scholarly journals The relationship between delivery mode and postpartum depression: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Yu-Xin Chen ◽  
Pei Zhao ◽  
ZhuLiduzi Jiesisibieke ◽  
Pei-En Chen ◽  
Tao-Hsin Tung ◽  
...  

Abstract Background: To assess the relationship between delivery mode and postpartum depression and to examine whether cesarean section (CS) has a higher risk of postpartum depression than vaginal delivery (VD). Methods: We searched the Cochrane Library, PubMed, and EMBASE from inception to 30 April 2019 without language limitations. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreements were resolved by discussion with a third author. We used the Newcastle-Ottawa Scale and GRADE methods to assess the quality of the included studies and evidences. This study had four included cohort studies data and carried out fixed-effect model meta-analysis. Results: The findings demonstrated a significant difference in the risk of postpartum depression between CS and VD. Compared with the control group, the CS group was associated with a higher prevalence of postpartum depression symptoms (Risk Ratio =1.29; 95% CI: 1.11-1.51). Conclusions: The findings supported a relationship between delivery mode and postpartum depression. Particularly, we found that CS is associated with a higher risk of postpartum depression. Therefore, we ought to encourage pregnant women who are without medical indication of CS to select VD.r Trial registration: The protocol of this systematic review was registered in the PROSPERO under the number CRD42019148154.

2020 ◽  
Author(s):  
Yu-Xin Chen ◽  
Pei Zhao ◽  
Zhu Liduzi Jiesisibieke ◽  
Pei-En Chen ◽  
Tao-Hsin Tung ◽  
...  

Abstract Background To assess the relationship between delivery mode and postpartum depression and to examine whether cesarean section (CS) has a higher risk of postpartum depression than vaginal delivery (VD). Methods We searched the Cochrane Library, PubMed, and EMBASE from inception to 30 April 2019 without language limitations. Then two authors independently selected the studies, assessed the quality of the included studies, and extracted data. Any disagreements were resolved by discussion with a third author. Next, we used the Newcastle-Ottawa Scale and GRADE methods are used to evaluate the quality of the included studies and evidences, respectively. This study had four included cohort studies data and carried out fixed-effect model meta-analysis. Results The findings demonstrated a significant difference in the risk of postpartum depression between CS and VD. Compared with the control group, the CS group was associated with a higher prevalence of postpartum depression symptoms (Risk Ratio = 1.29; 95% CI: 1.11–1.51). Conclusions The results showed that delivery mode has nonnegligible effects on the risk of postpartum depression. Particularly, we found that CS is associated with a higher risk of postpartum depression compared with VD. Therefore, we ought to encourage pregnant women who are without medical indication of CS to select VD. Trial registration: The protocol of this systematic review was registered in PROSPERO under the number CRD42019148154.


Author(s):  
Pinky Kotecha ◽  
Alexander Light ◽  
Enrico Checcucci ◽  
Daniele Amparore ◽  
Cristian Fiori ◽  
...  

AbstractObjectiveThe aim of this systematic review is to evaluate the data currently available regarding the repurposing of different drugs for Covid-19 treatment. Participants with suspected or diagnosed Covid-19 will be included. The interventions being considered are drugs being repurposed, and comparators will include standard of care treatment or placebo.MethodsWe searched Ovid-MEDLINE, EMBASE, Cochrane library, clinical trial registration site in the UK(NIHR), Europe (clinicaltrialsregister.eu), US (ClinicalTrials.gov) and internationally (isrctn.com), and reviewed the reference lists of articles for eligible articles published up to April 22, 2020. All studies in English that evaluated the efficacy of the listed drugs were included. Cochrane RoB 2.0 and ROBINS-I tool were used to assess study quality. This systematic review adheres to the PRISMA guidelines. The protocol is available at PROSPERO (CRD42020180915).ResultsFrom 708 identified studies or clinical trials, 16 studies and 16 case reports met our eligibility criteria. Of these, 6 were randomized controlled trials (763 patients), 7 cohort studies (321 patients) and 3 case series (191 patients). Chloroquine (CQ) had a 100% discharge rate compared to 50% with lopinavir-ritonavir at day 14, however a trial has recommended against a high dosage due to cardiotoxic events. Hydroxychloroquine (HCQ) has shown no significant improvement in negative seroconversion rate which is also seen in our meta-analysis (p=0.68). Adverse events with HCQ have a significant difference compared to the control group (p=0.001). Lopinavir-ritonavir has shown no improvement in time to clinical improvement which is seen in our meta-analyses (p=0.1). Remdesivir has shown no significant improvement in time to clinical improvement but this trial had insufficient power.DiscussionDue to the paucity in evidence, it is difficult to establish the efficacy of these drugs in the treatment of Covid-19 as currently there is no significant clinical effectiveness of the repurposed drugs. Further large clinical trials are required to achieve more reliable findings. A risk-benefit analysis is required on an individual basis to weigh out the potential improvement in clinical outcome and viral load reduction compared to the risks of the adverse events. (1-16)


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 4091-4091
Author(s):  
Samragnyi Madala ◽  
Kira MacDougall ◽  
Balarama Krishna Surapaneni ◽  
Robin Park ◽  
Anup Kasi ◽  
...  

4091 Background: The relationship between Helicobacter pylori (H.pylori) and hepatocellular carcinoma (HCC) was first proposed in 1994. Since then, several studies have been performed to explore the association. The role of Hepatitis C (HCV) viruses coexisting with H.pylori in causing HCC was also studied. With the emergence of data in this regard, a causal relationship has been postulated, but not confirmed, and hence the relationship remains controversial. Our meta-analysis aims to summarize the research on this topic and investigate if there exists a relationship between H. pylori infection and the development of HCC and if the presence of HCV along with H.pylori plays a role in liver carcinogenesis. Methods: Following PRISMA guidelines, we performed a systematic review of all relevant studies published in the literature using keywords “Helicobacter pylori” and “Hepatocellular carcinoma” on major literature databases, including PubMed, EMBASE, Web of Science, and Cochrane controlled trials register. A total of 656 studies were identified between 1994 to March 2020, out of which 26 studies qualified under our selection criteria. Patients positive for HCC are included as cases and patients that did not have HCC under control group. In both groups, H.pylori positive patients and their HCV status, was identified. Results: Out of the 26 studies included in the final analysis, the prevalence of H. pylori infection was 64.78% (561 of 866) amongst HCC cases and 47.92% (1718 of 3585) in the non-HCC control group. The summary odds ratio for the association of H. pylori infection with the risk for HCC using the random-effects model was determined to be 4.75 (95% CI, 3.06-7.37), I²=63%. Subgroup analysis to determine the odds of developing HCC in the presence of H.pylori and HCV coinfection, was 13.97 (95% CI, 3.94-49.61), I²=81%. Whereas, the odds of developing HCC in the presence of only HCV without H.pylori was found to be 2.21 (0.70-6.94), I²=79. Subgroup analysis by study design showed no significant difference between the study groups (P= 0.5705). Conclusions: Our meta-analysis showed a positive association between H. pylori infection and the development of HCC. It showed a significantly higher risk of developing HCC in the presence of HCV infection along with H.pylori. Further prospective cohort studies are needed to prove the causal relationship, especially in cases of Hepatitis B, C coinfection, and cirrhotic patients.[Table: see text]


Author(s):  
Jiawei Qin ◽  
Kaize Zhao ◽  
Yannan Chen ◽  
Shuai Guo ◽  
Yue You ◽  
...  

The effect of exercise intervention on balance capacity among type 2 diabetes mellitus (T2DM) patients has not been evaluated. The objective of this systematic review and meta-analysis is to investigate the effect of exercise intervention on balance capacity among T2DM patients compared to the control group (usual care, waitlist, no-treatment, education). We conducted a comprehensive literature search through PubMed, EMBASE, Physiotherapy Evidence Database (PEDro), Cochrane library, Web of Science (WOS) from inception to August 2020. The literature language was limited to English. Randomized controlled trials (RCTs) or quasi-experimental (Q-E) trials that examined the effect of exercise intervention on balance capacity among T2DM patients were included. We used the standard methods of meta-analysis to evaluate the outcomes of exercise intervention for balance capacity of T2DM patients. A total of 14 trials (11 RCTs and 3 Q-E trials) involving 883 participants were eligible. The meta-analysis of some studies demonstrated that exercise intervention could significantly improve Berg Balance Scale (BBS) (MD = 2.56; 95%CI [0.35, 4.77]; P = .02), SLST (Single Leg Stance Test) under the eyes-open (EO) condition (MD = 3.63; 95%CI [1.79, 5.47]; P = .0001) and eyes-close (EC) condition (MD = 0.41; 95%CI [0.10, 0.72]; P = .01) compared to control group. There was no significant difference in Time Up and Go Test (TUGT) (MD = −0.75; 95%CI [−1.69, 0.19]; P = .12) and fall efficacy (SMD = −0.44; 95%CI [−0.86, −0.01]; P = .05). Narrative review of some studies indicated that exercise intervention could improve postural stability measured by Sensory Organization Test (SOT) and Center of Pressure (COP) variables, etc. This systematic review and meta-analysis summarized that exercise intervention could improve balance capacity in T2DM patients. However, further studies with high quality are required to evaluate its effect.


Author(s):  
Priscila Matsuoka ◽  
Rodrigo Castro ◽  
Edmund Baracat ◽  
Jorge Haddad

Objective To evaluate if performing anti-incontinence procedures during surgical anterior and/or apical prolapse correction in women with asymptomatic urinary incontinence (UI) may prevent stress urinary incontinence (SUI) postoperatively. Methods We have performed a systematic review of articles published in the PubMed, Cochrane Library, and Lilacs databases until March 31, 2016. Two reviewers performed the data collection and analysis, independently. All of the selected studies were methodologically analyzed. The results are presented as relative risk (RR), with a 95% confidence interval (CI). Results After performing the selection of the studies, only nine trials fulfilled the necessary prerequisites. In the present review, 1,146 patients were included. Altogether, the review included trials of three different types of anti-incontinence procedures. We found that performing any anti-incontinence procedure at the same time of prolapse repair reduced the incidence of SUI postoperatively (RR = 0.50; 95% CI: 0.28–0.91). However, when we performed the analysis separately by the type of anti-incontinence procedure, we found different results. In the subgroup analysis with midurethral slings, it is beneficial to perform it to reduce the incidence of SUI (RR = 0.08; 95% CI: 0.02–0.28). On the other hand, in the subgroup analysis with Burch colposuspension, there was no significant difference with the control group (RR = 1.47; 95% CI: 0.28–7.79]). Conclusion Performing any prophylactic anti-incontinence procedure at the same time as prolapse repair reduced the incidence of SUI postoperatively. The Burch colposuspension did not show any decrease in the incidence of SUI postoperatively.


PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8826
Author(s):  
Caroline Tanadi ◽  
Alfredo Bambang ◽  
Indra Putra Wendi ◽  
Veronika M. Sidharta ◽  
Linawati Hananta ◽  
...  

Background Many studies have reported the presence of Positive Regulatory/Su(var)3-9, Enhancer-of-zeste and Trithorax Domain 2 (PRDM2) downregulation in cancer. However, its potential as a diagnostic biomarker is still unclear. Hence, a systematic review and meta-analysis were conducted to address this issue. Introduction As of 2018, cancer has become the second leading cause of death worldwide. Thus, cancer control is exceptionally vital in reducing mortality. One such example is through early diagnosis of cancer using tumor biomarkers. Having a function as a tumor suppressor gene (TSG), PRDM2 has been linked with carcinogenesis in several solid tumor. This study aims to assess the relationship between PRDM2 downregulation and solid tumor, its relationship with clinicopathological data, and its potential as a diagnostic biomarker. This study also aims to evaluate the quality of the studies, data reliability and confidence in cumulative evidence. Materials & Methods A protocol of this study is registered at the International Prospective Register of Systematic Reviews (PROSPERO) with the following registration number: CRD42019132156. PRISMA was used as a guideline to conduct this review. A comprehensive electronic search was performed from inception to June 2019 in Pubmed, Cochrane Library, ProQuest, EBSCO and ScienceDirect. Studies were screened and included studies were identified based on the criteria made. Finally, data synthesis and quality assessment were conducted. Results There is a significant relationship between PRDM2 downregulation with solid tumor (RR 4.29, 95% CI [2.58–7.13], P < 0.00001). The overall sensitivity and specificity of PRDM2 downregulation in solid tumors is 84% (95% CI [39–98%]) and 86% (95% CI [71–94%]), respectively. There is a low risk of bias for the studies used. TSA results suggested the presence of marked imprecision. The overall quality of evidence for this study is very low. Discussion We present the first meta-analysis that investigated the potential of PRDM2 downregulation as a diagnostic biomarker in solid tumor. In line with previous studies, our results demonstrated that PRDM2 downregulation occurs in solid tumor. A major source of limitation in this study is the small number of studies. Conclusions Our review suggested that PRDM2 is downregulated in solid tumor. The relationship between PRDM2 downregulation and clinicopathological data is still inconclusive. Although the sensitivity and specificity of PRDM2 downregulation are imprecise, its high values, in addition to the evidence that suggested PRDM2 downregulation in solid tumor, hinted that it might still have a potential to be used as a diagnostic biomarker. In order to further strengthen these findings, more research regarding PRDM2 in solid tumors are encouraged.


2021 ◽  
Author(s):  
Mostafa Torbati ◽  
Parya Emamverdizadeh ◽  
Mohammadalili Torbati ◽  
Mahsa Maghalian ◽  
Mojgan Mirghafourvand

Background: Oral and dental diseases are among the common health conditions which can have different effects on the individuals’ health and quality of life. The objective of this study was to examine the effect of garlic (Allium sativum) extract on saliva Streptococcus mutans (primary outcome) and its side effects (secondary outcome). Methods: In the present systematic review and meta-analysis, English and Persian databases (PubMed, Cochrane Library, Google Scholar, Scopus, Web of Science, SID, and Magiran) were systematically searched until February 25, 2021. The quality of the included studies was examined using Cochrane handbook, and the meta-analysis was carried out using RevMan 5.3. Heterogeneity of the studies was analyzed by index I2. Moreover, the quality of the evidence was assessed through GRADE approach. Results: A total of 93 studies were found on the databases; 89 articles were screened by title and abstract review and were removed as 19 studies were repetitive and 70 studies were unrelated to the subject under study. Ultimately, 4 articles with a sample size of 171 participants were included in this study, and two of the four studies were meta-analyzed. In all the 4 studies, garlic extract was effective in reducing the number of saliva Streptococcus mutans colonies compared to the control group. The results of the meta-analysis showed that using garlic extract mouthwash significantly decreased the average number of saliva Streptococcus mutans colonies (Mean Difference: -3.32; 95%CI: -4.39 to -2.26; P<0.00001). Conclusion: Although this review study indicated the significant effect of garlic extract in reducing saliva Streptococcus mutans, the evidence is not sufficient enough to recommend garlic extract to fight saliva Streptococcus mutans, and more clinical trials with stronger designs and larger sample sizes are needed.


Author(s):  
Gaohong Wu ◽  
Haifeng Geng ◽  
Yue Jiang ◽  
Wei Song ◽  
Xueping Zhu ◽  
...  

To evaluate the efficacy of fish oil for protection against coronary heart disease (CHD), we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the use of fish oil for protection against CHD. We retrieved relevant articles published from January 1966 to January 2020 by searching the PubMed, EMBASE, Cochrane CENTRAL, and Web of Science databases. RCTs of fish oil in preventing CHD were selected. The study quality was evaluated using the Cochrane Risk of Bias tool with RevMan 5.3 software. The first selection involved 350 citations. After screening and evaluation of suitability, 19 RCTs adjusted for clustering were included in the meta-analysis. All selected manuscripts considered that fish oil was effective in preventing CHD, secondary outcome measures included angina, sepsis and death. Compared with the control group, fish oil may confer significant protection against CHD (odds ratio = 0.84; 95% confidence interval: 0.72–0.98). There was no significant difference in the incidence of secondary outcomes between the observation group and the control group (P &gt; 0.05). The above results show that fish oil plays an important role in reducing CHD and cardiovascular events. However, because of the suboptimal quality of the studies included into the meta-analysis, these results do not justify adding fish oils systematically to the heavy pharmaceutical assortment already recommended in CHD patients.


Electronics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1003
Author(s):  
Wenjing Wang ◽  
Sharon Sui-lam Wong ◽  
Frank Ho-yin Lai

As a popular method, virtual reality (VR) is still controversial in its effect on the balance function of patients with Parkinson’s disease. This systematic review aims to discuss such effects of VR and to compare it with that resulting from traditional therapies. A comprehensive search was conducted for randomized controlled trials published from 2000 to 2020 through the following databases: PubMed, Web of Science, CINAHL, Embase, Cochrane Library. Fifteen articles were included for the systematic review. An evaluation on their methodological qualities was performed using the PEDro scale, followed by an assessment of their risk of biases in accordance with the Cochrane Handbook for Systematic Reviews of Interventions for quality assessment. In terms of dynamic balance, the BBS score of the VR group was significantly improved when compared with the control group (SMD = 0.52, 95% CI = 0.31–0.73). However, no significant difference was observed between the two groups on TUG (SMD = −0.26; 95% CI = −0.62–0.1; p = 0.16). Besides, the VR group also showed better results in improving patients’ static balance, balance confidence, and quality of life. A funnel plot was created to investigate the effects of each study included in the meta-analysis in order to identify any existing publication bias. This systematic review shows that the application of VR leads to more significant improvement in the balance of patients with Parkinson’s disease than having them perform traditional exercises. It can be used as an auxiliary method of rehabilitation.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Yonghui Hou ◽  
Ying Liu ◽  
Minying Li ◽  
Baile Ning ◽  
Zehuai Wen ◽  
...  

Objectives. To systematically assess the efficacy of acupuncture combined with rehabilitation on unilateral neglect after stroke. Methods. The Cochrane Library, PubMed, Excerpt Medical Database (EMBASE), China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (CBM), and Wan Fang databases were searched online for randomised controlled trials (RCTs) of acupuncture and its effects on unilateral neglect after stroke from their inception to September 2019. RCTs on acupuncture combined with rehabilitation in the experimental group for unilateral neglect compared with rehabilitation alone or rehabilitation plus sham acupuncture in the control group were included. Two authors separately screened the literature, extracted the data, and evaluated the quality of the included studies. Review Manager 5.3 software was used for the data analysis. Results. A total of 542 patients from nine RCTs were included. The meta-analysis showed that the experimental groups could significantly improve Fugl–Meyer Assessment (FMA) (MD = 11.54, 95% CI [9.54, 13.54], P<0.00001) and the ability of daily living (SMD = 1.35, 95% CI [0.64, 2.07], P<0.00001) when compared with the control groups. However, there was no significant difference in the drop of Catherine Bergego Scale (CBS) and Behavioural Inattention Test-conventional (BIT-C) between the two groups. Conclusions. Acupuncture combined with rehabilitation was more effective in improving the motor function and the ability of daily living. Because of the limitations regarding the quantity and quality of the studies in this meta-analysis, high-quality and well-designed RCTs are necessary to validate the above conclusions.


Sign in / Sign up

Export Citation Format

Share Document