Safety of Administering Live Vaccines during Pregnancy: A Systematic Review and Meta-Analysis of Pregnancy Outcomes

Live-attenuated vaccines (LAV) are currently contraindicated during pregnancy, given uncertain safety records for the mother–infant pair. LAV might, however, play an important role to protect them against serious emerging diseases, such as Ebola and Lassa fever. For this systematic review we searched relevant databases to identify studies published up to November 2019. Controlled observational studies reporting pregnancy outcomes after maternal immunization with LAV were included. The ROBINS-I tool was used to assess risk of bias. Pooled odds ratios (OR) were obtained under a random-effects model. Of 2831 studies identified, fifteen fulfilled inclusion criteria. Smallpox, rubella, poliovirus, yellow fever and dengue vaccines were assessed in these studies. No association was found between vaccination and miscarriage (OR 0.98, 95% CI 0.87–1.10), stillbirth (OR 1.04, 95% CI 0.74–1.48), malformations (OR 1.09, 95% CI 0.98–1.21), prematurity (OR 0.99, 95% CI 0.90–1.08) or neonatal death (OR 1.06, 95% CI 0.68–1.65) overall. However, increased odds of malformations (OR 1.24; 95% CI 1.03–1.49) and miscarriage after first trimester immunization (OR 4.82; 95% CI 2.38–9.77) was found for smallpox vaccine. Thus, we did not find evidence of harm related to LAV other than smallpox with regards to pregnancy outcomes, but quality of evidence was very low. Overall risks appear to be small and have to be balanced against potential benefits for the mother-infant pair.

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Association of serum PAPP-A levels in first trimester with small for gestational age and adverse pregnancy outcomes: systematic review and meta-analysis

Prenatal Diagnosis ◽

10.1002/pd.5001 ◽

2017 ◽

Vol 37 (3) ◽

pp. 253-265 ◽

Cited By ~ 29

Author(s):

R. Katie Morris ◽

Ashwini Bilagi ◽

Pooja Devani ◽

Mark D. Kilby

Keyword(s):

Systematic Review ◽

Gestational Age ◽

Small For Gestational Age ◽

Pregnancy Outcomes ◽

Meta Analysis ◽

First Trimester ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy

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Pregnancy outcomes following first-trimester exposure to topical retinoids: a systematic review and meta-analysis

British Journal of Dermatology ◽

10.1111/bjd.14053 ◽

2015 ◽

Vol 173 (5) ◽

pp. 1132-1141 ◽

Cited By ~ 12

Author(s):

Y.C. Kaplan ◽

J. Ozsarfati ◽

F. Etwel ◽

C. Nickel ◽

I. Nulman ◽

...

Keyword(s):

Systematic Review ◽

Pregnancy Outcomes ◽

Meta Analysis ◽

First Trimester ◽

Topical Retinoids ◽

Trimester Exposure

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Nordic Walking for Overweight and Obese People: A Systematic Review and Meta-Analysis

Journal of Physical Activity and Health ◽

10.1123/jpah.2019-0357 ◽

2020 ◽

Vol 17 (7) ◽

pp. 762-772

Author(s):

Miguel A. Sanchez-Lastra ◽

Kyle J. Miller ◽

Rodolfo I. Martínez-Lemos ◽

Antón Giráldez ◽

Carlos Ayán

Keyword(s):

Systematic Review ◽

Methodological Quality ◽

Meta Analysis ◽

Scientific Evidence ◽

Nordic Walking ◽

Obese People ◽

Confounding Variables ◽

Potential Benefits ◽

Evidence Database

Background: Nordic walking (NW) is a potentially beneficial exercise strategy for overweight and obese people. To date, no reviews have synthesized the existing scientific evidence regarding the effects of NW on this population. This systematic review and meta-analysis aimed to identify the characteristics, methodological quality, and results of the investigations that have studied the effects of NW in overweight and obese individuals. Methods: Six electronic databases were searched up to June 2019 for studies that examined the effects of NW on people with a body mass index ≥ 25 kg/m2. The methodological quality of the included randomized controlled trials was retrieved from the physiotherapy evidence database or evaluated using the physiotherapy evidence database scale. Results: Twelve studies were included in the review. The investigations were mostly good-to-fair methodological quality. NW groups had a significant improvement on parameters such as fasting plasma glucose, abdominal adiposity, and body fat compared with the baseline, but no significant improvements were found when compared with control groups. Conclusions: NW can potentially lead to improvements in parameters related to major health outcomes in overweight and obese people. The lack of control for confounding variables in the analyzed studies prevents further elaboration on its potential benefits.

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The Efficacy of Traditional Chinese Medicine Shoutai Pill Combined with Western Medicine in the First Trimester of Pregnancy in Women with Unexplained Recurrent Spontaneous Abortion: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2020/7495161 ◽

2020 ◽

Vol 2020 ◽

pp. 1-13

Author(s):

Hui-fang Li ◽

Qi-hong Shen ◽

Xiao-qing Li ◽

Zhang-feng Feng ◽

Wei-min Chen ◽

...

Keyword(s):

Systematic Review ◽

Chinese Medicine ◽

Spontaneous Abortion ◽

Western Medicine ◽

Meta Analysis ◽

First Trimester ◽

Recurrent Spontaneous Abortion ◽

Unexplained Recurrent Spontaneous Abortion ◽

First Trimester Of Pregnancy

Background. Shoutai Pill (STP), a famous classic herbal formula documented in traditional Chinese medicine (TCM), is widely available in China for treating unexplained recurrent spontaneous abortion (URSA). This systematic review and meta-analysis aims at evaluating the efficacy and safety of STP in the first trimester of pregnancy in women with a history of unexplained recurrent spontaneous abortion. Methods. The following eight databases were searched from their establishment to Dec 31, 2019, for randomized controlled trials (RCTs): PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), the Chinese BioMedical database (CBM), Chinese Scientific Journal Database (VIP), and the Wanfang database. The quality of evidence was estimated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results. A total of 12 studies (916 patients) with URSA were contained in this meta-analysis. The forest plot showed that patients treated with Shoutai Pill and western medicine had a significantly lower incidence of early pregnancy loss (RR: 0.42; 95% CI: 0.34–0.52; P<0.01, I2=0%). Subgroup analysis revealed that different types of TCM syndrome differentiation had the similar results. Also, in the combined group, patients had a lower TCM syndromes and symptoms and serum D-dimer level, while higher incidence of live birth. Conclusions. Our findings suggest that cotreatment with STP and western medicine might be superior to western medicine alone in the first trimester of pregnancy to prevent miscarriage in women with unexplained recurrent spontaneous abortion, and there was no adverse event in the experimental group reported. However, the methodological quality of included RCTs was unsatisfactory; it is necessary to verify its effectiveness with further more standardized researches of rigorous design.

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Hemoglobin Concentration and Pregnancy Outcomes: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2013/769057 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 21

Author(s):

Bunyarit Sukrat ◽

Chumpon Wilasrusmee ◽

Boonying Siribumrungwong ◽

Mark McEvoy ◽

Chusak Okascharoen ◽

...

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Gestational Age ◽

Pregnancy Outcomes ◽

Meta Analysis ◽

First Trimester ◽

Third Trimester ◽

The Third

Objective. To conduct a systematic review and meta-analysis of hemoglobin effect on the pregnancy outcomes.Methods. We searched MEDLINE and SCOPUS from January 1, 1990 to April 10, 2011. Observational studies addressing association between hemoglobin and adverse pregnancy outcomes were selected. Two reviewers independently extracted data. A mixed logistic regression was applied to assess the effects of hemoglobin on preterm birth, low birth weight, and small for gestational age.Results. Seventeen studies were included in poolings. Hemoglobin below 11 g/dL was, respectively, 1.10 (95% CI: 1.02–1.19), 1.17 (95% CI: 1.03–1.32), and 1.14 (95% CI: 1.05–1.24) times higher risk of preterm birth, low birth weight, and small for gestational age than normal hemoglobin in the first trimester. In the third trimester, hemoglobin below 11 g/dL was 1.30 (95% CI: 1.08–1.58) times higher risk of low birth weight. Hemoglobin above 14 g/dL in third trimester decreased the risk of preterm term with ORs of 0.50 (95% CI: 0.26–0.97), but it might be affected by publication bias.Conclusions. Our review suggests that hemoglobin below 11 g/dl increases the risk of preterm birth, low birth weight, and small gestational age in the first trimester and the risk of low birth weight in the third trimester.

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