OR: 2.39, 95% CI: 2.00-2.85), respiratory diseases (OR: 2.02, 95% CI: 1.80-2.26), cerebrovascular diseases (OR: 4.12, 95% CI: 3.04-5.58), any types of cancers (OR: 2.22, 95% CI: 1.63-3.03), renal (OR: 3.02, 95% CI: 2.60-3.52), and liver diseases (OR: 1.44, 95% CI: 1.21-1.71). Conclusions: This study provides evidence of a higher likelihood of deaths among COVID-19 patients against morbidity categories. These findings could potentially help healthcare providers to sort out the most endangered COVID-19 patients by comorbidities, take precautionary measures during hospitalization, assess susceptibility to death, and prioritize their treatment, which could potentially reduce the number of fatalities in COVID-19.

scholarly journals COVID-19 clinical characteristics, and sex-specific risk of mortality: Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Mohammad Javad Nasiri ◽  
Sara Haddadi ◽  
Azin Tahvildari ◽  
Yeganeh Farsi ◽  
Mahta Arbabi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Clinical Laboratory ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
World Health ◽  
Laboratory Findings ◽  
Risk Of Mortality ◽  
Health Organization

Objectives: The rapidly evolving coronavirus disease 2019 (COVID-19), was declared a pandemic by the World Health Organization on March 11, 2020. It was first detected in the city of Wuhan in China and has spread globally resulting in substantial health and economic crisis in many countries. Observational studies have partially identified the different aspects of this disease. Up to this date, no comprehensive systematic review for the clinical, laboratory, epidemiologic and mortality findings has been published. We conducted this systematic review and meta-analysis for a better understanding of COVID-19. Methods: We reviewed the scientific literature published from January 1, 2019 to March 3, 2020. Statistical analyses were performed with STATA (version 14, IC; Stata Corporation, College Station, TX, USA). The pooled frequency with 95% confidence intervals (CI) was assessed using random effect model. Publication bias was assessed and p <0.05 was considered a statistically significant publication bias. Results: Out of 1102 studies, 32 satisfied the inclusion criteria. A total of 4789 patients with a mean age of 49 years were evaluated. Fever (83.0%, CI 77.5 to 87.6), cough (65.2%, CI 58.6 to 71.2) and myalgia/fatigue (34.7, CI 26.0 to 44.4) were the most common symptoms. The most prevalent comorbidities were hypertension (18.5 %, CI 12.7 to 24.4) and Cardiovascular disease (14.9 %, CI 6.0 to 23.8). Among the laboratory abnormalities, elevated C-Reactive Protein (CRP) (72.0% (CI 54.3 to 84.6) and lymphopenia (50.1%, CI 38.0 to 62.4) were the most common findings. Bilateral ground-glass opacities (66.0%, CI 51.1 to 78.0) was the most common CT-Scan presentation. Pooled mortality rate was 6.6%, with males having significantly higher mortality compared to females (OR 3.4; 95% CI 1.2 to 9.1, P = 0.01). Conclusion: COVID-19 commonly presented with a progressive course of cough and fever with more than half of hospitalized patients showing leukopenia or a high CRP on their laboratory findings. Mortality associated with COVID19 was higher than that reported in studies in China with Males having a 3-fold higher risk of mortality in COVID19 compared to females.

scholarly journals Effect of anticholinergic medications on the risk of dementia: a Protocol of systematic review and meta-analysis

2021 ◽  
Author(s):  
Elham Maraghi ◽  
Ali Reza Safarpour ◽  
Maryam Hajmohammadi ◽  
Ali Akbar Oroojan ◽  
Amal Saki Malehi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Meta Analysis ◽  
Grey Literature ◽  
Random Effect ◽  
Random Effect Model ◽  
Forest Plot ◽  
Anticholinergic Drugs ◽  
Effect Model ◽  
Statistical Heterogeneity

Abstract Introduction: The most kind of dementia is Alzheimer's disease. Alzheimer’s is a type of degenerative cerebrovascular disorder which exacerbates over time. Meanwhile, anticholinergic drugs can potentially modify the risk factors. As different studies have achieved different results and the clinical findings of these interventions have not been conclusive, the objective of this research will be to evaluate the effect of anticholinergic drugs on the risk of dementia.Materials& Methods: This systematic review and meta-analysis with no language limitation between 1988.12.15 and 2020.12.15 will search WoS, EMBASE, MEDLINE/PubMed, Scopus, ProQuest electronic databases and grey literature. Our search strategy with suitability criteria evaluating the effect of anticholinergic drugs on the risk of dementia. Two authors will independently implement the selection phases, data extraction, and quality assessment. Any discrepancies between reviewers will be resolved by consensus; otherwise, the viewpoint of a third specialist person will be applied. The reviewers will evaluate the risk of bias using NOS. We will conduct a meta-analysis with Random Effect Model or Fixed Effect Model according to severity of methodological heterogeneity. The results will be presented via the forest plot for the composition of final studies’ data, to demonstrate the separated and combined frequency and their corresponding 95% CIs and summary tables and narrative summaries. Using I2 statistics and the Q-statistic test, the statistical heterogeneity will be evaluated. For evaluating the possible reporting bias, the Funnel plot will be used; also Begg's and Egger's tests will be applied for significant results of the publication bias, and the Fill & Trim method for reformed publication bias. Ethical and dissemination: The systematic review findings will be published in a peer-reviewed journal and will also be presented at national/international academic and clinical conferences.PROSPRO Registration: CRD42020219612

scholarly journals Birth by Caesarean Section and Offspring Overweight and Obesity in Adult Life: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Manuela Chiavarini ◽  
Benedetta De Socio ◽  
Irene Giacchetta ◽  
Roberto Fabiani
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Adult Life ◽  
Overweight And Obesity ◽  
Risk Estimate ◽  
Increased Risk ◽  
Important Health

Overweight/obesity is one of the most important health problem worldwide. Birth by cesarean section has been shown to influence long-term health outcome including obesity. The aim of this systematic review-meta-analysis is to examine whether cesarean section increases the risk of offspring&rsquo; s overweight/obesity. The study follows the PRISMA and MOOSE guidelines. A systematic literature search was con-ducted on Scopus, PubMed, and WoS until December 2020. For inclusion, studies must have re-ported either (I) both Birth by cesarean section and adult (&ge; 18 years) offspring BMI, (II) cohort or case&ndash;control study design and (III) a risk estimate. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger&rsquo;s test and Begg&rsquo;s test. Me-ta-analysis was performed through a random effect model. Eleven studies with a combined population of 180.408 subjects were included in the meta-analysis. The overall analysis (n = 18) yielded a combined risk estimate for overweight/obesity of 1.19 (95% CI 1.08-1.31) and the test of heterogeneity resulted Q=53,37 (I2 = 70,37 %, P&le;0&bull;0001). The risk of offspring obesity is 1.23 (95% CI 1.09-1.39) and the test of heterogeneity resulted Q=39.50 (I2= 72,15%, P&le;0&bull;0001). Children born by cesarean section have an increased risk of developing obesity in adulthood

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