Risk factors and population attributable risk percent for lactation mastitis in Chinese women: a systematic review and meta-analysis

Abstract Background: Lactation mastitis (LM) is one of the most common breast disorders experienced by postpartum women, affecting approximately 3% to 20% breastfeeding mothers. Although a few researches have studied the risk factors related to LM, there are still some inconsistent problems on this topic and nationally representative evidence is scarce. This study was aimed to determine the well-accepted risk factors for LM in Chinese women. Methods: Six electronic literature databases were searched from their inception to June 1st, 2020. We used RevMan5.3 and Stata14.0 for data analysis. The strength of the association was summarized using odds ratio (OR) with 95% confidence intervals (CI). The population attributable risk (PAR) percent was calculated for significant risk factors. The fail-safe number (Nfs) was used to estimate publication bias and robustness of the current results. Results: Twelve studies involving 6539 participants were included. A total of 18 potential risk factors were eventually evaluated. Significant risk factors for LM included improper breastfeeding posture (OR 2.47, 95%CI 2.09-2.92; PAR 26.51%), improper milking method (OR 6.79, 95%CI 3.45-13.34; PAR 59.14%), repeated milk stasis (OR 6.08, 95%CI 3.75-9.88; PAR 37.42%), little or no cleaning of nipples (OR 2.38, 95%CI 1.88-3.03; PAR 31.28%), abnormal nipple or crater nipple (OR 2.94, 95%CI 1.76-4.91; PAR 33.99%), primipara (OR 1.91, 95%CI 1.26-2.90; PAR 39.06%), history of breast trauma (OR 3.57, 95%CI 2.86-4.46; PAR 13.36%), experience of cesarean section (OR 1.77, 95%CI 1.32-2.38; PAR 28.34%), low educational level (OR 1.85, 95%CI 1.04-3.28, PAR 23.67%), breast massage experience of non-medical personnel (OR 1.90, 95%CI 1.36-2.65, PAR 20.89%), postpartum within 6 months (OR 5.11, 95%CI 2.66-9.82; PAR 65.93%), prone sleeping position (OR 2.53, 95%CI1.51-4.22; PAR 22.72%) and postpartum rest time less than 3 months (OR 4.71, 95%CI 3.92-5.65; PAR 56.95%). There seemed to be good robustness of the pooled results for most of the included risk factors.Conclusion: This study found several important risk factors of LM in Chinese women. In particular, the incidence of LM can be reduced by controlling several modifiable factors such as breastfeeding posture, milking method, milk stasis situation and nipple cleaning condition, etc.

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Risk factors for lactation mastitis in China: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0251182 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251182

Author(s):

Bao-Yong Lai ◽

Bo-Wen Yu ◽

Ai-Jing Chu ◽

Shi-Bing Liang ◽

Li-Yan Jia ◽

...

Keyword(s):

Risk Factors ◽

Medical Staff ◽

Chinese Women ◽

Meta Analysis ◽

Population Attributable Risk ◽

Significant Risk ◽

Biomedical Literature ◽

Individual Risk ◽

China National Knowledge Infrastructure ◽

Sleeping Position

Background Lactation mastitis (LM) affects approximately 3% to 33% of postpartum women and the risk factors of LM have been extensively studied. However, some results in the literature reports are still not conclusive due to the complexity of LM etiology and variation in the populations. To provide nationally representative evidence of the well-accepted risk factors for LM in China, this study was aimed to systematically summary the risk factors for LM among Chinese women and to determine the effect size of individual risk factor. Material and methods Six major Chinses and English electronic literature databases (PubMed, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wan fang Database and China Science Technology Journal Database) were searched from their inception to December 5st, 2020. Two authors extracted data and assessed the quality of included trials, independently. The strength of the association was summarized using the odds ratio (OR) with 95% confidence intervals (CI). The population attributable risk (PAR) percent was calculated for significant risk factors. Results Fourteen studies involving 8032 participants were included. A total of 18 potential risk factors were eventually evaluated. Significant risk factors for LM included improper milking method (OR 6.79, 95%CI 3.45–13.34; PAR 59.14%), repeated milk stasis (OR 6.23, 95%CI 4.17–9.30; PAR 49.75%), the first six months postpartum (OR 5.11, 95%CI 2.66–9.82; PAR 65.93%), postpartum rest time less than 3 months (OR 4.71, 95%CI 3.92–5.65; PAR 56.95%), abnormal nipple or crater nipple (OR 3.94, 95%CI 2.34–6.63; PAR 42.05%), breast trauma (OR 3.07, 95%CI 2.17–4.33; PAR 15.98%), improper breastfeeding posture (OR 2.47, 95%CI 2.09–2.92; PAR 26.52%), postpartum prone sleeping position (OR 2.46, 95%CI 1.58–3.84; PAR 17.42%), little or no nipple cleaning (OR 2.05, 95%CI 1.58–2.65; PAR 24.73%), primipara (OR 1.73, 95%CI 1.25–2.41; PAR 32.62%), low education level (OR 1.63, 95%CI 1.09–2.43; PAR 23.29%), cesarean section (OR 1.51, 95%CI 1.26–1.81; PAR 18.61%), breast massage experience of non-medical staff (OR 1.51, 95%CI 1.25–1.82; PAR 15.31%) and postpartum mood disorders (OR 1.47, 95%CI 1.06–2.02; PAR 21.27%). Conclusions This review specified several important risk factors for LM in China. In particular, the incidence of LM can be reduced by controlling some of the modifiable risk factors such as improper breastfeeding posture, improper milking method, repeated milk stasis, nipple cleaning, breast massage experience of non-medical staff and postpartum sleeping posture.

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Preoperative and intraoperative risk factors of postoperative pancreatic fistula after pancreaticoduodenectomy – systematic review and meta-analysis

Polish Journal of Surgery ◽

10.5604/01.3001.0014.9659 ◽

2021 ◽

Vol 93 (6) ◽

pp. 1-10

Author(s):

Kajetan Kiełbowski ◽

Estera Bakinowska ◽

Rafał Uciński

Keyword(s):

Risk Factors ◽

Pancreatic Fistula ◽

Meta Analysis ◽

Significant Risk ◽

Postoperative Pancreatic Fistula ◽

Pancreatic Anastomosis ◽

Pancreatic Fat ◽

Number Of Patients ◽

Potential Risk Factors ◽

Mean Differences

Introduction: Postoperative pancreatic fistula (POPF) is a potentially life-threatening complication after pancreaticoduodenectomy (PD). It is observed when the amylase activity in the drain fluid exceeds three times the normal upper value. Grades B and C of POPF are considered as clinically relevant. Fistula might originate due to failure of healing of a pancreatic anastomosis or from raw pancreatic surface. Materials and methods: 18 retrospective and prospective studies published between 2015 and 2020 were included in this meta-analysis. Total number of patients was 5836. To investigate potential risk factors associated with the occurrence of POPF, odds ratios (OR) with 95% confidence intervals (CI) were calculated. To compare discontinuous data, mean differences (MD) were calculated. Results: 13 factors were divided into preoperative and intraoperative groups. Male sex, higher BMI, soft pancreatic texture and small pancreatic duct were considered as significant risk factors while vascular resection lowered the risk of development pancreatic fistula. Discussion: It is considered that the development of POPF is associated with intrapancreatic fat. More severe infiltration with fat tissue is responsible for soft texture of the gland, while higher BMI is one of the risk factors of increased pancreatic fat. On the contrary, diabetes is associated with fibrotic pancreas which could lower the risk of developing POPF.

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Risk factors of postoperative delirium in the knee and hip replacement patients: a systematic review and meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02127-1 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Xiao Rong ◽

Zi-chuan Ding ◽

Hao-da Yu ◽

Shun-Yu Yao ◽

Zong-Ke Zhou

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Hip Replacement ◽

Postoperative Delirium ◽

Meta Analysis ◽

Significant Risk ◽

Replacement Surgery ◽

Obstructive Sleep ◽

Potential Risk Factors ◽

Newcastle Ottawa Scale

Abstract Background The risk factors of postoperative delirium (POD), a serious while preventable complication, developed by patients undergoing knee and replacement surgery are still under investigation. In this systematic review and meta-analysis, we identified risk factors associated with POD in knee and hip replacement. Methods PubMed, Ovid MEDLINE, and Ovid EMBASE were used to identify original researches. The studies evaluating the risk factors of POD after knee and hip replacement were reviewed, and the qualities of the included studies were assessed with Newcastle–Ottawa Scale. Data were extracted, pooled, and a meta-analysis was completed Result Twenty-two studies were finally included with a total of 11934 patients who underwent knee or hip replacement and 1841 developed POD with an incidence of 17.6% (95% confidential interval (CI) 13.2–22.0%). Eighteen significant risk factors were identified including advanced age (odds ratio (OR) 1.15 95% CI 1.08–1.22), cognitive impairment (OR 6.84, 95% CI 3.27–14.33), history of cerebrovascular events (OR 2.51, 95% CI 1.28–4.91), knee replacement (OR 1.42, 95% CI 1.00–2.02), blood loss (standardized mean difference (SMD) 0.30, 95% CI 0.15–0.44), dementia (OR 3.09, 95% CI 2.10–4.56), neurologic disorders (OR 2.26, 95% CI 1.23–4.15), psychiatric illness (OR 2.74, 95% CI 1.34–5.62), and obstructive sleep apnea (OR 4.17, 95% CI 1.72–10.09) along with several comorbidity evaluation scores and laboratory markers. Conclusion We identified risk factors consistently associated with the incidence of POD in knee and hip replacement. Strategies and interventions should be implemented to the patients receiving knee or hip replacement with potential risk factors identified in this meta-analysis.

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Prevalence and risk factors for repeat induced abortion among Chinese women: a systematic review and meta-analysis

The European Journal of Contraception & Reproductive Health Care ◽

10.1080/13625187.2021.1944618 ◽

2021 ◽

pp. 1-10

Author(s):

Jinlin Liu ◽

Zhuqing Duan ◽

Hairui Zhang ◽

Chunmei Wen ◽

Longmei Tang ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Chinese Women ◽

Meta Analysis ◽

Induced Abortion

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Factors affecting the incidence of postoperative periprosthetic fractures following primary and revision hip arthroplasty: a systematic review and meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02152-0 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Christos Bissias ◽

Angelos Kaspiris ◽

Athanasios Kalogeropoulos ◽

Konstantinos Papoutsis ◽

Nikolaos Natsioulas ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Revision Arthroplasty ◽

Female Gender ◽

Periprosthetic Fractures ◽

Factors Affecting ◽

Potential Risk Factors ◽

Grade 3

Abstract Objectives The increasing number of hip arthroplasties (HA), due to the growing elderly population, is associated with the risk of femoral periprosthetic fractures (FPFs). The purpose of this study was to identify potential risk factors for the development of FPFs after HA. Methods A systematic review was conducted in five data bases (Medline, Embase, Cochrane, Cinahl, ICTRP) according to the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines up to May 2019, using the key words “risk factor,” “periprosthetic fracture,” and “hip replacement or arthroplasty.” Meta-analysis of the clinical outcomes of HA and subgroup analysis based on the factors that were implicated in FPFs was performed. Results Sixteen studies were included (sample size: 599,551 HA patients, 4253 FPFs, incidence 0.71%). Risk factors statistically associated with increased incidence of FPFs were female gender (+ 40%), previous revision arthroplasty surgery (× 3 times), and the presence of rheumatoid arthritis (× 2.1 times), while osteoarthritis (− 57%), cement application (− 59%), and insertion of Biomet (− 68%) or Thompson’s prosthesis (− 75%) were correlated with low prevalence of FPFs. Obesity, cardiac diseases, advanced age, bad general health (ASA grade ≥ 3), and use of Exeter or Lubinus prosthesis were not linked to the appearance of FPFs. Conclusion This meta-analysis suggested that female gender, rheumatoid arthritis, and revision arthroplasty are major risk factors for the development of FPFs after a HA. In those patients, frequent follow-ups should be planned. Further prospective studies are necessary to clarify all the risk factors contributing to the appearance of FPFs after HA.

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Post-Bariatric Abdominoplasty: Analysis of 406 Cases With Focus on Risk Factors and Complications

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa067 ◽

2020 ◽

Vol 41 (1) ◽

pp. 59-71 ◽

Cited By ~ 3

Author(s):

Torsten Schlosshauer ◽

Marcus Kiehlmann ◽

Diana Jung ◽

Robert Sader ◽

Ulrich M Rieger

Keyword(s):

Risk Factors ◽

Wound Healing ◽

Surgical Technique ◽

Significant Risk ◽

Level Of Evidence ◽

Increased Risk ◽

Potential Risk Factors ◽

Wound Healing Problems ◽

Bariatric Patients

Abstract Background Post-bariatric patients present a surgical challenge within abdominoplasty because of residual obesity and major comorbidities. In this study, we analyzed complications following abdominoplasty in post-bariatric patients and evaluated potential risk factors associated with these complications. Objectives The authors sought to determine the complications and risk factors following abdominoplasty in post-bariatric patients. Methods A retrospective study of patients who underwent abdominoplasty was performed from January 2009 to December 2018 at our institution. Variables analyzed were sex, age, body mass index (BMI), smoking, surgical technique, operative time, resection weight, drain output, and complications. Results A total of 406 patients were included in this study (320 female and 86 male) with a mean age of 44.4 years and a BMI of 30.6 kg/m2. Abdominoplasty techniques consisted of traditional (64.3%), fleur-de-lis technique (27.3%), and panniculectomy without umbilical displacement (8.4%). Overall complications recorded were 41.9%, the majority of these being wound-healing problems (32%). Minor and major complications were found in 29.1% and 12.8% of patients, respectively. A BMI value of ≥30 kg/m2 was associated with an increased risk for wound-healing problems (P = 0.001). The frequency of total complications was significantly related to age (P = 0.007), BMI (P = 0.004), and resection weight (P = 0.001). Abdominoplasty technique tended to influence total complications. Conclusions This study demonstrates in a fairly large sample of post-bariatric patients (n = 406) that abdominoplasty alone can be performed safely, with an acceptable complication rate. Age, BMI, and resection weight are shown to be significant risk factors for total complications. The role of surgical technique needs to be evaluated further. Level of Evidence: 4

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Population attributable risk of aflatoxin-related liver cancer: Systematic review and meta-analysis

European Journal of Cancer ◽

10.1016/j.ejca.2012.02.009 ◽

2012 ◽

Vol 48 (14) ◽

pp. 2125-2136 ◽

Cited By ~ 146

Author(s):

Yan Liu ◽

Chung-Chou H. Chang ◽

Gary M. Marsh ◽

Felicia Wu

Keyword(s):

Systematic Review ◽

Liver Cancer ◽

Meta Analysis ◽

Population Attributable Risk ◽

Attributable Risk

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Prevalence of Human Cystic Echinococcosis in Rio Negro Province, Argentina and Direct Risk Factors for Infection

10.21203/rs.3.rs-260421/v1 ◽

2021 ◽

Author(s):

Leonardo Uchiumi ◽

Guillermo Mujica ◽

Daniel Araya ◽

Juan Carlos Salvitti ◽

Mariano Sobrino ◽

...

Keyword(s):

Risk Factors ◽

Potential Risk ◽

Rural Areas ◽

Cystic Echinococcosis ◽

Significant Risk ◽

Prevalence Ratio ◽

Bivariate Analysis ◽

Rio Negro ◽

Potential Risk Factors ◽

Current Address

Abstract Background: Cystic echinococcosis (CE) is a parasitic zoonosis caused by infection with the larval stage of Echinococcus granulosus sensu lato This study investigated the prevalence and potential risk factors associated with human CE in the towns and rural areas of Ñorquinco and Ramos Mexia, Rio Negro province, Argentina. Methods: In order to detect abdominal CE cysts, we screened 892 volunteers by ultrasound and investigated potential risk factors for CE using a standardized questionnaire. Bivariate and multivariate analyses were used to estimate the Prevalence Ratio (PR) and their 95% CIs of the association between CE and the factors investigated. Results: Abdominal CE was detected in 42/892 screened volunteers (4.7%, CI 3.2-6.1), only two of who being under 15 years of age. Thirteen CE (30.9%) cases had 25 cysts in active stages (CE1, CE2, CE3) The most relevant risk factors identified in the bivariate analysis included: live in rural area (p=0.003), age >40 years (p=0.000), drinking always water of natural source (p=0.007), residing in rural areas during first five years of life (p=0.000) and live more than 20 years at your current address (p=0.013). In the multivariate model, statistically significant risk factors were: frequently touch dogs (p=0.012), residing in rural areas during first five years of life (p=0.004), smoking (p=0.000), age > 60 years (p=0.002) and live in rural areas (p=0.017).Conclusions: our results point toward infection with CE being acquired since childhood and with constant exposure throughout life, especially in rural areas with a general environmental contamination

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Prevalence and risk factors of root resorption of adjacent teeth in maxillary canine impaction, among untreated children and adolescents

European Journal of Orthodontics ◽

10.1093/ejo/cjy078 ◽

2018 ◽

Vol 41 (5) ◽

pp. 447-453 ◽

Cited By ~ 4

Author(s):

Frédéric Rafflenbeul ◽

Catherine-Isabelle Gros ◽

François Lefebvre ◽

Sophie Bahi-Gross ◽

Raphaëlle Maizeray ◽

...

Keyword(s):

Risk Factors ◽

Children And Adolescents ◽

Root Resorption ◽

Significant Risk ◽

Significant Risk Factor ◽

Data Sets ◽

Maxillary Canine ◽

3D Data ◽

Potential Risk Factors ◽

Associated Risk Factors

Summary Objectives The aim of this retrospective study was to assess in maxillary canine impaction cases both the prevalence of root resorption of adjacent teeth among untreated children and adolescents, and its associated risk factors. Subjects and methods Sixty subjects (mean age 12.2 years; SD 1.9; range 8–17 years) with 83 displaced maxillary canines and without any past or ongoing orthodontic treatment were included in this study. The presence of root resorption was evaluated on images from a single cone beam computed tomography (CBCT) unit. Potential risk factors were measured on the CBCT images and on panoramic reconstructions of the 3D data sets. The sample was characterized by descriptive statistics and multiple logistic regressions were performed to predict root resorption. Results Root resorption of at least one adjacent tooth was detected in 67.5 per cent of the affected quadrants. It was found that 55.7 per cent of the lateral incisors, 8.4 per cent of the central incisors, and 19.5 per cent of first premolars were resorbed. Of the detected resorptions, 71.7 per cent were considered slight, 14.9 per cent moderate, and 13.4 per cent severe. Contact between the displaced canine(s) and the adjacent teeth roots was the only identified statistically significant risk factor, all teeth being considered (odds ratio [OR] = 18.7, 95% confidence interval: 2.26–756, P < 0.01). An enlarged canine dental follicle, a peg upper lateral, or an upper lateral agenesis were not significantly associated with root resorption of adjacent teeth, nor were age nor gender. Conclusions Root resorption of adjacent teeth was detected in more than two-thirds of a sample of sixty untreated children and adolescents.

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