Anti-thyroid drug use during the first trimester of pregnancy and the risk of birth defects in offspring: systematic review and meta-analysis of observational studies with methodological considerations

ABSTRACTBackgroundMaternal anti-thyroid drug (ATD) use during the first trimester of pregnancy has been associated with an increased risk of birth defects in offspring. Uncertainty remains on the size of this risk and how it compares to untreated hyperthyroidism due to methodological limitations of previous studies.MethodsSystematic review of MEDLINE and EMBASE identifying observational studies examining ATD use during the first trimester of pregnancy and risk of birth defects. Data were extracted on study characteristics, adjusted effect estimates and comparator groups. Effect estimates were pooled using a random-effects generic inverse variance method of analysis and absolute risk calculated.ResultsSeven cohort studies and one case–control study (involving 6212322 pregnancies and 388976 birth defects) were identified. Compared to unexposed women without hyperthyroidism, the association between ATD first trimester use and birth defects in offspring was: adjusted risk ratio [aRR] 1.16 95% CI 1.08-1.25 for propylthyoruacil (PTU); aRR 1.28 95% CI 1.06-1.54 for methimazole/carbimazole (MMI/CMZ); aRR 1.51, 95% CI 1.16-1.97 for both MMI/CMZ and PTU; and aRR 1.15 95%CI 1.02-1.29 for untreated hyperthyroidism. The risk of major birth defects per 1000 live births was: 9.6 for PTU; 16.8 for MMI/CMZ; 30.6 for both MMI/CMZ and PTU; and 9.0 for untreated hyperthyroidism.ConclusionsWhen appropriately analysed this risk of birth defects associated with ATD use in the first trimester of pregnancy is attenuated. Although still elevated, the risk of birth defects is smallest with PTU compared to use of MMI/CMZ and may be similar to that of untreated hyperthyroidism.

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Antithyroid drug use during pregnancy and the risk of birth defects in offspring: systematic review and meta‐analysis of observational studies with methodological considerations

British Journal of Clinical Pharmacology ◽

10.1111/bcp.14805 ◽

2021 ◽

Author(s):

Daniel R. Morales ◽

Lionel Fonkwen ◽

Hedvig M. E. Nordeng

Keyword(s):

Systematic Review ◽

Drug Use ◽

Birth Defects ◽

Observational Studies ◽

Meta Analysis ◽

Antithyroid Drug ◽

Methodological Considerations

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Pregnancy-related complications and incidence of atrial fibrillation: a systematic review and meta-analysis

EP Europace ◽

10.1093/europace/euab116.145 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

T Al Bahhawi ◽

A Aqeeli ◽

S L Harrison ◽

D A Lane ◽

I Buchan ◽

...

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Cohort Studies ◽

Observational Studies ◽

Large Scale ◽

Data Extraction ◽

Meta Analysis ◽

Significant Heterogeneity ◽

Random Effects Models ◽

Increased Risk

Abstract Funding Acknowledgements Type of funding sources: None. Background Pregnancy-related complications have been previously associated with incident cardiovascular disease. However, data are scarce on the association between pregnancy-related complications and incident atrial fibrillation (AF). This systematic review examines associations between pregnancy-related complications and incident AF. Methods A systematic search of the literature utilising MEDLINE and EMBASE (Ovid) was conducted from 1990 to 6 April 2020. Observational studies examining the association between pregnancy-related complications including hypertensive disorders of pregnancy (HDP), gestational diabetes, placental abruption, preterm birth, low birth weight, small-for-gestational-age and stillbirth, and incidence of AF were included. Screening and data extraction were conducted independently by two reviewers. Inverse-variance random-effects models were used to pool hazard ratios. Results: Six observational studies met the inclusion criteria one case-control study and five retrospective cohort studies, with four studies eligible for meta-analysis. Sample sizes ranged from 1,839-1,303,365. Mean/median follow-up for the cohort studies ranged from 7-36 years. Most studies reported an increased risk of incident AF associated with pregnancy-related complications. The pooled summary statistic from four studies reflected a greater risk of incident AF for HDP (hazard ratio (HR) 1.47, 95% confidence intervals (CI) 1.18-1.84; I2 = 84%) and from three studies for pre-eclampsia (HR 1.71, 95% CI 1.41-2.06; I2 = 64%; Figure). Conclusions The results of this review suggest that pregnancy-related complications particularly pre-eclampsia appear to be associated with higher risk of incident AF. The small number of included studies and the significant heterogeneity in the pooled results suggest further large-scale prospective studies are required to confirm the association between pregnancy-related complications and AF. Abstract Figure.

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Gamma-glutamyltransferase predicts increased risk of mortality: A systematic review and meta-analysis of prospective observational studies

Free Radical Research ◽

10.3109/10715762.2014.902055 ◽

2014 ◽

Vol 48 (6) ◽

pp. 716-728 ◽

Cited By ~ 12

Author(s):

Y. Long ◽

F. Zeng ◽

J. Shi ◽

H. Tian ◽

T. Chen

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Meta Analysis ◽

Gamma Glutamyltransferase ◽

Risk Of Mortality ◽

Increased Risk

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Prenatal vitamin D status and offspring’s growth, adiposity and metabolic health: a systematic review and meta-analysis

British Journal Of Nutrition ◽

10.1017/s0007114517003646 ◽

2018 ◽

Vol 119 (3) ◽

pp. 310-319 ◽

Cited By ~ 14

Author(s):

Christina Santamaria ◽

Wei Guang Bi ◽

Line Leduc ◽

Negar Tabatabaei ◽

Prévost Jantchou ◽

...

Keyword(s):

Systematic Review ◽

Vitamin D ◽

Observational Studies ◽

Growth Parameters ◽

Meta Analysis ◽

Metabolic Health ◽

Vitamin D Status ◽

Increased Risk ◽

Vitamin D Levels ◽

Offspring Growth

AbstractIn this systematic review and meta-analysis of observational studies, we aimed to estimate the associations between prenatal vitamin D status and offspring growth, adiposity and metabolic health. We searched the literature in human studies on prenatal vitamin D status and offspring growth in PubMed, up to July 2017. Studies were selected according to their methodological quality and outcomes of interest (anthropometry, fat mass and diabetes in offspring). The inverse variance method was used to calculate the pooled mean difference (MD) with 95 % CI for continuous outcomes, and the Mantel–Haenszel method was used to calculate the pooled OR with 95 % CI for dichotomous outcomes. In all, thirty observational studies involving 35 032 mother–offspring pairs were included. Vitamin D status was evaluated by circulating 25-hydroxyvitamin D (25(OH)D) level. Low vitamin D status was based on each study’s cut-off for low 25(OH)D levels. Low prenatal vitamin D levels were associated with lower birth weight (g) (MD −100·69; 95 % CI −162·25, −39·13), increased risk of small-for-gestational-age (OR 1·55; 95 % CI 1·16, 2·07) and an elevated weight (g) in infant at the age of 9 months (g) (MD 119·75; 95 % CI 32·97, 206·52). No associations were observed between prenatal vitamin D status and other growth parameters at birth, age 1 year, 4–6 years or 9 years, nor with diabetes type 1. Prenatal vitamin D may play a role in infant adiposity and accelerated postnatal growth. The effects of prenatal vitamin D on long-term metabolic health outcomes in children warrant future studies.

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A posteriori dietary patterns and metabolic syndrome in adults: a systematic review and meta-analysis of observational studies

Public Health Nutrition ◽

10.1017/s1368980018000216 ◽

2018 ◽

Vol 21 (9) ◽

pp. 1681-1692 ◽

Cited By ~ 11

Author(s):

Sakineh Shab-Bidar ◽

Mahdieh Golzarand ◽

Mina Hajimohammadi ◽

Sara Mansouri

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

Dietary Patterns ◽

Dietary Pattern ◽

Observational Studies ◽

Meta Analysis ◽

A Posteriori ◽

Significant Positive Association ◽

Western Dietary Pattern ◽

Increased Risk

AbstractObjectiveObservational studies reported potential associations between different dietary patterns and the risk of metabolic syndrome (MetS); however, a consistent perspective has not been established to date. The current systematic review and meta-analysis aimed to evaluate the relationship between a posteriori dietary patterns and MetS by pooling available data.DesignMEDLINE and EMBASE databases were searched for relevant articles published up to July 2015 with no time restriction and with English language restriction. Two independent reviewers completed study selection and data extraction. Random-effects models (DerSimonian–Laird method) were used to pool effect sizes of eligible studies. The potential sources of heterogeneity were assessed using the I2 statistic.ResultsNineteen papers that identified dietary patterns using an a posteriori method were selected and included in the meta-analysis. The ‘Healthy/Prudent’ dietary pattern was inversely associated with risk of MetS (OR=0·89; 95 % CI 0·84, 0·94, P=0·002). In contrast, the ‘Unhealthy/Western’ dietary pattern had a significant positive association with risk of MetS (OR=1·16; 95 % CI 1·11, 1·22, P<0·001).ConclusionsOur findings provide evidence that greater adherence to a healthy/prudent dietary pattern is associated with a lower risk of MetS, while an unhealthy/Western dietary pattern is associated with increased risk of MetS. These data suggest that a diet based on healthy food choices is also beneficial for prevention of MetS.

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The safety of oral fluconazole during the first trimester of pregnancy: a systematic review and meta‐analysis

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.15913 ◽

2019 ◽

Vol 126 (13) ◽

pp. 1546-1552 ◽

Cited By ~ 5

Author(s):

Z Zhang ◽

X Zhang ◽

Y‐y Zhou ◽

C‐m Jiang ◽

H‐y Jiang

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

First Trimester ◽

Oral Fluconazole ◽

First Trimester Of Pregnancy

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Is antibiotics use really associated with increased risk of colorectal cancer? An updated systematic review and meta-analysis of observational studies

International Journal of Colorectal Disease ◽

10.1007/s00384-020-03658-z ◽

2020 ◽

Vol 35 (8) ◽

pp. 1397-1412 ◽

Cited By ~ 2

Author(s):

Guangbo Qu ◽

Chenyu Sun ◽

Monica Sharma ◽

John Patrick Uy ◽

Evelyn J. Song ◽

...

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Observational Studies ◽

Meta Analysis ◽

Increased Risk ◽

Antibiotics Use

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Egg Consumption and Risk of Upper Aero-Digestive Tract Cancers: A Systematic Review and Meta-Analysis of Observational Studies

Advances in Nutrition ◽

10.1093/advances/nmz010 ◽

2019 ◽

Vol 10 (4) ◽

pp. 660-672 ◽

Cited By ~ 1

Author(s):

Azadeh Aminianfar ◽

Roohallah Fallah-Moshkani ◽

Asma Salari-Moghaddam ◽

Parvane Saneei ◽

Bagher Larijani ◽

...

Keyword(s):

Systematic Review ◽

Esophageal Cancer ◽

Cohort Studies ◽

Prospective Cohort ◽

Observational Studies ◽

Meta Analysis ◽

Case Control ◽

Egg Consumption ◽

Prospective Cohort Studies ◽

Increased Risk

ABSTRACT Limited data are available that summarize the relation between egg intake and the risk of upper aero-digestive tract (UADT) cancers. This systematic review and meta-analysis was conducted to investigate the association between egg intake and the risk of UADT cancers. Medline/PubMed, ISI web of knowledge, EMBASE, Scopus, and Google Scholar were searched using relevant keywords. Observational studies conducted on humans investigating the association between egg consumption and the risk of UADT cancers were included. Overall, 38 studies with a total of 164,241 subjects (27, 025 cases) were included. Based on 40 effect sizes from 32 case-control studies, we found a 42% increased risk of UADT cancers among those with the highest egg consumption (ranging from ≥1 meal/d to ≥1 time/mo among studies) compared to those with the lowest intake (ranging from 0–20 g/d to never consumed among studies) (overall OR: 1.42; 95% CI: 1.19, 1.68; P < 0.001). However, this association was only evident in hospital-based case-control (HCC) studies (OR = 1.50; 95% CI: 1.34, 1.68; P < 0.001 for ‘oropharyngeal and laryngeal cancer’ and OR: 1.27; 95% CI: 1.08, 1.50; P = 0.004 for esophageal cancer) and not in population-based case-control (PCC) studies (OR = 1.25; 95% CI: 0.59, 2.67; P = 0.56 for ‘oropharyngeal and laryngeal cancer’ and OR: 1.29; 95% CI: 0.92, 1.81; P = 0.13 for esophageal cancer). In addition, the association was not significant in prospective cohort studies (overall OR: 0.86; 95% CI: 0.71, 1.04; P = 0.11). Considering individual cancers, a positive association was observed between the highest egg consumption, compared with the lowest, and risk of oropharyngeal (OR: 1.88; 95% CI: 1.61, 2.20; P < 0.001), laryngeal (OR: 1.83; 95% CI: 1.45, 2.32; P < 0.001), oral & pharyngeal & laryngeal (OR: 1.37; 95% CI: 1.12, 1.67; P < 0.001), and esophageal cancers (OR: 1.28; 95% CI: 1.10,1.48; P = 0.001). We also found an inverse association between egg intake and the risk of oral cancer (OR: 0.78; 95% CI: 0.62, 0.99; P = 0.04). In conclusion, high egg consumption (ranging from ≥1 meal/d to ≥1 time/mo among studies) was associated with increased risk of UADT cancers only in HCC studies but not in PCC or prospective cohort studies. PROSPERO registration number: CRD42018102619.

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