Prevalence of Hypothyroidism in Pregnant Women in India: A Meta-Analysis of Observational Studies

Introduction. This meta-analysis was conducted to estimate the prevalence of hypothyroidism among pregnant women in India. Methods. We searched PubMed, Web of Science, Scopus, Google Scholar, and Shodhganga (Indian thesis repository) for observational studies, providing prevalence of hypothyroidism among pregnant women in India. Systematic study selection and data extraction procedures were followed. Quality assessment of each study was done using JBI critical appraisal checklist. The random effects model was used for pooling the effect sizes. Publication bias was assessed using the funnel plot and rank correlation test. I2 statistics was used to measure heterogeneity across the studies. Heterogeneity in the pooled estimates was further explored with subgroup analyses and meta-regression analysis. Results. Sixty-one studies were found eligible and included in this review. The pooled estimate of the prevalence of hypothyroidism in pregnant women was 11.07% (95% CI: 8.79–13.84, I2 = 99%). Pooled prevalence estimates of subclinical and overt hypothyroidism are 9.51% (95% CI: 7.48–12.04, I2 = 98%) and 2.74% (95% CI: 2.08–3.58, I2 = 94%). Conclusion. We documented 11.07% pooled prevalence of hypothyroidism in pregnant women in India.

Download Full-text

Pooled estimate of vitamin D deficiency among pregnant women in India: a systematic review and meta-analysis

Journal of Health Population and Nutrition ◽

10.1186/s41043-021-00253-y ◽

2021 ◽

Vol 40 (1) ◽

Author(s):

Angeline Jeyakumar ◽

Vidhya Shinde ◽

Reshma Ravindran

Keyword(s):

Systematic Review ◽

Vitamin D ◽

Pregnant Women ◽

Vitamin D Deficiency ◽

Meta Analysis ◽

Health Concern ◽

Study Quality ◽

Care Services ◽

Pooled Prevalence ◽

Women In India

Abstract Background Vitamin D deficiency among pregnant women is a public health concern globally. In India, individual studies report high prevalence. However, lack of national data masks the true burden. This work determined the pooled prevalence of vitamin D deficiency among pregnant women in India through a systematic review of literature and meta-analysis. Methods Three different search engines yielded 15 eligible articles. Study quality was assessed by 10 different criteria and summary of study quality was categorized as per Cochrane standards. Meta-analysis was performed to estimate pooled prevalence of vitamin D deficiency among healthy pregnant women and heterogeneity among selected studies. A sample of n = 4088 was used to study the pooled prevalence among pregnant women. Results The random effects combined estimate was 32.35% (95% CI, (12.58–117.48). High heterogeneity (tau2 = 0.39, I2 = 100%) and high risk of bias was observed among the selected studies. The test for overall effect was observed to be z = 2.54(P = 0.01). Conclusion Pooled estimate > 30% emphasizes the need for screening through antenatal care services and initiate preventive measures to address the deficiency.

Download Full-text

Medication-Related Osteonecrosis of the Jaw in Patients Treated Concurrently with Antiresorptive and Antiangiogenic Agents: Systematic Review and Meta-Analysis

Journal of Immunotherapy and Precision Oncology ◽

10.36401/jipo-21-14 ◽

2021 ◽

Author(s):

Akanksha Srivastava ◽

Graciela M. Nogueras Gonzalez ◽

Yimin Geng ◽

Alexander M. Won ◽

Jeffrey Myers ◽

...

Keyword(s):

Relative Risk ◽

Data Extraction ◽

Meta Analysis ◽

Osteonecrosis Of The Jaw ◽

Accurate Estimation ◽

Antiangiogenic Agents ◽

Study Selection ◽

Pooled Prevalence ◽

Exposure Variable ◽

Retrospective Cohort Studies

ABSTRACT Introduction Medication-related osteonecrosis of the jaws (MRONJ) is a known adverse event related to the use of antiresorptive (AR) drugs. More recently, an association between antiangiogenic (AA) drugs and MRONJ has been suggested. This review aimed to investigate the overall prevalence and relative risk of MRONJ in patients treated concurrently with AA and AR agents in comparison with a single AA or AR drug. Methods A review protocol was registered with PROSPERO (ID: CRD42020214244). A systematic literature search, study selection, quality assessment, and data extraction were carried out following PRISMA guidelines. Random-effects meta-analysis models were used to summarize relative estimates for the outcomes, namely prevalence and relative risk of MRONJ. Exposure variable included type of drug, specifically AA and AR agents administered either concurrently or individually. Results Eleven studies were included in the final qualitative and quantitative syntheses. The overall pooled weighted prevalence of MRONJ with concurrent AA-AR drugs was 6% (95% CI: 3–8%), compared with 0% (95% CI: 0–0%) for AA only and 5% (95% CI: 0–10%) for AR only. However, high heterogeneity was noted among included studies. Retrospective cohort studies showed a higher pooled prevalence of 13% (95% CI: 10–17%) for concurrent AA-AR therapy. The pooled risk ratio for MRONJ revealed a risk with concurrent AA-AR drugs 2.57 times as high as with AR only (95% CI: 0.84–7.87); however, this difference was not statistically significant. Concurrent AA-AR drugs had a risk for MRONJ 23.74 times as high as with AA only (95% CI: 3.71–151.92). Conclusions High-quality, representative studies are needed for accurate estimation of relative risk of MRONJ with concurrent AA and AR therapy.

Download Full-text

Risk of Gastrointestinal Bleeding on Treatment With Statin Alone or With Concomitant Administration of Warfarin: A Systematic Review and Meta-analysis of 5.3 Million Participants

Annals of Pharmacotherapy ◽

10.1177/10600280211049727 ◽

2021 ◽

pp. 106002802110497

Author(s):

Akshaya Srikanth Bhagavathula ◽

Kota Vidyasaga ◽

Eyob Alemayehu Gebreyohannes ◽

Wubshet Tesfaye

Keyword(s):

Gastrointestinal Bleeding ◽

Observational Studies ◽

Data Extraction ◽

Meta Analysis ◽

Concomitant Administration ◽

Pooled Analysis ◽

Data Synthesis ◽

Study Selection ◽

Statin Monotherapy ◽

Statin Use

Objective: This study aimed to comprehensively evaluate the risk of gastrointestinal bleeding (GIB) with statin monotherapy or with concomitant warfarin use. Data Sources: PubMed, Web of Science, and EMBASE (via Scopus) were searched for observational studies that reported the risk of GIB in adults on statin therapy or with concomitant warfarin use until August 28, 2021. Study Selection and Data Extraction: Observational studies evaluating the risk of GIB in adults (age >18 years) on statin medication or concomitant use with warfarin were included. Data Synthesis: In all, 14 studies with a total of 5 235 123 participants, reporting 48 677 GIB events (43 734 from statin users and 4943 from users of statin combined with warfarin), were included in the analyses. The pooled analysis revealed no difference in the risk of GIB with statin monotherapy (relative risk [RR]: 0.65; 95% CI: 0.42-1.02) or concomitant statin + warfarin use (RR: 0.97; 95% CI: 0.91-1.02). Prior use of statin was not associated with GIB risk (RR: 0.88; 95% CI: 0.63-1.22), whereas a shorter duration of statin use (<5 years) was associated with a lower risk of GIB (RR: 0.42; 95% CI: 0.18-0.97). Relevance to Patient Care and Clinical Practice: This analysis provides strong evidence on the association between statin use (with/without warfarin) and risk of GIB. Conclusion: Statin alone or combined with warfarin was not significantly associated with either an increased or decreased risk of GIB. The GIB risk was significantly lower when statins were used for a short duration (<5 years). The putative relationship between statins and GIB in warfarin users warrant further investigation.

Download Full-text

Association between abnormal maternal serum levels of vitamin B12 and preeclampsia: a systematic review and meta-analysis

Nutrition Reviews ◽

10.1093/nutrit/nuaa096 ◽

2020 ◽

Author(s):

Farzaneh Mardali ◽

Somaye Fatahi ◽

Maryam Alinaghizadeh ◽

Hamed Kord Varkaneh ◽

Mohammad Hassan Sohouli ◽

...

Keyword(s):

Systematic Review ◽

Vitamin B12 ◽

Pregnant Women ◽

Data Extraction ◽

Meta Analysis ◽

Serum Vitamin ◽

Serum Levels ◽

Folic Acid Supplementation ◽

Maternal Serum ◽

Study Selection

Abstract Context Some evidence has shown an association between maternal vitamin B12 levels and the development of preeclampsia in pregnant women, but the relationship between preeclampsia and vitamin B12 is not clear. Objective The aim of this systematic review was to compare serum vitamin B12 levels in women with preeclampsia with those in normotensive pregnant women. Data Sources The PubMed/MEDLINE, Scopus, and Web of Science databases were searched up to August 2019, along with the reference lists of included articles. Study Selection The literature was searched for observational studies that investigated vitamin B12 levels in women with preeclampsia. Data Extraction Data were extracted independently by 2 authors. Data were pooled using a random-effects model. Results Vitamin B12 levels in women with preeclampsia were significantly lower than those in healthy women (mean, −15.24 pg/mL; 95%CI, −27.52 to −2.954; P < 0.015), but heterogeneity between studies was high (I2 = 97.8%; P = 0.0103). Subgroup analyses based on folic acid supplementation, homocysteine concentrations, and gestational age at the time of sampling for vitamin B12 assessment did not identify the sources of heterogeneity. Conclusions Women with preeclampsia had significantly lower vitamin B12 concentrations than normotensive pregnant women.

Download Full-text

Proton pump inhibitors use and risk of preeclampsia

10.1101/2021.09.15.21263602 ◽

2021 ◽

Author(s):

Salman Hussain ◽

Ambrish Singh ◽

Benny Antony ◽

Jitka Klugarová ◽

Miloslav Klugar

Keyword(s):

Pregnant Women ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Epidemiological Studies ◽

Study Selection ◽

Newcastle Ottawa Scale ◽

Risk Of Preeclampsia

AbstractPreeclampsia is one of the common complications of pregnancy and is characterized by high blood pressure. Proton pump inhibitors (PPIs) are commonly used for the management of gastroesophageal reflux disease among pregnant women. Recently, multiple epidemiological studies suggested the association between PPIs use and the risk of preeclampsia. This study aims to review the evidence and meta-analyse the pooled risk of preeclampsia in PPI users from epidemiological studies. Databases-MEDLINE, Embase, Scopus, Web of Science Core Collection, Emcare, and CINAHL (EBSCO) as well as sources of grey literature, ProQuest Dissertations & Theses Global, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform will be searched to identify the epidemiological studies assessing the association between PPIs use and the risk of preeclampsia. Study selection, data extraction, and quality assessment will be performed by two independent authors. The risk of bias among included studies will be evaluated by using the Newcastle-Ottawa scale. The pooled effect of PPIs use on the risk of preeclampsia in pregnant women is the primary outcome of interest. Meta-analysis will be performed using Review Manager version 5.4.

Download Full-text

The prevalence of occupational stress among Iranian midwives: a systematic review and meta-analysis

British Journal of Midwifery ◽

10.12968/bjom.2021.29.11.634 ◽

2021 ◽

Vol 29 (11) ◽

pp. 634-640

Author(s):

Reza Ghanei Gheshlagh ◽

Hayedeh Rezaei ◽

Naser Parizad

Keyword(s):

Occupational Stress ◽

Work Experience ◽

Observational Studies ◽

Meta Analysis ◽

Stress Coping ◽

Pooled Prevalence ◽

Quality Of Patient Care ◽

Stress Coping Strategies ◽

Meta Regression Analysis

Background Occupational stress is one of the undesirable risk factors found in the midwifery profession. It can lead to job burnout, job loss and negatively affect the quality of patient care. This study aimed to estimate the prevalence of occupational stress among Iranian midwives. Methods Through searching national and international databases, a total of 11 observational studies with full texts were extracted. Observational studies in Persian or English that reported the prevalence or frequency of job stress among Iranian midwives were included in the analysis. Irrelevant studies, those conducted on midwifery students and gray literature were excluded. The meta-analysis was conducted using the random-effects model. Results 11 articles reviewed occupational stress in 1196 midwives (an average of 108 midwives per study). Analysis of the articles showed that the pooled prevalence of occupational stress was 70.82% in Iranian midwives. Meta-regression analysis showed that the prevalence of occupational stress was not related to mean age, work experience, articles' publication year or sample size. Conclusions The prevalence of occupational stress is high among Iranian midwives and it can have harmful consequences for them and their patients. Therefore, the training of stress coping strategies seems to be appropriate for this group.

Download Full-text

Abstract 13656: Outcomes of Pre-existing Cardiovascular Disease Amongst COVID-19 Patients

Circulation ◽

10.1161/circ.142.suppl_3.13656 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Chail Shah ◽

Harmandeep Singh ◽

Mehwish Martin ◽

Salma Yousuf ◽

Payu Raval ◽

...

Keyword(s):

Observational Studies ◽

Meta Analysis ◽

Invasive Mechanical Ventilation ◽

Mesh Terms ◽

Pooled Prevalence ◽

Epidemiology Data ◽

History Of ◽

Meta Regression ◽

Meta Regression Analysis ◽

Epidemiological Characteristics

Introduction: COVID-19 has multiorgan involvement and it is believed that outcomes are poor amongst patients with hypertension (HTN) and pre-existing cardiovascular disorders (CVD). Hypothesis: The objective of this meta-analysis is to evaluate outcomes [mortality and invasive mechanical ventilation (IMV) utilization] of COVID-19 in patients with pre-existing HTN and CVD. Methods: English full-text-observational studies having data on epidemiological characteristics of patients with COVID-19 were identified searching PubMed using MeSH-terms from December 1, 2019, to April 30, 2020. Studies having CVD or HTN as one of the pre-existing comorbidities and described outcomes including IMV and mortality were selected with a consensus of three reviewers. 29 studies met these criteria. Following MOOSE protocol, data on patients’ characteristics especially age and history of CVD, HTN, IMV, and mortality were pooled using a random-effects model. The pooled prevalence of CVD and HTN were calculated. Meta-regression was performed and correlation coefficient (r) and odds ratio (OR) were estimated to evaluate the effects of pre-existing CVD and HTN on outcomes of COVID-19 patients. Results: Out of 29 studies with COVID-19 epidemiology data, 21, 17, 18 and 19 studies have details on mortality, IMV, HTN, and pre-existing CVD, respectively. Pooled prevalence of HTN was 28.2% [95%CI:22.1%-35.1%; p<0.001; 4858/11626 patients; Heterogeneity (I 2 ):97.8%] and pre-existing CVD was 12.2% [8.9%-16.6%; p<0.001; 2044/11664 patients; I 2 :96.8%]. In age-adjusted meta-regression analysis, IMV was significantly higher among COVID-19 patients with pre-existing CVD [r:0.28; OR:1.3 (1.1-1.6); I 2 :89.7%; p=0.0028] without significant association with HTN [r:0.01; OR:1.0 (0.9-1.1); I 2 :95.9%; p=0.8161]. HTN [r:0.001; OR:1.0 (0.9-1.1); I 2 :96%; p=0.9685] and pre-existing CVD [r:-0.01; OR:0.9 (0.9-1.1); I 2 :96.3%; p=0.8772] had no significant association with mortality amongst COVID-19 patients. Conclusion: In the age-adjusted analysis, though we identified pre-existing CVD as a risk factor for higher utilization of IMV, pre-existing CVD and HTN had no independent role in increasing mortality.

Download Full-text

Association Between Plasma Homocysteine Levels and Subclinical Hypothyroidism in Adult Subjects: A Meta-Analysis

Hormone and Metabolic Research ◽

10.1055/a-1199-2633 ◽

2020 ◽

Vol 52 (09) ◽

pp. 625-638

Author(s):

Shou-Fa Zhang ◽

Li-Zhi Li ◽

Wei Zhang ◽

Jin-Rong Guo ◽

Fang-Fang Liu ◽

...

Keyword(s):

Subclinical Hypothyroidism ◽

Observational Studies ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Plasma Homocysteine ◽

Cochrane Library ◽

Overt Hypothyroidism ◽

Weighted Mean ◽

Meta Regression Analysis

AbstractIncreased plasma homocysteine (Hcy) levels have been widely documented in patients with overt hypothyroidism; however, the significance of Hcy level changes in patients with subclinical hypothyroidism (SCH) remains controversial. The aim of this meta-analysis was to determine the Hcy status in patients with SCH compared with euthyroid subjects. We searched PubMed, Embase, and Cochrane Library databases prior to December 2019 to identify eligible studies and assessed the quality of selected studies using the Newcastle-Ottawa Quality Assessment Scale. Publication bias was evaluated by Begg’s test and Egger’s test. Meta-regression analysis was conducted to investigate the source of heterogeneity. A likely source of heterogeneity was the year of the study. All statistical analyses were performed with RevMan 5.3 and Stata 12.0 software. Our meta-analysis of twelve observational studies with 684 patients showed that those with SCH aged between 18 and 65 years old were associated with a slightly increased plasma Hcy level compared with euthyroid controls. The pooled result of the weighted mean difference (WMD) of increased tHcy levels was 1.16 μmol/l (95% CI: 0.51, 1.82; p=0.0005). The Hcy level in patients with SCH aged between 18 and 65 years old is significantly increased compared to euthyroid controls.

Download Full-text

Estimated prevalence of dental fear in adults: a systematic review and meta-analysis

10.1101/2020.11.30.20241216 ◽

2020 ◽

Cited By ~ 1

Author(s):

Ethieli R. Silveira ◽

Mariana G. Cademartori ◽

Helena S. Schuch ◽

Jason M. Armfield ◽

Flavio F. Demarco

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

Population Based ◽

Dental Fear ◽

Study Selection ◽

Pooled Prevalence ◽

Subgroup Analyses ◽

Fear And Anxiety

ABSTRACTObjectivesTo systematically review the literature on the prevalence of dental fear in adults to estimate a worldwide pooled prevalence and to investigate factors related to the heterogeneity of estimates.MethodsInclusion criteria were population-based studies reporting the prevalence or data that allowed the calculation of prevalence of dental fear in adults and/or elders. Five electronic databases (Embase, PubMed, Scopus, Virtual Health Library (BVS) and Web of Science) were searched. Two researchers independently performed the study selection, data extraction and quality assessment of the included studies. The prevalence pooled estimates of dental fear were calculated using fixed- and random-effect models. Subgroup analyses were performed to investigate variability between studies.ResultsThe search strategy identified 4,486 studies. After removal of duplicates (1,722), title and abstract screening (2,764) and full-text reading (108), 31 publications were deemed eligible for this systematic review. A total of 72,577 individuals 18 years of age or older composed the sample of this systematic review. The global estimated prevalence of dental fear and anxiety (DFA), high DFA and severe DFA in adults were 13.8%, 11.2% and 2.6%, respectively. Subgroup analyses showed a higher prevalence of DFA, high DFA and severe DFA among women and younger adults. The instrument used to measure dental fear also affected the prevalence of the outcome.ConclusionsDental fear and high dental fear are prevalent in adults worldwide, being more prevalent among women.

Download Full-text

Determinants of Frequent Attendance in Primary Care. Study Protocol for a Systematic Review of Longitudinal Studies

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103710 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3710

Author(s):

André Hajek ◽

Benedikt Kretzler ◽

Hans-Helmut König

Keyword(s):

Systematic Review ◽

Primary Care ◽

Longitudinal Studies ◽

Observational Studies ◽

Data Extraction ◽

Meta Analysis ◽

Study Selection ◽

Frequent Attendance ◽

Longitudinal Observational Studies

Thus far, no study has systematically synthesized longitudinal studies investigating the determinants of frequent attendance in primary care. Consequently, the purpose of our systematic review is to give an overview of evidence based on longitudinal observational studies analyzing the determinants of frequent attendance. Three electronic databases (Medline, PsycINFO, CINAHL) will be searched. Moreover, the reference lists of studies included in our systematic review will be searched manually. Longitudinal observational studies examining the determinants of frequent attendance in primary care will be included. Disease-specific samples will be excluded. Data extraction focuses on methods (e.g., measurement of frequent attendance, statistical analysis), characteristics of the sample and key results. Furthermore, the quality of the studies included will be examined using an appropriate tool. Two reviewers will perform study selection, data extraction, and quality assessment. A meta-analysis will be conducted (if possible).

Download Full-text