Prevalence of rhesus D-negative blood type and the challenges of rhesus D immunoprophylaxis among obstetric population in Ethiopia: a systematic review and meta-analysis

Abstract Background Transplacental or fetomaternal hemorrhage (FMH) may occur during pregnancy or at delivery and lead to immunization to the D antigen if the mother is Rh-negative and the baby is Rh-positive. This can result in hemolytic disease of the fetus and newborn (HDFN) in subsequent D-positive pregnancies. Therefore, the aim of this systematic review and meta-analysis was to estimate distribution of ABO and Rh (D) blood groups among pregnant women in Ethiopia. Method We searched PubMed, Google Scholar, EMBASE, Cochrane Library, HINARI, AFRO Library Databases, and African Online Journal databases for all available studies using the following keywords: “High rhesus (Rh(D)) negative frequency”, “ABO blood group distribution”, “haemolytic disease of the newborn (HDN)”, “rh isoimmunization”, “anti-RhD immunoglobulin”, “D-negative pregnancies”, “Frequency”, “ABO and Rh blood group distribution”, “feto-maternal hemorrhage”, “rhesus D negative pregnant mothers”, “kleihauer-betke test (KBT)”, “Neonatal Hyperbilirubinemia”, “non-sensitized RhD-negative pregnant women”, “antenatal anti-D immunoglobulin prophylaxis”, “Hemolytic disease of the newborn (alloimmunization), Ethiopia. The search string was developed using “AND” and “OR” Boolean operators. All published and unpublished observational studies reporting the distribution of ABO and Rh (D) blood groups among pregnant women in Ethiopia were included. The study participants were all pregnant women in Ethiopia, and the main outcome measure of this systematic review and meta-analysis was Rhesus D-negative blood type and ABO blood group distribution among pregnant women in Ethiopia. The data was extracted by the author (AAA) by using a standardized JBI data extraction format. Microsoft Excel (2016), and Stata version 11.0 (Stata Corporation, College Station, Texas, USA) software were used for data entry and analysis, respectively. The random effect model was used for estimating the pooled effects, and the publication bias was assessed by visual inspection of the funnel plots and objectively by using the Egger’s test (i.e. p < 0.05). Results One hundred thirty-two articles were identified through electronic database searching. Of which, 34 were excluded due to duplication, 65 through review of titles and abstracts, and 22 full-text articles were excluded for not reporting the outcome variable and other reasons. Finally, 7 were included to estimate the distribution of ABO and Rh (D) blood groups among pregnant women in Ethiopia. The pooled distribution of Rh-negative blood group among pregnant women in Ethiopia was 10.8% (95%CI: 7.53–14.07, I2 = 85%, p < 0.001). In the ABO system, type O was the most prevalent 39.9% (37.51–42.38), followed by A (30.59% (26.00–35.18)), B (23.04% (20.03–26.05)), and AB the least (4.82%(3.17–6.47)), in the pattern O > A > B > AB. Conclusion The pooled distribution of Rh-negative blood group among pregnant women in Ethiopia was high. Rh alloimmunization remains a major factor responsible for perinatal morbidity in Ethiopia and may result in the compromise of the woman’s obstetric care due to the unaffordability of anti-D immunoglobulin. There is the urgent need for the implementation of universal access to anti-D immunoglobulin for the Rh-negative pregnant population in Ethiopia.

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The Association Between ABO Blood Group and Preeclampsia: A Systematic Review and Meta-Analysis

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.665069 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ting Li ◽

Yixiao Wang ◽

Lan Wu ◽

Zhonghui Ling ◽

Chanjuan Li ◽

...

Keyword(s):

Systematic Review ◽

Regression Analysis ◽

Blood Group ◽

Meta Analysis ◽

Blood Groups ◽

Abo Blood Group ◽

Linear Regression Equation ◽

Funnel Plot ◽

Meta Regression ◽

Meta Regression Analysis

Objective: This meta-analysis comprehensively evaluated the association between ABO blood group and the risk of preeclampsia (PE).Design: Systematic review and meta-analysis.Data sources: PubMed, Web of Science, and ScienceDirect databases from their inception to September 23, 2020.Methods: Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were obtained through random-effects and fixed-effects models according to heterogeneity. Meta-regression analysis was applied to explore the source of heterogeneity. We conducted a subgroup analysis by the publication year, study design, state, and Newcastle-Ottawa Scale (NOS) score. In addition, we calculated the rate of each ABO blood group in PE by total pooled effects.Results: A total of 12 articles with 714,153 patients were included in our analysis. Compared with people without PE (control group), the O blood group presented a lower risk of PE (OR 0.95, 95% CI 0.93–0.97). The AB (OR 1.46, 95% CI 1.12–1.91) blood group presented a higher risk. However, the total pooled OR and 95% CI for the A (OR 1.02, 95% CI 0.90–1.16) and B (OR 1.02, 95% CI 0.98–1.05) blood groups were not significant. The funnel plot and linear regression equation showed that there was no publication bias for the O, A, or B blood groups (all P > 0.05). However, the funnel plot and linear regression equation for the AB blood group were obviously asymmetric (P < 0.05), and the publication bias persisted even after the trim-and-fill method was applied (P < 0.05). Multivariable meta-regression analysis did not find a specific source of heterogeneity. The A blood group showed an association with early-onset PE (OR 0.53, 95% CI 0.33–0.83), and the other blood groups showed no significant differences. In PE, the rates of the O, A, B, and AB blood groups decreased gradually (0.39, 0.33, 0.19, 0.07).Conclusion: These findings suggest that pregnant women with AB blood group are more likely to develop PE, and more attention should be paid to AB blood group whose blood pressure is high but not sufficient to diagnose PE.Systematic Review Registration: Prospero CRD42021227930.

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ABO Blood Group is Associated with COVID-19 Susceptibility: a Systematic Review and Meta-Analysis

Iberoamerican Journal of Medicine ◽

10.53986/ibjm.2021.0012 ◽

2020 ◽

Vol 3 (1) ◽

pp. 71-84

Author(s):

Richard Chinaza Ikeagwulonu ◽

◽

Chinonyelum Thecla Ezeonu ◽

Mark Uchejeso Obeta ◽

Ngozi Immaculata Ugwu ◽

...

Keyword(s):

Blood Group ◽

Meta Analysis ◽

Blood Groups ◽

Blood Type ◽

Abo Blood Group ◽

Abo Blood Groups ◽

Blood Group A ◽

Search Terms ◽

Group A

Introduction: Conflicting evidences exist that ABO blood groups correlate with the susceptibility to COVID-19 and its clinical outcomes. This study aimed to pool available articles that assessed a possible relationship between COVID-19 and ABO blood groups. Materials and methods: A search was conducted in four databases comprising Pubmed/Medline, Google scholar, Journal storage (JSTOR) and African Journals Online (AJOL) for relevant studies available before 25th August 2020 and contained extractable data on ABO blood type distribution and COVID-19 disease. Search terms included a combination of “ABO blood group, and COVID-19, coronavirus, and SARS-COV-2”. Results: Fourteen articles that met study inclusion criteria were selected from a total of five hundred and eighty-five articles identified through database search. The fourteen articles reviewed comprised of a total of 73934 subjects (13189 SARS-COV-2 positive cases and 60745 controls). Overall, the risk of SARS-COV-2 infection was found to be significantly increased in patients with blood group A with ORs: 1.24 (95%Cl: 1.09-1.41, P = 0.001). Additionally, blood group O subjects were seen to have decreased odds of contracting COVID-19 infection (OR: 0.78, 95%Cl: 0.68 – 0.89, P=0.0003). No significant association was found between ABO blood groups and COVID -19 severity and mortality. Conclusions: Blood group A was associated with a higher risk of SARS-COV-2 infection whereas risk of infection was lower in blood group O subjects. No statistical significant association was found between ABO blood groups and COVID-19 severity and mortality. The precise role of ABO blood group in COVID-19 susceptibility, severity and mortality requires further research for clarification.

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ABO blood groups and hepatitis B virus infection: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-034114 ◽

2020 ◽

Vol 10 (1) ◽

pp. e034114 ◽

Cited By ~ 11

Author(s):

Wenzhan Jing ◽

Siyu Zhao ◽

Jue Liu ◽

Min Liu

Keyword(s):

Systematic Review ◽

Hepatitis B Virus ◽

Blood Group ◽

Meta Analysis ◽

Blood Groups ◽

Hbv Infection ◽

Abo Blood Group ◽

Abo Blood Groups ◽

B Virus ◽

Group B

ObjectiveHepatitis B virus (HBV) infection is a major public health problem worldwide. Several studies have reported that ABO blood groups may be associated with HBV infection. However, its association is still controversial. We performed a meta-analysis to investigate whether ABO blood groups were associated with HBV infection.DesignSystematic review and meta-analysis.Data sourcesRelevant studies available before 1 December 2019 were identified by searching PubMed, EMBASE, Web of Science, ScienceDirect and the Cochrane Library.Eligibility criteriaAll cross-sectional or cohort studies from which the data of ABO blood group distribution and HBV infection could be extracted.Data extraction and synthesisStudies were identified and extracted by two reviewers independently. Risk ratios (RRs) and 95% CIs were pooled by random-effect models to quantify this association.ResultsThirty-eight eligible articles including 241 868 HBV-infected subjects and 6 487 481 uninfected subjects were included. Overall, the risk of HBV infection had decreased by 8% in subjects with blood group B when compared with non-B blood group (RR=0.92, 95% CI 0.86 to 0.98). In the subgroup analyses, the inverse relationship between blood group B and HBV infection remained stable in higher endemic areas (HBV prevalence ≥5%), Asian people, larger sample size studies (≥2000), general population and blood donors, lower middle income group and studies published before the year 2010. Additionally, subjects with blood group O had a 12% increased risk of HBV infection (RR=1.12, 95% CI 1.01 to 1.24) in higher endemic areas. In the sensitivity analysis, the pooled risk estimates of blood group B and HBV infection were still stable.ConclusionsOur data suggested that the blood group B was associated with a lower risk of HBV infection. More research is needed to clarify the precise role of the ABO blood group in HBV infection to address the global question of HBV infection.

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ABO blood group antigens may be associated with increased susceptibility to schistosomiasis: a systematic review and meta-analysis

Journal of Helminthology ◽

10.1017/s0022149x18001116 ◽

2018 ◽

Vol 94 ◽

Cited By ~ 2

Author(s):

R.E. Tiongco ◽

N.A. Paragas ◽

M.J. Dominguez ◽

S.L. Lasta ◽

J.K. Pandac ◽

...

Keyword(s):

Systematic Review ◽

Blood Group ◽

Subgroup Analysis ◽

Meta Analysis ◽

Blood Type ◽

Abo Blood Group ◽

Blood Group Antigens ◽

Pathophysiological Mechanism ◽

Blood Flukes ◽

Increased Susceptibility

Abstract Schistosomiasis or bilharzia is a widespread parasitic disease caused by blood flukes of the genus Schistosoma. Some factors have been investigated previously regarding their effect on the pathophysiological mechanism of human schistosomiasis, but the possible influence of the ABO blood group on the severity of Schistosoma infection has been the most promising. Hence, we performed a systematic review and meta-analysis to further investigate the association of the ABO blood group with schistosomiasis susceptibility. Selected publications were retrieved from PubMed up to 21 August 2018, for related studies written in English. Number of cases (with schistosomiasis) and controls (without schistosomiasis) were extracted across all ABO blood types. Odds ratios (OR) and 95% confidence intervals (CI) were computed, pooled and interpreted. Subgroup analysis by the species of Schistosoma infecting the population and the participants’ ethnicity was also performed. The overall analysis revealed heterogeneity in the outcomes, which warranted the identification of the cause using the Galbraith plot. Post-outlier outcomes of the pooled ORs show that individuals who are not blood type O are more susceptible (OR: 1.40; 95% CI: 1.17–1.67; PA < 0.001) to schistosomiasis than those who are blood type O (OR: 0.71; 95% CI: 0.60–0.85; PA < 0.001). Subgroup analysis yielded the same observations regardless of the species of schistosome and the ethnicity of the participants. Results of this meta-analysis suggest that individuals who are blood type B and A are more susceptible to schistosomiasis than those who are blood type O. However, more studies are needed to confirm our claims.

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Distribution of ABO Blood Groups and Their Association With Low Risk of Severe COVID-19 Infection in Patients

10.21203/rs.3.rs-139563/v1 ◽

2021 ◽

Author(s):

Minfei Peng ◽

Shigao Huang ◽

Qingqing Lv ◽

Chaochao Chen ◽

Jiajia Qin ◽

...

Keyword(s):

Blood Group ◽

Lower Risk ◽

Infection Risk ◽

Blood Groups ◽

Blood Type ◽

Abo Blood Group ◽

Susceptible Population ◽

Blood Types ◽

And Gender ◽

Group Distribution

Abstract Background: To date, only few studies have focused on the correlation between ABO blood groups and COVID-19 infection risk, especially gender differences in infection risk. Our study aimed to describe the ABO blood group distribution and its association with risk of severe COVID-19 infection for effective identification of the susceptible population. Method：From January 21 to February 20, 2020, we compared the ABO blood group distribution and gender distribution and performed a correlation analysis in severe, non-severe, and non-COVID-19 patients. Results The results showed that the laboratory indices were significantly different between blood type O and non-blood-type-O COVID-19 patients. This indicated that patients of the type O blood group had a relatively lower risk of severe COVID-19 infection than patients of other blood types; in particular, females with blood type O had a lower risk of severe COVID-19 infection than males. Conclusion: Herein, we report a potentially simple prediction decision system to minimize the risk of severe COVID-19 infection based on blood type. Special attention should be paid to patients with blood types other than type O to minimize their risk of severe COVID-19 infection.

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Relationship between the ABO Blood Group and the COVID-19 Susceptibility

10.1101/2020.03.11.20031096 ◽

2020 ◽

Cited By ~ 78

Author(s):

Jiao Zhao ◽

Yan Yang ◽

Hanping Huang ◽

Dong Li ◽

Dongfeng Gu ◽

...

Keyword(s):

Blood Group ◽

Blood Groups ◽

Blood Type ◽

Abo Blood Group ◽

The Novel ◽

Group A ◽

Abo Blood Type ◽

Novel Coronavirus ◽

The Relationship ◽

Group Distribution

AbstractThe novel coronavirus disease-2019 (COVID-19) has been spreading around the world rapidly and declared as a pandemic by WHO. Here, we compared the ABO blood group distribution in 2,173 patients with COVID-19 confirmed by SARS-CoV-2 test from three hospitals in Wuhan and Shenzhen, China with that in normal people from the corresponding regions. The results showed that blood group A was associated with a higher risk for acquiring COVID-19 compared with non-A blood groups, whereas blood group O was associated with a lower risk for the infection compared with non-O blood groups. This is the first observation of an association between the ABO blood type and COVID-19. It should be emphasized, however, that this is an early study with limitations. It would be premature to use this study to guide clinical practice at this time, but it should encourage further investigation of the relationship between the ABO blood group and the COVID-19 susceptibility.

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Remotely delivered interventions to support women with symptoms of anxiety in pregnancy: a mixed methods systematic review of quantitative and qualitative evidence (Preprint)

10.2196/preprints.28093 ◽

2021 ◽

Author(s):

Kerry Evans ◽

Stefan Rennick-Egglestone ◽

Serena Cox ◽

Yvonne Kuipers ◽

Helen Spiby

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Quantitative Data ◽

Meta Analysis ◽

Treatment Options ◽

Social Science Citation Index ◽

Cochrane Library ◽

Access To Treatment ◽

On Line ◽

In Pregnancy

BACKGROUND Symptoms of anxiety are common in pregnancy, with severe symptoms associated with negative outcomes for women and babies. Low level psychological therapy is recommended as first line treatment options for women with mild to moderate anxiety, with the aim to prevent an escalation of symptoms and provide women with coping strategies. Remotely delivered interventions have been suggested to improve access to treatment and support for women in pregnancy and provide a cost-effective, flexible and timely solution. OBJECTIVE To identify and evaluate remotely delivered, digital or on-line interventions to support women with symptoms of anxiety in pregnancy. METHODS A mixed method systematic review following a convergent segregated approach to synthesise the qualitative and quantitative data. The ACM Digital Library, AMED, ASSIA, CRD, CENTRAL, the Cochrane Library, CINAHL, EMBASE, HTA, IEEE Xplore, JBI, Maternity and Infant Care, Medline, PsycINFO and the Social Science Citation Index were searched in October 2020. Quantitative or qualitative primary research including pregnant women which evaluated remotely delivered interventions reporting measures of anxiety, fear, stress, distress, women’s views, feedback and opinions were included in the review. RESULTS Three qualitative and 14 were quantitative studies included. Populations included a general antenatal population, and pregnant women with anxiety and depression, fear of childbirth, insomnia and pre-term labour. Interventions included CBT, Problem Solving, Mindfulness and Educational designs. Most interventions were delivered via on-line platforms and 8 included direct contact from trained therapists or coaches. A meta-analysis of the quantitative data found for I-CBT and facilitated interventions there was observed beneficial effect in relation to the reduction of anxiety scores (SMD=-0.49; 95% CI=-0.75 to -0.22; SMD=-0.48; 95% CI=-0.75 to -0.22). However, due to limitations in the amount of available data and study quality, the findings should be interpreted with caution. Synthesised findings from quantitative and qualitative data found some evidence to suggest that interventions are more effective when women are motivated to maintain regular participation in interventions. Participation may be enhanced by providing regular contact with therapists, targeting interventions for women with anxiety symptoms; providing peer support forums; including components of relaxation and cognitive based skills; and providing sufficient sessions to develop new skills without being too time consuming. CONCLUSIONS There is limited evidence to suggest that pregnant women may benefit from remotely delivered interventions. The synthesised findings highlighted components of interventions which may improve the effectiveness and acceptability of remotely delivered interventions. These include providing women with contact with a therapist, healthcare professional or peer community. Women may be more motivated to complete interventions which are perceived as relevant or tailored to their needs and situations. Remote interventions may also provide women with greater anonymity to help them feel more confident in disclosing their symptoms.

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Prevalence of Syphilis among Pregnant Women in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2019/4562385 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Siraj Hussen ◽

Birkneh Tilahun Tadesse

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Screening Program ◽

Meta Analysis ◽

Relevant Literature ◽

Sub Saharan Africa ◽

Cochrane Library ◽

Forest Plot ◽

Pooled Prevalence ◽

Sub Saharan

Objective. Syphilis is one of the most imperative STIs, caused by the spirochete Treponema pallidum. During pregnancy it is associated with disastrous health outcomes in the newborn. In sub-Saharan Africa, study findings on the prevalence of syphilis among pregnant women are highly dispersed and inconsistent. The aim of the current review is to conduct a systematic review and meta-analysis of syphilis in sub-Saharan Africa among pregnant women. Design. Systematic review and meta-analysis. Data Sources. Databases including MEDLINE, PubMed, Cochrane Library, Google Scholar, and HINARI and reference lists of previous prevalence studies were systematically searched for relevant literature from January 1999 to November 2018. Results were presented in forest plot, tables, and figures. Random-effects model was used for the meta-analysis. For the purpose of this review, a case of syphilis was defined as positive treponemal or nontreponemal tests among pregnant women. Data Extraction. Our search gave a total of 262 citations from all searched databases. Of these, 44 studies fulfilling the inclusion criteria and comprising 175,546 subjects were finally included. Results. The pooled prevalence of syphilis among pregnant women in sub-Saharan Africa was 2.9% (95%CI: 2.4%-3.4%). East and Southern African regions had a higher syphilis prevalence among pregnant women (3.2%, 95% CI: 2.3%-4.2% and 3.6%, 95%CI: 2.0%-5.1%, respectively) than the sub-Saharan African pooled prevalence. The prevalence of syphilis among pregnant women in most parts of the region seemed to have decreased over the past 20 years except for the East African region. However, prevalence did not significantly differ by region and time period. Conclusion. This review showed a high prevalence of syphilis in sub-Saharan Africa among pregnant women. The evidence suggests strengthening the screening program during pregnancy as part of the care package during antenatal care visits. Programs focusing on primary prevention of syphilis in women should also be strengthened.

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Iron stores in pregnant women with sickle cell disease: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-026497 ◽

2019 ◽

Vol 9 (9) ◽

pp. e026497 ◽

Cited By ~ 2

Author(s):

Desmond Aroke ◽

Benjamin Momo Kadia ◽

Tsi Njim

Keyword(s):

Systematic Review ◽

Sickle Cell Disease ◽

Iron Deficiency ◽

Pregnant Women ◽

Sickle Cell ◽

Iron Deficiency Anaemia ◽

Meta Analysis ◽

Cochrane Library ◽

Cell Disease ◽

Deficiency Anaemia

IntroductionSickle cell disease (SCD) is the most common inherited disease worldwide. The greatest disease burden is seen in sub-Saharan Africa. Early diagnosis and improved care of people living with SCD have led to an increase in the number of women with SCD reaching the reproductive age. Iron deficiency anaemia remains the most common cause of anaemia in pregnancy, affecting 51%–63% of pregnancies in Africa. However, the unavailability of guidelines on supplementation of iron in this pregnant subpopulation often leaves clinicians in a fix. We propose to conduct the first systematic review and possibly a meta-analysis on the prevalence, associated factors and maternal/fetal outcomes of iron deficiency anaemia among pregnant women with SCD.Methods and analysisWe will search the following electronic databases for studies on the iron status of pregnant women with SCD: PubMed, MEDLINE, EMBASE, Google Scholar, African Journals Online, African Index Medicus, Popline and the Cochrane Library. After the selection of eligible studies from the search output, review of full text, data extraction and data synthesis will be performed. Studies obtained from the review shall be evaluated for quality, risk of bias and heterogeneity. Appropriate statistical methods shall be used to pool prevalence estimates for matching studies globally and in subpopulations. This protocol has been reported as per the 2015 guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols.Ethics and disseminationThere is no requirement for ethical approval as the proposed study will use published data. The findings of this study will be published in a peer-reviewed journal and will be presented at conferences.Trial registration numberCRD42018109803.

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