Burden and Determinant of Inadequate Dietary Diversity among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis

Background. Inadequate dietary diversity intake during pregnancy results in increased risks of negative maternal and perinatal outcomes. About one million neonates die on the first day of life due to inadequate dietary intake during pregnancy as a result of maternal complication and adverse birth outcomes. This review summarizes the burden of inadequate dietary diversity and its determinants among pregnant women at the national level of Ethiopia. Methods. Studies were retrieved from selected electronic databases, including PubMed, Cochrane Library, and Google Scholar. Random-effects model meta-analysis was used to estimate the pooled burden of inadequate dietary diversity and its determinants at a 95% confidence interval with its respective odds ratio (OR) using statistical R-software version 3.6.1. Moreover, quality appraisal of the included studies, publication bias, and level of heterogeneity were checked with subgroup analysis and sensitivity influential test. The searches were restricted to articles published in the English language only, and Medical Subject Headings (MeSH terms) was used to help expand the search in advanced PubMed search. Result. A total of 850 articles were identified through the initial search of which 21 studies were included in the final review yielding a total sample size of 9,230 pregnant women. The pooled prevalence of inadequate dietary diversity was 53% (95% CI: 44%, 62%). Food insecurity [AOR = 2.18, (95% CI: 1.02, 4.63)], family size of greater than four [AOR = 1.46, (95% CI: 1.10, 1.95)], rural residence [AOR = 4.52, (95% CI: 1.02, 20.09)], no formal educational status [AOR = 4.50, (95% CI: 1.02, 20.09)], and a lack of counseling about dietary diversity [AOR = 2.75, (95% CI: 2.17, 3.48)] were among the significantly associated factors for inadequate dietary diversity. Conclusion. In this review, there was a high prevalence of inadequate dietary diversity among pregnant women at the national level in Ethiopia. Therefore, strengthening early counseling and diagnosis of dietary intake and undernutrition during the antenatal care period is important.

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What Is the Clinical Evidence Supporting Trauma Team Training (TTT): A Systematic Review and Meta-Analysis

Medicina ◽

10.3390/medicina55090551 ◽

2019 ◽

Vol 55 (9) ◽

pp. 551

Author(s):

Noonan ◽

Olaussen ◽

Mathew ◽

Mitra ◽

Smit ◽

...

Keyword(s):

Systematic Review ◽

Clinical Outcomes ◽

Patient Outcomes ◽

Meta Analysis ◽

Ct Scanning ◽

Trauma Team ◽

Team Training ◽

Cochrane Library ◽

Medical Subject Headings ◽

Mesh Terms

Background and Objectives: Major trauma centres manage severely injured patients using multi-disciplinary teams but the evidence-base that targeted Trauma Team Training (TTT) improves patients’ outcomes is unclear. This systematic review aimed to identify the association between the implementation of TTT programs and patient outcomes. Methods: We searched OVID Medline, PubMed and The Cochrane Library (CENTRAL) from the date of the database commencement until 10 of April 2019 for a combination of Medical Subject Headings (MeSH) terms and keywords relating to TTT and clinical outcomes. Reference lists of appraised studies were also screened for relevant articles. We extracted data on the study setting, type and details about the learners, as well as clinical outcomes of mortality and/or time to critical interventions. A meta-analysis of the association between TTT and mortality was conducted using a random effects model. Results: The search yielded 1136 unique records and abstracts, of which 18 full texts were reviewed. Nine studies met final inclusion, of which seven were included in a meta-analysis of the primary outcome. There were no randomised controlled trials. TTT was not associated with mortality (Pooled overall odds ratio (OR) 0.83; 95% Confidence Interval; 0.64–1.09). TTT was associated with improvements in time to operating theatre and time to first computerized tomography (CT) scanning. Conclusions: Despite few publications related to TTT, its introduction was associated with improvements in time to critical interventions. Whether such improvements can translate to improvements in patient outcomes remains unknown. Further research focusing on the translation of standardised trauma team reception “actions” into TTT is required to assess the association between TTT and patient outcome.

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Prevalence of maternal Group B Streptococcus rectovaginal colonization among pregnant women in Ethiopia: protocol for a systematic review and meta-analysis

10.21203/rs.3.rs-406725/v1 ◽

2021 ◽

Author(s):

Delayehu Bekele ◽

Dawit Getachew Assefa ◽

Wondimu Gudu ◽

Mekitie Wondafrash ◽

Lemi Belay Tolu

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Vertical Transmission ◽

Meta Analysis ◽

National Level ◽

Group B Streptococcus ◽

Cochrane Library ◽

Resistance Pattern ◽

Reference List ◽

Group B

Abstract Background: Rectovaginal colonization with Group B streptococcus (GBS) during pregnancy is an important risk factor for serious infections including neonatal sepsis, pneumonia, and meningitis. It is also associated with stillbirth and preterm birth. Since globally rates of GBS colonization, as well as rates of vertical transmission to the newborn, differ broadly, having national data is important for implementing strategies to reduce neonatal morbidity and mortality as a result of GBS infection. We propose this systematic review and meta-analysis to describe the prevalence of rectovaginal GBS colonization, rate of vertical transmission, and the antibiotic resistance pattern among third trimester pregnant women in Ethiopia.Methods: A systematic search will be done of PubMed (MEDLINE), EMBASE, CINHAL, and Cochrane Library. In addition, google scholar will be searched, and a reference list of the already identified articles will be checked to find additional eligible articles that were missed during the initial search. Two reviewers will screen all retrieved articles and assess the methodological quality of included studies using the Newcastle-Ottawa Scale (NOS) checklist. Any disagreement between two reviewers will be resolved by a third reviewer. We will extract data using the JBI data extraction tool for the systematic review of prevalence studies. The data analysis will be conducted using Stata Statistical Software: Release 15. We will present pooled estimates of the prevalence of GBS colonization and rates of vertical transmission with a 95% confidence interval.Discussion: This will be the first synthesis of data on GBS during pregnancy at a national level. It will inform decision-makers in determining whether a universal or a risk-based screening strategy is most appropriate, as well as guiding them in adopting an intrapartum antibiotic protocol.Registration: Submitted to PROSPERO on 18/03/2021

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Clinical Manifestation and Maternal Complications and Neonatal outcomes in Pregnant Women with COVID 19: An Update a Systematic Review and Meta-analysis

10.21203/rs.3.rs-27383/v1 ◽

2020 ◽

Author(s):

Marzieh Soheili ◽

Ghobad Moradi ◽

Hamid Reza Baradaran ◽

Maryam Soheili ◽

Yousef Moradi

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

English Language ◽

Meta Analysis ◽

Clinical Manifestations ◽

Fetal Distress ◽

Cochrane Library ◽

Maternal Complications ◽

Pooled Prevalence ◽

Co Morbidity

Abstract Background Existing evidence indicates that the risk of obstetric and perinatal outcomes is higher in women with coronavirus infection. outbreaks suggest that pregnant women and their fetuses are particularly susceptible to poor outcomes. However, there is little known about pregnancy related complications and co-morbidity in this group of women. Therefore, this, systematic review and meta-analysis performed in order to find out whether COVID-19 may cause different manifestations and outcomes in antepartum and postpartum period or not.Methods We searched databases, including Medline (PubMed), Embase, Scopus, Web of sciences, Cochrane library, Ovid and CINHAL to retrieve all articles reporting the prevalence of maternal and neonatal complications, in addition clinical manifestations, in pregnant women with COVID 19 that published with English language from January to April 2020. Results 11 studies with total 177 pregnant women included in this systematic review.Results show that the pooled prevalence of neonatal mortality, lower birth weight, stillbirth, premature birth, and intrauterine fetal distress in women with COVID 19 were 4% (95% Cl: 1 - 9%), 21% (95% Cl: 11 – 31%), 2% (95% Cl: 1 - 6%), 28% (95% Cl: 12 - 44%), and 15% (95% Cl: 4 - 26%); respectively. Also the pooled prevalence of fever, cough, diarrhea and dyspnea were 56% (95% Cl: 30 - 83%), 30% (95% Cl: 21 - 39%), 9% (95% Cl: 2 - 16%), and 3% (95% Cl: 1 - 6%) in the pregnant women with COVID-19.Conclusion According to this systematic review and meta-analysis, the pregnant women with COVID-19 with or without pneumonia, are at a higher risk of pre-eclampsia, preterm birth, miscarriage and cesarean delivery. Furthermore, the risk of LBW and intrauterine fetal distress seems increased in neonates.

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Effectiveness, Uses and Safety of Granulocyte Colony Stimulating Factor biosimilars: a protocol for systematic review and meta-analysis

10.21203/rs.3.rs-195467/v1 ◽

2021 ◽

Author(s):

Chi-kadibia Theophilus Ukoma ◽

Emmanuel Okechukwu Nna ◽

Helen Chioma Okoye ◽

Augustine Nwakuche Duru ◽

Samuel Osobuchi Ngene ◽

...

Keyword(s):

Systematic Review ◽

English Language ◽

Reference Product ◽

Meta Analysis ◽

Severe Neutropenia ◽

Cochrane Library ◽

Published Data ◽

Mesh Terms ◽

Statistical Heterogeneity ◽

Registration Number

Abstract Background Granulocyte Colony-stimulating factors (G-CSF) biosimilars are recombinant biologics that are similar to a reference product, neupogen, a 175 amino acid recombinant human G-CSF. Characteristically, biosimilars are produced from living cells as high molecular weight, heterogenous compounds that are highly immunogenic. They are primarily used to treat febrile and severe neutropenia in oncology patients as well as mobilize peripheral stem cells in transplant donors. However, as biosimilars are produced by biological processes rather than chemical synthesis, their comparable effectiveness and safety are very paramount to clinical uses. We aimed to produce a protocol for consistent and accurate systematic review and meta-analysis of G-CSF biosimilars.Methods We developed a search strategy using MeSH terms, key words and entry terms to search 9 databases: PubMed, AJOL, Embase, Google Scholar, Scopus, Cochrane Library, CINAHL, Web of Science and ResearchGate. Only randomized controlled trials retreivable in the English language will be included in this study. The primary measurable outcomes in this study are uses, effectiveness and safety of G-CSF biosimilars. Identified primary studies will be screened, deduplicated and selected based on study design, inclusion/exclusion criteria and outcome measures using DistillerSR software. Studies will be assessed for methodological, clinical and statistical heterogeneity. Extractable data items for effectiveness measure are: i) proportion of patients with 50% increase in absolute neutrophil count within 3–7 days; ii) resolution of fever within 3–7 days, iii) resolution of intra-oral mucosa ulcers within 7–10 days and iv) resoluton of difficulty in swallowing within 7–10 days. Measures of safety are i) proportion of patients with immunologic reactions, ii) any other documented adverse events. Quality scores and risk of bias for individual studies will be reported. Funnel Plots will be used for assessing publication bias in selected studies. Effect size, variance, SE and % CI and heterogeneity tests will be reported on forest plots using the CMA software version 3. Subgroup analysis and meta-regression will also be included using secondary outcomes as moderators and explanatory variables. The systematic review and meta-analysis will be reported according to PRISMA 2015 Statement.Discussion Ethical approval will not be required since this study will be based on published data. G-CSF biosimilars will be compared with the reference product, neupogen (filgrastin). The uses, effectiveness and safety of the biosimilars will be discussed. The study will also examine short and long acting biosimilars and compare their overall effectiveness. The strength of evidence from this study will be assessed using the NIH Quality assessment for systematic review and meta-analysis.Trial Registration Number The study is registered with PROSPERO, with registration number CRD42021232375

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Opioid Detoxification in Pregnancy: Systematic Review and Meta-Analysis of Perinatal Outcomes

American Journal of Perinatology ◽

10.1055/s-0038-1670680 ◽

2018 ◽

Vol 36 (06) ◽

pp. 581-587 ◽

Cited By ~ 3

Author(s):

Michelle Wang ◽

Spencer Kuper ◽

Brian Sims ◽

Cayce Paddock ◽

John Dantzler ◽

...

Keyword(s):

Cohort Studies ◽

English Language ◽

Meta Analysis ◽

Perinatal Outcomes ◽

Opioid Use Disorder ◽

Cochrane Library ◽

Opioid Use ◽

Increased Risk ◽

Risk Of Relapse ◽

In Pregnancy

Objective We sought to compare the efficacy and safety of detoxification from opioids compared with opioid replacement therapy (ORT) during pregnancy. Study Design We searched PubMed, Embase, Cochrane Library, and ClinicalTrials.gov from inception to June 2017 for English-language randomized-controlled trials or cohort studies that compared detoxification with ORT. We sought studies with outcomes data on maternal abstinence at the time of delivery, neonatal abstinence syndrome (NAS), stillbirth, and preterm birth (PTB). We calculated pooled relative risks (RRs) with a random-effects model, assessed heterogeneity using the chi-square test for heterogeneity, and quantified heterogeneity using the I 2 test. We assessed publication bias using funnel plots and the Harbord test. Results Three cohort studies met the inclusion criteria; eligible studies included 235 women with opioid use disorder in pregnancy. Maternal detoxification was associated with increased risk of relapse (RR = 1.91; 95% confidence interval [CI] = 1.14–3.21); however, no treatment differences were observed for the rates of NAS (RR = 0.99; 95% CI = 0.38–2.53) or PTB (RR = 0.39; 95% CI = 0.10–1.60). Conclusion Our findings suggest an increased risk of relapse with detoxification treatment compared with ORT; however, detoxification does not alter the risk of PTB or NAS. Further studies should confirm our findings and explore mechanisms to fight the current opioid epidemic.

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Effects of Yoga in Pregnancy on Postpartum Depression: A Systematic Review

Modern Care Journal ◽

10.5812/modernc.115237 ◽

2021 ◽

Vol 18 (2) ◽

Author(s):

Dina Abadiavil ◽

Neda Sharifi ◽

Sareh Dashti ◽

Tahereh Fathi Najafi

Keyword(s):

Systematic Review ◽

Postpartum Depression ◽

Pregnant Women ◽

English Language ◽

Meta Analysis ◽

Cochrane Library ◽

Yoga Intervention ◽

Clinical Databases ◽

Medium Quality ◽

Preventive Effects

Context: Postpartum depression is a common condition, which is managed by antidepressants. Antidepressants are generally considered to be safe during breastfeeding, and the probability of exposure to antidepressants through breast milk is low to very low. Due to the beliefs of breastfeeding women that antidepressants may have side effects on infants, complementary and alternative medicine (CAM) is being investigated to play a role in the management of postpartum depression. Yoga is among the complementary therapies that showed preventive effects against depression in some age and disease groups. The aim of this systematic review was to assess the effects of Yoga intervention on healthy pregnant women and its preventive effects on postpartum depression. Methods: Clinical databases, including Scopus, PubMed, Medlib, Web of Science, Psych Info, and Cochrane Library, as well as Google Scholar, were searched using search keywords, including pregnant women, women, maternal period, yoga, mindfulness, postpartum depression, and depression. Clinical trial, case-control, and cohort articles in English language that assessed the effects of Yoga on postpartum depression in healthy women were reviewed. Among the initial 982 identified studies, five studies (271 subjects) were eligible for the review. Due to the high heterogeneity in the studies, meta-analysis was not performed. Results: One study had medium quality, one study had good quality, and three studies had high quality. Yoga intervention included physical and mindfulness exercises and assessed mood and behavior during pregnancy. The intervention duration ranged between 6 and 24 weeks during pregnancy. In the majority of studies, Yoga intervention reduced postpartum depression and other mental disorders. Conclusions: Yoga may be a beneficial and safe choice in the management of postpartum depression in healthy pregnant women.

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Pregnancy and Delivery Outcomes Following Benzodiazepine Exposure: A Systematic Review and Meta-analysis

The Canadian Journal of Psychiatry ◽

10.1177/0706743720904860 ◽

2020 ◽

Vol 65 (12) ◽

pp. 821-834

Author(s):

Sophie Grigoriadis ◽

Lisa Graves ◽

Miki Peer ◽

Lana Mamisashvili ◽

Myuri Ruthirakuhan ◽

...

Keyword(s):

Birth Weight ◽

Gestational Age ◽

English Language ◽

Meta Analysis ◽

Perinatal Outcomes ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Delivery Outcomes ◽

Increased Risk ◽

Nicu Admission

Objective: Understanding the effects of benzodiazepines (BZDs) on maternal/fetal health remains incomplete despite their frequent use. This article quantifies the effects of antenatal BZD exposure on delivery outcomes. Methods Data Sources: Medline, PsycINFO, CINAHL, Embase, and the Cochrane Library were searched till June 30, 2018. Study Selection: English-language cohort studies comparing antenatal BZD exposure to an unexposed group on any delivery outcome were eligible. In all, 23,909 records were screened, 56 studies were assessed, and 14 studies were included. Data Extraction: Two reviewers independently assessed quality and extracted data. Estimates were pooled using random effects meta-analysis. Sub-analyses examined several potential moderators including timing of exposure. Results: There were 9 outcomes with sufficient data for meta-analysis. Antenatal BZD exposure was significantly associated with increased risk of 6 outcomes initially: spontaneous abortion (pooled odds ratio = 1.86; 95% confidence interval [CI], 1.43 to 2.42), preterm birth (1.96; 95% CI, 1.25 to 3.08), low birth weight (2.24; 95% CI, 1.41 to 3.88), low Apgar score (2.19; 95% CI, 1.94 to 2.47), Neonatal Intensive Care Unit (NICU) admission (2.61; 95% CI, 1.64 to 4.14), and induced abortion (2.04; 95% CI, 1.23 to 3.40). There was significant heterogeneity between studies for most outcomes without consistent moderators. Birth weight (mean difference [MD]: −151.35 g; 95% CI, −329.73 to 27.03), gestational age (−0.49 weeks; 95% CI, −1.18 to 0.19), and small for gestational age (SGA; 1.42; 95% CI, 1.00 to 2.01) did not show significant associations although after adjusting for publication bias, gestational age, and SGA became significant, totaling 8 significant outcomes. Conclusions: Antenatal BZD exposure appears to be statistically associated with increased risk of several adverse perinatal outcomes. Although confounds cannot be ruled out, NICU admission does appear clinically relevant and consistent with the antidepressant literature.

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Comparison of Perinatal Outcomes of Pregnant Women with SARS, MERS and COVID-19: A Systematic Review and Meta-Analysis

SSRN Electronic Journal ◽

10.2139/ssrn.3582809 ◽

2020 ◽

Author(s):

Pengming Sun ◽

Hangjing Gao ◽

Xiqi Huang ◽

Huanrui Zheng ◽

Hongning Cai ◽

...

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Meta Analysis ◽

Perinatal Outcomes

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Liraglutide for the Treatment of Obesity: Analyzing Published Reviews

Current Pharmaceutical Design ◽

10.2174/1381612825666190701155737 ◽

2019 ◽

Vol 25 (15) ◽

pp. 1783-1790 ◽

Cited By ~ 3

Author(s):

Rosario Pastor ◽

Josep A. Tur

Keyword(s):

Weight Loss ◽

Clinical Trials ◽

Systematic Reviews ◽

Randomized Clinical Trials ◽

Statistical Tests ◽

Overweight And Obesity ◽

Cochrane Library ◽

Medical Subject Headings ◽

Mesh Terms ◽

Treatment Of Obesity

Background: Several drugs have been currently approved for the treatment of obesity. The pharmacokinetic of liraglutide, as well as the treatment of type 2 diabetes mellitus, have been widely described. Objective: To analyze the published systematic reviews on the use of liraglutide for the treatment of obesity. Methods: Systematic reviews were found out through MEDLINE searches, through EBSCO host and the Cochrane Library based on the following terms: "liraglutide" as major term and using the following Medical Subject Headings (MesH) terms: "obesity", "overweight", "weight loss". A total of 3 systematic reviews were finally included to be analyzed. Results: From the three systematic reviews selected, only two included the randomized clinical trials, while the third study reviewed both randomized and non-randomized clinical trials. Only one review performed statistical tests of heterogeneity and a meta-analysis, combining the results of individual studies. Another review showed the results of individual studies with odds ratio and confidence interval, but a second one just showed the means and confidence intervals. In all studies, weight loss was registered in persons treated with liraglutide in a dose dependent form, reaching a plateau at 3.0 mg dose, which was reached just in men. Most usual adverse events were gastrointestinal. Conclusion: More powerful and prospective studies are needed to assess all aspects related to liraglutide in the overweight and obesity treatment.

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Newer Volatile Anesthetic Agents in Cardiac Anesthesia: Review of Literature

Journal of Cardiac Critical Care TSS ◽

10.1055/s-0041-1723929 ◽

2021 ◽

Author(s):

Alka Mandke ◽

Manjula Sarkar ◽

Charulata Deshpande ◽

Arun Maheshwari ◽

Bhupesh Kumar ◽

...

Keyword(s):

Volatile Anesthetic ◽

Cochrane Library ◽

Cochrane Central Register ◽

Cardiac Anesthesia ◽

Medical Subject Headings ◽

Holistic View ◽

Anesthetic Agents ◽

Cardiac Anaesthesia ◽

Mesh Terms ◽

Inhalational Anaesthesia

AbstractMyocardial protection with volatile anesthetic agents have been suggested by multiple studies. These studies, however, are scattered and are often limited to a particular aspect of cardiac anesthesia. Older inhalational agents like halothane is known to cause significant hepatic damage in patients undergoing long duration surgeries while isoflurane is known to have marked vasodilating properties that also affects the coronary arteries leading to coronary “steal” phenomenon. Additionally, newer agents, like sevoflurane and desflurane, have shown more prominent cardioprotective effects than older agents. We searched ScholarOne, Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library. The medical subject headings (MeSH) terms “anaesthesia, inhalational,” “anaesthesia, intravenous, or TIVA,” and “Cardiac anaesthesia or Cardiac Surgery” were used. Additional studies were identified by review of the reference sections of all eligible studies. The aim of this review article is to bring together the evidences with newer inhalational agents and provide a holistic view of their benefits and shortcomings in cardiac anesthesia.

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