scholarly journals Association of antenatal corticosteroids with morbidity and mortality among multiple gestations: a protocol for meta-analysis

2020 ◽  
Author(s):  
Dongxin Lin ◽  
Dazhi Fan ◽  
Gengdong Chen ◽  
Caihong Luo ◽  
Xiaoling Guo ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Morbidity And Mortality ◽  
Antenatal Corticosteroids ◽  
Multiple Gestations

scholarly journals Association of antenatal corticosteroids with morbidity and mortality among preterm multiple gestations: meta-analysis of observational studies

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047651
Author(s):  
Dongxin Lin ◽  
Dazhi Fan ◽  
Gengdong Chen ◽  
Caihong Luo ◽  
Xiaoling Guo ◽  
...  
Keyword(s):  
Observational Studies ◽  
Data Extraction ◽  
Meta Analysis ◽  
Periventricular Leukomalacia ◽  
Intraventricular Haemorrhage ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Antenatal Corticosteroids ◽  
Multiple Gestations ◽  
Subgroup Analyses

ObjectiveThis meta-analysis aimed to assess the efficacy of antenatal corticosteroids (ACS) on morbidity and mortality among preterm multiple pregnancies.MethodsThe PubMed, Embase, Web of Science and Cochrane Library databases were searched for studies investigating the outcomes among preterm multiple gestations following to ACS, from their inception to 1 November 2020. Two authors independently performed the study selection, risk of bias assessment and data extraction. The primary outcomes were respiratory distress syndrome (RDS) and mortality and secondary outcomes included intraventricular haemorrhage (IVH), periventricular leukomalacia (PVL), necrotising enterocolitis, retinopathy of prematurity and bronchopulmonary dysplasia. Pooled ORs were obtained using random effects models. Subgroup analyses were performed to explain heterogeneity by ACS completeness, administration-to-delivery intervals (≤7 days) and single or multicentre.ResultsA total of 16 observational studies with 36 973 newborns were included in the meta-analysis. ACS treatment was associated with a reduction in RDS (OR 0.66; 95% CI 0.54 to 0.82; I2=91.4%; p<0.001), mortality (OR 0.64; 95% CI 0.50 to 0.81; I2=85.9%; p<0.001), IVH (OR 0.67; 95% CI 0.54 to 0.83; I2=77.4%; p<0.001) and PVL (OR 0.65; 95% CI 0.47 to 0.92; I2=75.5%; p<0.001). Subgroup analyses showed ACS completeness, administration-to-delivery interval and multicentre study affected these associations.DiscussionACS may be beneficial for reducing the risks of RDS, mortality, IVH and PVL among preterm multiple gestations. The efficacy of ACS could be affected by ACS completeness and administration-to-delivery. More robust evidence on the efficacy of ACS treatment among multiple gestations is warranted.

scholarly journals Intestinal parasitic infections and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zelalem Animaw ◽  
Addisu Melese ◽  
Habtamu Demelash ◽  
Girma Seyoum ◽  
Abiy Abebe
Keyword(s):  
Pregnant Women ◽  
Associated Factors ◽  
Intestinal Parasites ◽  
Meta Analysis ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Stool Examination ◽  
Parasitic Infections ◽  
Intestinal Parasitic Infections ◽  
Pooled Prevalence

Abstract Background Intestinal parasitic infections (IPIs) are public health problems widely distributed in the world and cause significant morbidity and mortality; many of which occur among women of reproductive age. IPIs caused by helminthes and protozoan parasites are common among pregnant women. Data on the national pooled prevalence of intestinal parasites and associated factors during pregnancy is not documented well in Ethiopia. This review aims at summarizing evidences on the burden of IPIs and associated factors among pregnant women in Ethiopia. Methods Published and unpublished studies were thoroughly searched at MEDLINE/PubMed, EMBASE, Google Scholar, CINAHL, Cochrane library and Science Direct. In addition, repositories of Addis Ababa, Gondar and Jimma Universities were searched. Eligible studies were selected following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. The pooled prevalence of intestinal parasites and summary odds ratios (ORs) were determined with 95 % confidence intervals (CI). Sub-groups analyses were done based on study region, types of parasites, methods of stool examination and study setting. The statistical analyses were performed using STATA version 14.0 software. Results Among 168 retrieved studies, 31 studies with a total population of 12,118 pregnant women were included. The estimated pooled prevalence of IPIs among pregnant women in Ethiopia was 27.32 % (95 % CI: 20.61, 33.87 %). In the subgroup analysis, Oromia and Amhara regions had the highest prevalence with a 29.78 % (95 % CI: 15.97, 43.60) and 29.63 % (95 % CI: 15.37, 43.89); respectively. In addition, studies conducted in the community showed higher prevalence than institution based studies (49.93 % Vs 24.84 %; respectively). The most prevalent type of intestinal parasite identified were Hookworm followed by Ascaris lumbricoides with a pooled prevalence of 11.2 and 10.34 %, respectively. In our analysis; residence, being bare footed, lack of hand washing habit and eating uncooked/raw vegetables were significantly associated with IPIs among pregnant women in Ethiopia. Conclusions Prevalence of IPIs during pregnancy is relatively high in Ethiopia. Poor hygienic practices were identified as risk factors. Based on our finding, targeted preventive measures shall be considered so as to prevent morbidity and mortality due to IPIs.

REPEAT ANTENATAL CORTICOSTEROIDS: SHOULD IT BE PRESCRIBED AND IF SO WHEN AND HOW?

2008 ◽  
Vol 19 (2) ◽  
pp. 165-180
Author(s):  
TAK YEUNG LEUNG ◽  
DALJIT SINGH SAHOTA
Keyword(s):  
Distress Syndrome ◽  
Neonatal Outcome ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Corticosteroid Treatment ◽  
Therapeutic Effects ◽  
Antenatal Corticosteroids ◽  
Beneficial Effects ◽  
Neonatal Respiratory Distress ◽  
Randomised Controlled

Corticosteroid treatment before preterm delivery was shown to be effective in reducing neonatal respiratory distress syndrome (RDS) more than three decades ago. The beneficial effect of steroids was further confirmed by Roberts and Dalziel's meta-analysis of 21 randomised controlled studies (RCT), which was published as a Cochrane Review in 2006. The authors concluded that the administration of a single course of steroids improved neonatal outcome, reducing RDS by 60%, periventricular haemorrhage (PVH) and necrotizing enterocolitis (NEC) by half, and neonatal death (NND) by 70%. However, these beneficial effects do not last for more than 7 days. Furthermore, steroids take at least 24 hours to be fully effective. Hence, it was advocated in the 1990's that regular weekly booster courses be given in order to maintain the therapeutic effects in high risk cases, as the timing of preterm birth cannot be readily predicted.

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