scholarly journals The Potential of Metabolomic Analyses as Predictive Biomarkers of Preterm Delivery: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Emma Ronde ◽  
Irwin K. M. Reiss ◽  
Thomas Hankemeier ◽  
Tim G. De Meij ◽  
Nina Frerichs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Preterm Delivery ◽  
Predictive Biomarkers ◽  
Premature Delivery ◽  
Vaginal Fluid ◽  
Mortality And Morbidity ◽  
Non Invasive ◽  
Term Delivery ◽  
Cost Efficient ◽  
The Impact

Scopeas the leading cause of perinatal mortality and morbidity worldwide, the impact of premature delivery is undisputable. Thus far, non-invasive, cost-efficient and accurate biochemical markers to predict preterm delivery are scarce. The aim of this systematic review is to investigate the potential of non-invasive metabolomic biomarkers for the prediction of preterm delivery.Methods and ResultsDatabases were systematically searched from March 2019 up to May 2020 resulting in 4062 articles, of which 45 were retrieved for full-text assessment. The resulting metabolites used for further analyses, such as ferritin, prostaglandin and different vitamins were obtained from different human anatomical compartments or sources (vaginal fluid, serum, urine and umbilical cord) and compared between groups of women with preterm and term delivery. None of the reported metabolites showed uniform results, however, a combination of metabolomics biomarkers may have potential to predict preterm delivery and need to be evaluated in future studies.

scholarly journals Impact of the 2017 ACC/AHA Guideline for High Blood Pressure on Evaluating Gestational Hypertension–Associated Risks for Newborns and Mothers

2019 ◽  
Vol 125 (2) ◽  
pp. 184-194 ◽  
Author(s):  
Jie Hu ◽  
Yuanyuan Li ◽  
Bin Zhang ◽  
Tongzhang Zheng ◽  
Jun Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Preterm Delivery ◽  
High Blood Pressure ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Gestational Hypertension ◽  
Blood Pressure Elevation ◽  
Early Term ◽  
Term Delivery ◽  
The Impact

Rationale: In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new hypertension guideline for nonpregnant adults, using lower blood pressure values to identify hypertension. However, the impact of this new guideline on the diagnosis of gestational hypertension and the associated maternal and neonatal risks are unknown. Objective: To estimate the impact of adopting the 2017 ACC/AHA guideline on detecting gestational blood pressure elevations and the relationship with maternal and neonatal risk in the perinatal period using a retrospective cohort design. Methods and Results: This study included 16 345 women from China. Systolic and diastolic blood pressures of each woman were measured at up to 22 prenatal care visits across different stages of pregnancy. Logistic and linear regressions were used to estimate associations of blood pressure categories with the risk of preterm delivery, early-term delivery, and small for gestational age, and indicators of maternal liver, renal, and coagulation functions during pregnancy. We identified 4100 (25.1%) women with gestational hypertension using the 2017 ACC/AHA guideline, compared with 4.2% using the former definition. Gestational hypertension, but not elevated blood pressure (subclinical blood pressure elevation), was significantly associated with altered indicators of liver, renal, and coagulation functions during pregnancy for mothers and increased risk of adverse birth outcomes for newborns; adjusted odds ratios (95% CIs) for gestational hypertension stage 2 were 2.23 (1.18–4.24) for preterm delivery, 2.05 (1.67–2.53) for early-term delivery, and 1.43 (1.13–1.81) for small for gestational age. Conclusions: Adopting the 2017 ACC/AHA guideline would result in a substantial increase in the prevalence of gestational hypertension; subclinical blood pressure elevations during late pregnancy were not associated with increased maternal and neonatal risk in this cohort. Therefore, the 2017 ACC/AHA guideline may improve the detection of high blood pressure during pregnancy and the efforts to reduce maternal and neonatal risk. Replications in other populations are required.

scholarly journals Chronic Hypertension, Perinatal Mortality, and the Impact of Preterm Delivery: A Population-Based Study in the United States, 2015-2018

2021 ◽  
Author(s):  
Sonal Grover ◽  
Justin Brandt ◽  
Uma Reddy ◽  
Cande Ananth (STATS CONSULTS ONLY)
Keyword(s):  
Perinatal Mortality ◽  
Preterm Delivery ◽  
Mediation Analysis ◽  
Mortality Rates ◽  
Chronic Hypertension ◽  
Unmeasured Confounding ◽  
Early Term ◽  
Term Delivery ◽  
Causal Mediation Analysis ◽  
The Impact

Objective: To estimate the association between chronic hypertension and perinatal mortality and evaluate the extent to which this risk is impacted by preterm delivery. Design: Cross-sectional analysis. Setting: US, 2015-2018. Population: Singleton births from 20-44 weeks’ gestation. Main outcomes and measures: We derived the risk of perinatal mortality in relation to chronic hypertension from fitting log-linear Poisson models with robust variance. Risk ratios (RR) and 95% confidence intervals (CI) were estimated after adjusting for confounders. The impact of misclassifications and unmeasured confounding biases were assessed. Causal mediation analysis was performed to quantify the impact of preterm delivery on the association. Results: Of the 15,090,678 singleton births, perinatal mortality was 22.5 per 1000 births in chronic hypertensive pregnancies compared to 8.2 per 1000 births in normotensive pregnancies (adjusted RR 2.05, 95% CI 2.00, 2.10). Corrections for exposure misclassification and unmeasured confounding biases substantially increased the risk estimate. Although, causal mediation analysis revealed that most of the effect of chronic hypertension on perinatal mortality was mediated through preterm delivery, the perinatal mortality rates were highest at early term, term, and late term gestations, suggesting that a planned early term delivery at 37-386/7 weeks may optimally balance risk in these pregnancies. Additionally, 87% (95% CI 84, 90) of perinatal deaths could be eliminated if preterm deliveries, as a result of chronic hypertension were prevented. Conclusions: Chronic hypertensive pregnancies are associated with increased risk for perinatal mortality. Planned early term delivery and targeting modifiable risk factors for chronic hypertension may reduce perinatal mortality rates.

scholarly journals Exosomal microRNAs as potential circulating biomarkers in gastrointestinal tract cancers: A systematic review protocol (Preprint)

2017 ◽  
Author(s):  
Elmira Gheytanchi ◽  
Zahra Madjd ◽  
Leila Janani ◽  
Arezoo Rasti ◽  
Roya Ghods ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pathological Condition ◽  
Statistical Tests ◽  
Predictive Biomarkers ◽  
Diagnostic Tools ◽  
Limited Information ◽  
Prevalence Studies ◽  
Non Invasive ◽  
Gi Cancers ◽  
Exosomal Mirna

BACKGROUND microRNAs (miRNAs, miRs) are being suggested as potential diagnostic and predictive biomarkers for gastrointestinal (GI) cancers. The encapsulation of miRNAs in nano-sized exosomes makes them more resistant to degradation. Therefore, they may be useful diagnostic biomarkers for the detection of cancer in body fluids, especially in the serum of cancer patients. OBJECTIVE The aim of this study is to systematically review primary studies and identify the miRNA profiles of serum exosomes of GI cancers. METHODS This systematic review will be reported in line with the Preferred Reporting Items for Systematic Reviews (PRISMA-P) guidance. Relevant studies will be identified through a comprehensive search of the following main electronic databases: PubMed, Web of Science, Embase, Scopus and Google Scholar (up to July 2017). Full copies of articles will be identified by a defined search strategy. The quality assessment of the included studies will be performed by the guidelines for evaluating prevalence studies. Evaluation of the heterogeneity among the primary studies will be performed by χ2 and I2 statistical tests. RESULTS The analysis of circulating exosomal miRNA profiles provides attractive screening and non-invasive diagnostic tools for the majority of solid tumours including GI cancers. There is limited information regarding the relationship between serum exosomal miRNA profiles and the pathological condition of patients with different GI cancers. Since there is no specific biomarker for GI cancers, we aim to suggest a number of circulating exosomal miRNA candidates as potential multifaceted GI cancer biomarkers for clinical utility. CONCLUSIONS The findings of this review may be used in clinical settings and in designing and developing of the novel non-invasive biomarkers for early diagnosis and pathological condition of patients with GI cancers. CLINICALTRIAL CRD 42017057129

scholarly journals Comparison of serum ferritin levels in pregnant women with preterm and term deliveries

2020 ◽  
Vol 6 (2) ◽  
pp. e25-e25
Author(s):  
Tayebeh Jahedbozorgan ◽  
Minoo Yaghmaei ◽  
Maryam Naserieh
Keyword(s):  
At Risk ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Serum Ferritin ◽  
Ferritin Level ◽  
Normal Pregnancy ◽  
Acute Phase Reactant ◽  
Biochemical Tests ◽  
Mortality And Morbidity ◽  
Term Delivery

Introduction: Despite high rates of mortality and morbidity due to preterm delivery, none of the diagnostic and biochemical tests could help to accurately identify the cases at risk of preterm delivery. Objectives: Since ferritin is an acute phase reactant, this study aimed to evaluate serum ferritin levels in women with preterm and term delivery. Methods: This study was conducted on 150 women with preterm delivery (50 cases in each of the groups 24-30, 30-34, and 34-37 weeks of pregnancy), 150 women with term delivery, and 150 pregnant women who were between 24-37 weeks of pregnancy (same as preterm delivery groups). Results: The mean ferritin level in all preterm groups was significantly higher than that in the term group, but there was no difference among the preterm groups. In addition, ferritin level in each preterm group was significantly higher than those in the normal pregnancy group at the same gestational age. In preterm deliveries, ferritin levels were significantly higher in cases with prelabor rupture of membranes (PROM) or with a prolonged leakage (longer than 12 hours). In addition, in patients with PROM or prolonged leakage, ferritin levels were significantly higher in preterm deliveries than in term deliveries. A ferritin level of 37.5 ng/mL recognized as the best cut-off for preterm delivery, as compared with term delivery, and its sensitivity, specificity, and diagnostic accuracy was 78.7%, 68.7%, and 73.6%, respectively. Conclusion: The findings of the present study showed that serum ferritin level can be used to find patients at risk of preterm delivery.

scholarly journals Healthy Habits and Emotional Balance in Women during the Postpartum Period: Differences between Term and Preterm Delivery

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 937
Author(s):  
Andrea Gila-Díaz ◽  
Gloria Herranz Carrillo ◽  
Silvia M. Arribas ◽  
David Ramiro-Cortijo
Keyword(s):  
Postpartum Depression ◽  
Preterm Delivery ◽  
Postpartum Period ◽  
Depression Scale ◽  
Healthy Food ◽  
P Value ◽  
Healthy Habits ◽  
Food Pyramid ◽  
Term Delivery ◽  
The Impact

Breastfeeding could be considered as a vulnerable period, rising the risk to shift from optimism to pessimism. Preterm delivery is an event that increases postpartum maternal stress and depression, which can have a negative impact on breastfeeding and maternal–filial wellbeing. The adherence to healthy habits may have a positive influence on this vulnerable population. We aimed to analyze the impact of prematurity on maternal psychological aspects during postpartum and to study if adherence to the Healthy Food Pyramid influences psychological variables. Fifty-five breastfeeding women being attended in the Hospital Clínico San Carlos (Madrid, Spain) were recruited during the first day postpartum. The medical data were collected from the obstetrical records. The women answered an auto-administered questionnaire with several sections: sociodemographic characteristics, Perceived Stress Scale (PSS), and Life Orientation Test (LOT), at 14 days and 6 months postpartum, Adherence to the Healthy Food Pyramid Questionnaire (AP-Q) at 28 days postpartum and the Edinburgh Postpartum Depression Scale (EPDS) at 6 months postpartum. The PSS and LOT scores were not statistically different in mothers with preterm compared to term delivery either at 14 days or at 6 months postpartum. Longitudinally, the PSS did not show significant differences, but the LOT score was lower at 6 months compared to 14 days postpartum (p-Value = 0.046). A higher EPDS score was significantly found in mothers with preterm delivery (9.0 ± 4.7) than those with a term delivery (5.4 ± 4.2; p-value = 0.040). A significant and positive correlation was observed between the AP-Q score and LOT both at 14 days and 6 months postpartum. Conclusively, maternal optimism decreases during the postpartum period, women with preterm delivery being at risk of postpartum depression. Furthermore, there is a relationship between optimism and adherence to healthy habits. Healthcare professional counseling is essential during the entire breastfeeding period, particularly in vulnerable mothers with preterm delivery.

scholarly journals The Use of Near-Infrared Spectroscopy and/or Transcranial Doppler as Non-Invasive Markers of Cerebral Perfusion in Adult Sepsis Patients With Delirium: A Systematic Review

2021 ◽  
pp. 088506662199709
Author(s):  
Michael D. Wood ◽  
J. Gordon Boyd ◽  
Nicole Wood ◽  
James Frank ◽  
Timothy D. Girard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Transcranial Doppler ◽  
Cerebral Perfusion ◽  
Near Infrared ◽  
Cochrane Library ◽  
Delirium Assessment ◽  
Non Invasive ◽  
The Impact

Background: Several studies have previously reported the presence of altered cerebral perfusion during sepsis. However, the role of non-invasive neuromonitoring, and the impact of altered cerebral perfusion, in sepsis patients with delirium remains unclear. Methods: We performed a systematic review of studies that used near-infrared spectroscopy (NIRS) and/or transcranial Doppler (TCD) to assess adults (≥18 years) with sepsis and delirium. From study inception to July 28, 2020, we searched the following databases: Ovid MedLine, Embase, Cochrane Library, and Web of Science. Results: Of 1546 articles identified, 10 met our inclusion criteria. Although NIRS-derived regional cerebral oxygenation was consistently lower, this difference was only statistically significant in one study. TCD-derived cerebral blood flow velocity was inconsistent across studies. Importantly, both impaired cerebral autoregulation during sepsis and increased cerebrovascular resistance were associated with delirium during sepsis. However, the heterogeneity in NIRS and TCD devices, duration of recording (from 10 seconds to 72 hours), and delirium assessment methods (e.g., electronic medical records, confusion assessment method for the intensive care unit), precluded meta-analysis. Conclusion: The available literature demonstrates that cerebral perfusion disturbances may be associated with delirium in sepsis. However, future investigations will require consistent definitions of delirium, delirium assessment training, harmonized NIRS and TCD assessments (e.g., consistent measurement site and length of recording), as well as the quantification of secondary and tertiary variables (i.e., Cox, Mxa, MAPOPT), in order to fully assess the relationship between cerebral perfusion and delirium in patients with sepsis.

Pneumonia Is Associated with Increased Mortality in Hospitalized COPD Patients: A Systematic Review and Meta-Analysis

Respiration ◽  
2021 ◽  
Vol 100 (1) ◽  
pp. 64-76
Author(s):  
Yan Yu ◽  
Wei Liu ◽  
Hong-Li Jiang ◽  
Bing Mao
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Hospital Stay ◽  
Readmission Rate ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Mortality And Morbidity ◽  
Icu Stay ◽  
Copd Patients ◽  
The Impact

<b><i>Background:</i></b> Patients with chronic obstructive pulmonary disease (COPD) are at a heightened risk of pneumonia. Whether coexisting community-acquired pneumonia (CAP) can predict increased mortality in hospitalized COPD patients is still controversial. <b><i>Objective:</i></b> This systematic review and meta-analysis aims to assess the association between CAP and mortality and morbidity in COPD patients hospitalized for acute worsening of respiratory symptoms. <b><i>Methods:</i></b> In this review, cohort studies and case-control studies investigating the impact of CAP in hospitalized COPD patients were retrieved from 4 electronic databases from inception until December 2019. Methodological quality of included studies was assessed using Newcastle-Ottawa Quality Assessment Scale. The primary outcome was mortality. The secondary outcomes included length of hospital stay, need for mechanical ventilation, intensive care unit (ICU) admission, length of ICU stay, and readmission rate. The Mantel-Haenszel method and inverse variance method were used to calculate pooled relative risk (RR) and mean difference (MD), respectively. <b><i>Results:</i></b> A total of 18 studies were included. The presence of CAP was associated with higher mortality (RR = 1.85; 95% CI: 1.50–2.30; <i>p</i> &#x3c; 0.00001), longer length of hospital stay (MD = 1.89; 95% CI: 1.19–2.59; <i>p</i> &#x3c; 0.00001), more need for mechanical ventilation (RR = 1.48; 95% CI: 1.32–1.67; <i>p</i> &#x3c; 0.00001), and more ICU admissions (RR = 1.58; 95% CI: 1.24–2.03; <i>p</i> = 0.0002) in hospitalized COPD patients. CAP was not associated with longer ICU stay (MD = 5.2; 95% CI: −2.35 to 12.74; <i>p</i> = 0.18) or higher readmission rate (RR = 1.02; 95% CI: 0.96–1.09; <i>p</i> = 0.47). <b><i>Conclusion:</i></b> Coexisting CAP may be associated with increased mortality and morbidity in hospitalized COPD patients, so radiological confirmation of CAP should be required and more attention should be paid to these patients.

PP8 Trauma and the obesity epidemic: a systematic review of the impact of obesity on trauma mortality and morbidity

2019 ◽  
Vol 36 (10) ◽  
pp. e5.1-e5
Author(s):  
Simon Mayer ◽  
Sumitra Lahiri ◽  
Joseph Rowles
Keyword(s):  
Systematic Review ◽  
Length Of Stay ◽  
Injury Severity ◽  
Traumatic Injury ◽  
Strong Relationship ◽  
Normal Weight ◽  
The Body ◽  
Trauma Patients ◽  
Mortality And Morbidity ◽  
The Impact

BackgroundTrauma and obesity are both current global epidemics. A simple way to measure the body habitus of patients, to identify the overweight or obese is via the internationally recognized calculation of body mass index (BMI). The primary aim of this systematic review is to assess the mortality rate of those patients with a BMI > 30 kg/m2 in relation to traumatic injury and secondly to assess the effect of those patients with BMI > 30 kg/m2 upon the length of stay in hospital with regards to traumatic injury.MethodA systematic review of the literature was conducted via an internet search of databases and hand searching of references in identified publications from 1st January 1990 to 17th February 2018. Data was extracted from identified publications to include odds ratios of mortality and total length of stay in hospital (days) for patients with a BMI >30 kg/m2 from included studies when compared to patients with a BMI <24.9 kg/m2.ResultsA total of 23 studies met the inclusion criteria. 32, 378 patients were admitted to hospital with a BMI >30 kg/m2 and recorded injury severity score (ISS). Data collated identified BMI >30 kg/m2 OR 1.66 (95% CI 0.75 – 4.2) vs BMI <24.9 kg/m2 OR 0.93 (95% CI 0.82–1.5) to suffer mortality. ISS, BMI >30 kg/m2–19.93 vs 22.3 respectively. Furthermore, those categorised as BMI >30 kg/m2 have 3.78 additional days in the hospital compared to those defined as normal weight.ConclusionThis systematic review presents a strong relationship of increased mortality and complications in trauma patients with BMI >30 kg/m2. Complications are suggestive of those who have a BMI >30 kg/m2 are more likely to suffer detrimental effects following trauma predominantly due to pre-existing unknown co-morbidities. Although, the direct relationship between obesity, trauma and mortality is not fully understood at present and requires more research.

scholarly journals A Systematic Review of the Cardiovascular Manifestations and Outcomes in the Setting of Coronavirus-19 Disease

2020 ◽  
Author(s):  
Samarthkumar Thakkar ◽  
Shilpkumar Arora ◽  
Ashish Kumar ◽  
Rahul Jaswaney ◽  
Mohammed Faisaluddin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Inclusion Criteria ◽  
Mortality And Morbidity ◽  
Future Studies ◽  
Treatment And Prevention ◽  
Wide Range ◽  
Myocardial Infection ◽  
The Impact

The impact of coronavirus disease, 2019 (COVID-19), has been profound. Though COVID-19 primarily affects the respiratory system, it has also been associated with a wide range of cardiovascular (CV) manifestations portending extremely poor prognosis. The principal hypothesis for CV involvement is through direct myocardial infection and systemic inflammation. We conducted a systematic review of the current literature to provide a foundation for understanding the CV manifestations and outcomes of COVID-19. PubMed and EMBASE databases were electronically searched from the inception of the databases through April 27th, 2020. A second literature review was conducted to include major trials and guidelines that were published after the initial search but before submission. The inclusion criteria for studies to be eligible were case reports, case series, and observation studies reporting CV outcomes among patients with COVID-19 infection. This review of the current COVID-19 disease and CV outcomes literature revealed a myriad of CV manifestations with potential avenues for treatment and prevention. Future studies are required to understand on a more mechanistic level the effect of COVID-19 on the myocardium and thus provide avenues to improve mortality and morbidity.

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