Impact of severe maternal morbidity on adverse perinatal outcomes in high-income countries: systematic review and meta-analysis protocol

IntroductionSevere maternal morbidity (SMM) includes conditions that are on a continuum of maternal morbidity to maternal death. Rates of SMM are increasing both in high-income countries (HICs) as well as in low/middle-income countries (LMICs). There is evidence that analysis of SMM trends and detailed investigation of factors implicated in these cases may reflect the standard of maternal healthcare both in HICs and LMICs. SMM is also associated with poorer perinatal outcomes. The aim of this protocol is to describe the proposed methodology for the synthesis and analyses of the data describing the relationship between SMM and adverse perinatal outcomes in a systematic review and meta-analysis.MethodsThis systematic review and meta-analysis will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and will be registered with the International Prospective Register of Systematic Reviews (PROSPERO). Original peer-reviewed epidemiologic/clinical studies of observational (cross-sectional, cohort, case-control) and randomised controlled trial studies conducted in high-income countries will be included. An electronic search of PubMed, Embase, CINAHL and Scopus databases will be performed without restricting publication date/year. Two authors will independently screen the titles, review abstracts and perform data extraction. Where possible, meta-analyses will be done to calculate pooled estimates.Ethics and disseminationAs this is a protocol for systematic review and meta-analysis of published data, ethics review and approval are not required. The findings will be published in peer-reviewed journals and disseminated at scientific conferences.PROSPERO registration numberCRD42019130933.

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The Impact of Severe Maternal Morbidity on Perinatal Outcomes in High Income Countries: Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9072035 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2035

Author(s):

Tesfaye S. Mengistu ◽

Jessica M. Turner ◽

Christopher Flatley ◽

Jane Fox ◽

Sailesh Kumar

Keyword(s):

Systematic Review ◽

Maternal Morbidity ◽

Perinatal Death ◽

Meta Analysis ◽

Perinatal Outcomes ◽

Obstetric Hemorrhage ◽

Hypertensive Disorders ◽

Adverse Perinatal Outcomes ◽

Nicu Admission ◽

The Impact

While there is clear evidence that severe maternal morbidity (SMM) contributes significantly to poor maternal health outcomes, limited data exist on its impact on perinatal outcomes. We undertook a systematic review and meta-analysis to ascertain the association between SMM and adverse perinatal outcomes in high-income countries (HICs). We searched for full-text publications in PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Scopus databases. Studies that reported data on the association of SMM and adverse perinatal outcomes, either as a composite or individual outcome, were included. Two authors independently assessed study eligibility, extracted data, and performed quality assessment using the Newcastle–Ottawa Scale. We used random-effects modelling to calculate odds ratios (ORs) with 95% confidence intervals. We also assessed the risk of publication bias and statistical heterogeneity using funnel plots and Higgins I2, respectively. We defined sub-groups of SMM as hemorrhagic disorders, hypertensive disorders, cardiovascular disorders, hepatic disorders, renal disorders, and thromboembolic disorders. Adverse perinatal outcome was defined as preterm birth (before 37 weeks gestation), small for gestational age (SGA) (birth weight (BW) < 10th centile for gestation), low birthweight (LBW) (BW < 2.5 kg), Apgar score < 7 at 5 min, neonatal intensive care unit (NICU) admission, stillbirth and perinatal death (stillbirth and neonatal deaths up to 28 days). A total of 35 studies consisting of 38,909,426 women were included in the final analysis. SMMs associated with obstetric hemorrhage (OR 3.42, 95% CI: 2.55–4.58), severe hypertensive disorders (OR 6.79, 95% CI: 6.06–7.60), hepatic (OR 3.19, 95% CI: 2.46–4.13) and thromboembolic disorders (OR 2.40, 95% CI: 1.67–3.46) were significantly associated with preterm birth. SMMs from hypertensive disorders (OR 2.86, 95% CI: 2.51–3.25) or thromboembolic disorders (OR 1.48, 95% CI: 1.09–1.99) were associated with greater odds of having SGA infant. Women with severe hemorrhage had increased odds of LBW infant (OR 2.31, 95% CI: 1.57–3.40). SMMs from obstetric hemorrhage (OR 4.16, 95% CI: 2.54–6.81) or hypertensive disorders (OR 4.61, 95% CI: 1.17–18.20) were associated with an increased odds of low 5-min Apgar score and NICU admission (Severe obstetric hemorrhage: OR 3.34, 95% CI: 2.26–4.94 and hypertensive disorders: OR 3.63, 95% CI: 2.63–5.02, respectively). Overall, women with SMM were 4 times more likely to experience stillbirth (OR 3.98, 95% CI: 3.12–7.60) compared to those without SMM with cardiovascular disease (OR 15.2, 95% CI: 1.29–180.60) and thromboembolic disorders (OR 9.43, 95% CI: 4.38–20.29) conferring greatest risk of this complication. The odds of neonatal death were significantly higher in women with SMM (OR 3.98, 95% CI: 2.44–6.47), with those experiencing hemorrhagic (OR 7.33, 95% CI: 3.06–17.53) and hypertensive complications (OR 3.0, 95% CI: 1.78–5.07) at highest risk. Overall, SMM was also associated with higher odds of perinatal death (OR 4.74, 95% CI: 2.47–9.12) mainly driven by the increased risk in women experiencing severe obstetric hemorrhage (OR 6.18, 95% CI: 2.55–14.96). Our results highlight the importance of mitigating the impact of SMM not only to improve maternal health but also to ameliorate its consequences on perinatal outcomes.

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A systematic review and meta-analysis protocol examining the clinical characteristics and epidemiological features of olfactory dysfunction (OD) in coronavirus disease 2019 (COVID-19)

Systematic Reviews ◽

10.1186/s13643-021-01624-6 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Rosemond Qian-Xiu Tan ◽

Wai Tak Victor Li ◽

Wing-Zi Shum ◽

Sheung Chit Chu ◽

Hang-Long Li ◽

...

Keyword(s):

Systematic Review ◽

Clinical Data ◽

Systematic Reviews ◽

Clinical Characteristics ◽

Meta Analysis ◽

Olfactory Dysfunction ◽

Statistical Analyses ◽

Human Populations ◽

Meta Analyses ◽

Analysis Protocol

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has caused recurring and major outbreaks in multiple human populations around the world. The plethora of clinical presentations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been described extensively, of which olfactory dysfunction (OD) was established as an important and common extrapulmonary manifestation of COVID-19 infection. The aim of this protocol is to conduct a systematic review and meta-analysis on peer-reviewed articles which described clinical data of OD in COVID-19 patients. Methods This research protocol has been prospectively registered with the Prospective Register of Systematic Reviews (PROSPERO; CRD42020196202). CINAHL, ClinicalTrials.gov, Cochrane Central, EMBASE, MEDLINE and PubMed, as well as Chinese medical databases China National Knowledge Infrastructure (CNKI), VIP and WANFANG, will be searched using keywords including ‘COVID-19’, ‘coronavirus disease’, ‘2019-nCoV’, ‘SARS-CoV-2’, ‘novel coronavirus’, ‘anosmia’, ‘hyposmia’, ‘loss of smell’, and ‘olfactory dysfunction’. Systematic review and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines. Articles will be screened according to pre-specified inclusion and exclusion criteria to extract studies that include new clinical data investigating the effect of COVID-19 on olfactory dysfunction. Included articles will be reviewed in full; data including patient demographics, clinical characteristics of COVID-19-related OD, methods of olfactory assessment and relevant clinical outcomes will be extracted. Statistical analyses will be performed using the Comprehensive Meta-Analysis version 3. Discussion This systematic review and meta-analysis protocol will aim to collate and synthesise all available clinical evidence regarding COVID-19-related OD as an important neurosensory dysfunction of COVID-19 infection. A comprehensive search strategy and screening process will be conducted to incorporate broad clinical data for robust statistical analyses and representation. The outcome of the systematic review and meta-analysis will aim to improve our understanding of the symptomatology and clinical characteristics of COVID-19-related OD and identify knowledge gaps in its disease process, which will guide future research in this specific neurosensory defect. Systematic review registration PROSPERO registration number: CRD42020196202.

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Systematic Reviews and Meta-Analyses: Monoclonal antibody and anti-cytokine biologics for Kawasaki disease: A systematic review and meta-analysis

Seminars in Arthritis and Rheumatism ◽

10.1016/j.semarthrit.2021.07.020 ◽

2021 ◽

Author(s):

Osamu Nomura ◽

Sayaka Fukuda ◽

Erika Ota ◽

Hiroshi Ono ◽

Akira Ishiguro ◽

...

Keyword(s):

Systematic Review ◽

Monoclonal Antibody ◽

Kawasaki Disease ◽

Systematic Reviews ◽

Meta Analysis ◽

Meta Analyses

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Efficacy and safety of instantaneous wave-free ratio in patients undergoing coronary revascularisation: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-017868 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017868

Author(s):

Joey S.W. Kwong ◽

Sheyu Li ◽

Wan-Jie Gu ◽

Hao Chen ◽

Chao Zhang ◽

...

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Meta Analysis ◽

Adverse Outcomes ◽

Coronary Revascularisation ◽

Eligibility Criteria ◽

Registration Number ◽

Collection Form ◽

Randomised Controlled ◽

Meta Analyses

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.

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Research at Work: Systematic Reviews and Meta-Analyses

Families in Society The Journal of Contemporary Social Services ◽

10.1177/1044389419862112 ◽

2019 ◽

Vol 100 (3) ◽

pp. 312-316

Author(s):

Jeremiah W. Jaggers ◽

David Kondrat

Keyword(s):

Systematic Review ◽

Social Work ◽

Systematic Reviews ◽

Meta Analysis ◽

Important Research ◽

Social Work Practitioners ◽

Comprehensive Picture ◽

Meta Analyses

This article provides an overview of the systematic review and the meta-analysis. These tools provide a comprehensive picture of current research. What follows is an abridged explanation of each of these techniques. This approach is intended to provide a fundamental overview for social work practitioners, so that they may more readily access important research, while minimizing the time spent doing so.

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Association between adverse perinatal outcomes and sleep disturbances during pregnancy: a systematic review and meta-analysis

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2020.1711727 ◽

2020 ◽

pp. 1-9

Author(s):

Ziyi Yang ◽

Ziyu Zhu ◽

Chunyi Wang ◽

Fan Zhang ◽

Huan Zeng

Keyword(s):

Systematic Review ◽

Sleep Disturbances ◽

Meta Analysis ◽

Perinatal Outcomes ◽

Adverse Perinatal Outcomes

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Endovascular treatment for symptomatic intracranial artery stenosis: protocol for a systematic review and network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-022359 ◽

2018 ◽

Vol 8 (7) ◽

pp. e022359 ◽

Cited By ~ 2

Author(s):

Tao Wang ◽

Xue Wang ◽

Kun Yang ◽

Jing Zhang ◽

Jichang Luo ◽

...

Keyword(s):

Systematic Review ◽

Endovascular Treatment ◽

Systematic Reviews ◽

Meta Analysis ◽

Biomedical Literature ◽

Artery Stenosis ◽

Intracranial Artery ◽

Intracranial Artery Stenosis ◽

Literature Database ◽

Meta Analyses

IntroductionAtherosclerotic intracranial artery stenosis (ICAS) is one of most common causes of stroke, which is the second-leading cause of death worldwide. Medical, surgical and endovascular therapy are three major treatments for ICAS. Currently, medical therapy is considered as the standard of care for most patients with ICAS, while extracranial to intracranial bypass is only used in rare situations. Balloon angioplasty alone, balloon-mounted stent and self-expanding stent, collectively called endovascular treatment, have shown promising potentials in treating specific subgroups of patients with symptomatic ICAS; however, their comparative safety and efficacy is still unclear. Therefore, a systematic review with network meta-analysis is needed to establish a hierarchy of these endovascular treatments.Methods and analysisThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols was followed to establish this protocol. The search will be limited to studies published from 1 January 2000 to the formal search date. Major databases including Cochrane Library, MEDLINE, EMBASE, Chinese Biomedical Literature Database, conference proceedings and grey literature database will be searched for clinical studies comparing at least two interventions for patients with symptomatic ICAS. Primary outcomes include short-term and long-term mortality or stroke rate. Random effects pairwise and network meta-analyses of included studies will be performed on STATA (V.14, StataCorp, 2015). The surface under the cumulative ranking curve and mean rank will be calculated in order to establish a hierarchy of the endovascular treatments. Evaluation of the risk of bias, heterogeneity, consistency, transitivity and quality of evidence will follow the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions.Ethics and disseminationEthics approval is not needed as systematic review is based on published studies. Study findings will be presented at international conferences and published on a peer-reviewed journal.PROSPERO registration numberCRD42018084055; Pre-results.

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