scholarly journals Epidemiology of Microsatellite Instability High (MSI-H) and Deficient Mismatch Repair (dMMR) in Solid Tumors: A Structured Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-17 ◽  
Author(s):  
Maria Lorenzi ◽  
Mayur Amonkar ◽  
Jacky Zhang ◽  
Shivani Mehta ◽  
Kai-Li Liaw
Keyword(s):  
Literature Review ◽  
Solid Tumors ◽  
English Language ◽  
Meta Analysis ◽  
Evidence Base ◽  
Published Data ◽  
Cancer Type ◽  
Pooled Prevalence ◽  
Tumor Types ◽  
Structured Literature Review

Background. Given limited data on the epidemiology of MSI-H and dMMR across solid tumors (except colorectal cancer (CRC)), the current study was designed to estimate their prevalence. Materials and Methods. A structured literature review identified English language publications that used immunohistochemistry (IHC) or polymerase chain replication (PCR) techniques. Publications were selected for all tumors except CRC using MEDLINE, EMBASE, and Cochrane databases and key congresses; CRC and pan-tumor genomic publications were selected through a targeted review. Meta-analysis was performed to estimate pooled prevalence of MSI-H/dMMR across all solid tumors and for selected tumor types. Where possible, prevalence within tumor types was estimated by disease stages. Results. Of 1,176 citations retrieved, 103 and 48 publications reported prevalence of MSI-H and dMMR, respectively. Five pan-tumor genomic studies supplemented the evidence base. Tumor types with at least 5 publications included gastric (n = 39), ovarian (n = 23), colorectal (n = 20), endometrial (n = 53), esophageal (n = 6), and renal cancer (n = 8). Overall MSI-H prevalence (with 95% CI) across 25 tumors was based on 90 papers (28,213 patients) and estimated at 14% (10%–19%). MSI-H prevalence among Stage 1/2 cancers was estimated at 15% (8%–23%); Stages 3 and 4 prevalence was estimated at 9% (3%–17%) and 3% (1%–7%), respectively. Overall, dMMR prevalence across 13 tumor types (based on 54 papers and 20,383 patients) was estimated at 16% (11%–22%). Endometrial cancer had the highest pooled MSI-H and dMMR prevalence (26% and 25% all stages, respectively). Conclusions. This is the first comprehensive attempt to report pooled prevalence estimates of MSI-H/dMMR across solid tumors based on published data. Prevalence determined by IHC and PCR was generally comparable, with some variations by cancer type. Late-stage prevalence was lower than that in earlier stages.

scholarly journals The Prevalence of Metabolic Syndrome in Ethiopian Population: A Protocol for Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Sintayehu Ambachew ◽  
Aklilu Endalamaw ◽  
Belete Biadgo ◽  
Abebaw Worede ◽  
Mulugeta Melku
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
English Language ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Group Analysis ◽  
Published Data ◽  
The Metabolic Syndrome ◽  
Pooled Prevalence

Abstract Background: The metabolic syndrome is a clustering of hyperglycemia/insulin resistance, hypertension, dyslipidemia and obesity which are risk factors for cardiovascular disease, type 2 diabetes, stroke and all-cause mortality. The burden of metabolic syndrome is emerging alarmingly in low-and middle income countries like Ethiopia. This is the protocol to determine the pooled prevalence of metabolic syndrome in Ethiopian population.Methods: This systematic review and meta-analysis will include original articles of observational studies published in the English language. Searches will be carried out in PubMed, Google Scholar, and Africa Journals up to April 2019. A Fixed/Random-effect model will be used to estimate the pooled prevalence of metabolic syndrome in Ethiopia. Heterogeneity will be assessed using I² statistic. Sub-group analysis will also be conducted based on sex, study subjects, and methodological differences. Funnel plots and egger’s and Begg’s test will be used to asses publication bias.Ethics and dissemination: The review is based on published data; therefore, ethical approval is not required. The systematic review and meta-analysis will summarize the existing data on the prevalence of metabolic syndrome in Ethiopian population. This provides the empirical evidence necessary for researchers, policy-makers, and public health stakeholders to derive health-promoting policies, allocate resources, and set priorities for monitoring future trends. The final result will be presented at annual scientific meetings, conferences, and seminars. Moreover, it will also be published in the peer-reviewed reputable journal. We also plan to review every 5 years to provide updated information.Protocol registration number: PROSPERO International Prospective Register of Systematic Reviews (CRD42018090944)

scholarly journals Asymptomatic people with SARS-CoV-2 as unseen carriers of COVID-19: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Gopiram Syangtan ◽  
Shrijana Bista ◽  
Prabin Dawadi ◽  
Binod Rayamajhee ◽  
Lok Bahadur Shrestha ◽  
...  
Keyword(s):  
English Language ◽  
Meta Analysis ◽  
Age Groups ◽  
Published Data ◽  
Pooled Data ◽  
Asymptomatic Patients ◽  
Pooled Prevalence ◽  
Study Population ◽  
And Gender ◽  
Asymptomatic Individuals

Abstract Background The asymptomatic patients with SARS-CoV-2 can act as an unseen carrier for magnifying the transmission of COVID-19. Aims This study was designed to appraise the burden of asymptomatic individuals and estimate their occurrence among different age groups and gender by reviewing the existing published data on asymptomatic people with COVID-19. Methods Three electronic databases: PubMed, Embase and Web of Science (WoS) were used to search studies as per the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and the search was limited to English language. The study population of this review includes asymptomatic individuals infected by COVID-19. All original articles which have reported cases of the COVID-19 patients with no symptoms until 31 April 2020 were included in the study. Random effects model was applied to analyze pooled data on the prevalence of symptomless cases among total COVID-19 infected patients and also on different age groups and gender. Results In the meta-analysis of 16 studies, comprising 2,788 COVID-19 infected patients, the pooled prevalence of asymptomatic cases was 48.2% (95% CI, 30%-67%). Among the asymptomatic patients, 55.5% (95% CI, 43.6%-66.8%) were female and 49.6% (95% CI, 20.5%-79.1%) were children. Conclusion About half of the COVID-19 infected patients were asymptomatic cases. Children and females were more apparent to be asymptomatic patient of COVID-19 and could act as unseen carrier of SARS-CoV-2. Symptom based screening only, might fail to identify all SARS-CoV-2 infections escalating the threat of global spread of SARS-CoV-2. Therefore, mass surveillance system tracking asymptomatic cases is a pressing need of public health, paying special attention to female and young children, which could aid in prevention and containment of this unprecedented pandemic.

A comprehensive literature review and meta-analysis on prevalence of BRCAm, HRRm and HRD+ across tumor types.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10589-10589
Author(s):  
Changxia Shao ◽  
Jun Wan ◽  
Huilin Tang ◽  
Andrew Marley ◽  
Chelsey Miller ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Homologous Recombination ◽  
Literature Review ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Cancer Type ◽  
Random Effects Models ◽  
Summary Estimate ◽  
Cochrane Reviews ◽  
Tumor Types

10589 Background: Poly (ADP-ribose) polymerase inhibitor (PARPi) may have broad application in the treatment of cancer patients with mutations in BRCA (BRCAm) or other homologous recombination repair genes (HRRm) or with homologous recombination deficiency positive (HRD+). A literature review and meta-analysis were conducted to evaluate the prevalence of BRCAm, HRRm, and HRD+ across tumor types. Methods: Comprehensive searches for eligible studies in Ovid MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane reviews were performed in May 2020 to capture studies published in English, within 10 years for manuscripts and 3 years for abstracts across geographic regions. A weighted summary estimate was calculated for BRCAm. A summary estimate with corresponding 95% CI was calculated using random-effects models for HRD+ and HRRm. Results: A total of 342 eligible studies with at least 100 samples were included in the review of BRCA1/2m prevalence, containing a total of over 469,000 samples across 24 tumor types. The most frequent indications examined in the included studies were breast (study number n = 144), ovarian (53), prostate (17) and pancreatic (11) cancers. The prevalence of germline BRCA1m (gBRCA1m) and gBRCA2m was 5% and 4% for breast, 12% and 5% for ovarian, 1% and 3% for prostate, and 1% and 4% for pancreatic cancer, respectively. The prevalence of somatic BRCA1m (sBRCA1m) and somatic BRCA2m (sBRCA2m) was 3% and 3% for breast, 7% and 5% for ovarian, 3% and 5% for prostate, and 1% and 3% for pancreatic cancer, respectively. Few studies evaluated endometrial, lung and colon cancers, the prevalence of gBRCA1m or gBRCA2m was generally less than 1%, and the prevalence of sBRCA1m and sBRCA2 ranged 1 to 3%. Seven publications were identified where HRD+ was defined by either BRCAm or genomic instability score (GIS) ≥ 42 across breast, ovarian and pancreatic cancers. The overall HRD+ prevalence was 56% (95%CI: 48, 64), with similar prevalence observed across the 3 tumor types and was 50% (34, 66) for the 3 studies only counting GIS≥ 42. 194 studies across 26 tumor types were identified that examined HRRm as mutations in one or more HRR genes other than BRCA1/2m. The definitions of HRRm varied substantially across the studies, and ATM (2.8%), CHEK2 (1.6%), and PALB2 (1.6%) accounted for most of the observed mutations among HRR genes. Conclusions: Prevalence of BRCAm, HRRm and HRD+ varied by cancer type. This comprehensive meta-analysis enriches the knowledge in this field and demonstrates the need to standardize the measurement of HRRm and HRD.Understanding the prevalence of these biomarkers could have important clinical implications.

A comprehensive literature review and meta-analysis on prognostic value of BRCAm, HRRm and HRD+ across tumor types.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3125-3125
Author(s):  
Changxia Shao ◽  
Andrew Marley ◽  
Huilin Tang ◽  
Jun Wan ◽  
Chelsey Miller ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Literature Review ◽  
Meta Analysis ◽  
Positive Association ◽  
Cochrane Central Register ◽  
Cancer Type ◽  
Brca1 And Brca2 ◽  
Summary Estimate ◽  
Cochrane Reviews ◽  
Tumor Types

3125 Background: Poly (ADP-ribose) polymerase inhibitor (PARPi) may have broad application in the treatment of cancer patients with mutations of BRCA (BRCAm) or other homologous recombination repair genes (HRRm) or HR deficiency positive (HRD+). A literature review and meta-analysis were conducted to evaluate the clinical prognostic outcomes by total BRCAm, HRRm, and HRD+ status across tumor types among patients treated with non-PARPi treatment. Methods: Comprehensive searches for eligible studies in Ovid MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane reviews were performed in May 2020 to capture studies published in English within 10 years for manuscripts and 3 years for abstracts across geographic regions. A summary estimate with corresponding 95% CI was calculated using random-effects models due to varying effects sizes across studies. Results: A total of 135 eligible studies were included. Breast cancer (BC) patients with either BRCA1m or BRCA2m (BRCA1/2m) had a similar overall survival (OS) to those with wild-type BRCA1 and BRCA2 (BRCA1/2wt) across 18 studies reporting data on BRCA1m and BRCA2m. The pooled estimates of hazard ratio (HR) was 1.0 (95% CI: 0.8-1.3) overall and was 1.0 (0.7-1.5) for triple-negative BC (TNBC, 7 studies). Similarly, the HR was 1.1 (0.9-1.3) across all 10 studies reporting BRCA1m data and 1.1 (0.8-1.3) across all 7 studies reporting BRCA2m data. Ovarian cancer (OC) patients with BRCA1/2m had a significantly longer OS than those with BRCA1/2wt across 24 studies reporting BRCA1m and BRCA2m, with a HR of 0.7 (0.6-0.8). The HR was 0.6 (0.4, 0.8) across 4 studies on stage III-IV ovarian cancer. The HR was 0.8 (0.6-1.1) across 13 studies reporting BRCA1m and 0.5 (0.3-0.9) across 8 studies reporting BRCA2m. Less OS data were reported for other tumors, 6 studies for BRCA2m in prostate cancer with a HR of 1.9 (1.1-3.2) and 2 studies for BRCA1/2m in pancreatic cancer with a HR of 1.5 (0.8-3.1). Only 4 studies reported HRD+ by either BRCAm or genomic instability score (GIS) ≥ 42 and OS by HRD status; 3 on TNBC and 1 on high-grade serous ovarian cancer. The HR was 0.67 (0.43-1.02) for OS with HRD+ vs. HRD-. A total of 15 studies reported the association between HRRm and OS of cancers (5 on prostate, 4 on pancreas, 3 on ovary, 2 on breast and 1 on urothelial cancer), in which one or more HRR genes were examined. The HR was 1.0 (0.7-1.4) comparing patients with HRRm to those with HRRwt across tumor types. Due to the limited study number and inconsistent methodology/definitions of HRRm and HRD+, these results should be interpreted with caution. Conclusions: The effects of BRCA1/2m on OS in patients treated with chemotherapy varies by cancer type with no effect in BC and a positive association in OC. More study is required in other cancer types. There was no significant association found between HRD+ or HRRm with OS. These findings could help inform evidence-based treatment decisions.

scholarly journals Benefits of Outdoor Sports for Society. A Systematic Literature Review and Reflections on Evidence

2019 ◽  
Vol 16 (6) ◽  
pp. 937 ◽  
Author(s):  
Barbara Eigenschenk ◽  
Andreas Thomann ◽  
Mike McClure ◽  
Larissa Davies ◽  
Maxine Gregory ◽  
...  
Keyword(s):  
Literature Review ◽  
Meta Analysis ◽  
Evidence Base ◽  
Long Term Effects ◽  
Outdoor Sports ◽  
Health And Wellbeing ◽  
The Social ◽  
Study Designs ◽  
Benefits And Costs

The combination of physical activity and being in nature is recognized as providing a range of significant benefits. The objective of this literature review was to compile an overview of the social benefits and costs associated with outdoor sports within the academic literature and to reflect on the quality of underlying evidence that supports the relationship. A systematic review was carried out with seven partners from different European countries, including Bulgaria, France, Germany, United Kingdom, Italy, Portugal, and Spain. From a total of 17,560 studies identified, 133 studies were selected with relevant data extracted to standardized forms. The selected studies have been analyzed with qualitative research methods. A meta-analysis could not be conducted due to the heterogeneity of the study designs and outcome measures. As a result, the review gives an overview of the social impacts associated with outdoor sports which have been clustered to six broad categories: physical health, mental health and wellbeing, education and lifelong learning, active citizenship, crime reduction, and anti-social behavior, as well as additional benefits. The review furthermore revealed gaps in the evidence base which are especially notable in the long-term effects that outdoor sports can have on personal and social development.

scholarly journals Prevalence and Risk Factors of Thromboembolism among Patients With Coronavirus Disease-19: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 26 ◽  
pp. 107602962096708
Author(s):  
Belayneh Kefale ◽  
Gobezie T. Tegegne ◽  
Amsalu Degu ◽  
Melaku Tadege ◽  
Desalegn Tesfa
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
English Language ◽  
Meta Analysis ◽  
Thrombotic Event ◽  
Cochrane Library ◽  
Pooled Prevalence ◽  
D Dimer

Emerging evidence shows that the recent pandemic of coronavirus disease 19 (COVID-19) is characterized by coagulation activation and endothelial dysfunction. This increases the risk of morbidity, mortality and economic loss among COVID-19 patients. Therefore, there was an urgent need to investigate the extent and risk factors of thromboembolism among COVID-19 patients. English-language based databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Cochrane library) were exhaustively searched to identify studies related to prevalence of thromboembolism among hospitalized COVID-19 patients. A random-effects model was employed to estimate the pooled prevalence of thromboembolism. The pooled prevalence of thrombotic events was computed using STATA 16.0 software. Heterogeneity analysis was reported using I2. A total of 19 studies with 2,520 patients with COVID-19 were included. The pooled prevalence of thrombotic events of hospitalized patients with COVID-19 was 33% (95% CI: 25-41%, I2 = 97.30%, p < 0.001) with a high degree of heterogeneity across studies. Elevated D-dimer hospitalized in the intensive care unit and being under mechanical ventilation were the most frequently associated factors for the development of thrombotic events. The pooled prevalence of thrombotic events in COVID-19 patients was 33%. The prevalence of thrombotic event is variables on the basis of study design and study centers. Several risk factors such as, elevated D-dimer, hospitalized in the intensive care unit and being under mechanical ventilation, were the most frequently reported risk factors identified. Therefore, healthcare professionals should consider these risk factors to optimally manage thromboembolism in COVID-19 patients.

scholarly journals Device use errors with soft mist inhalers: A global systematic literature review and meta-analysis

2020 ◽  
Vol 17 ◽  
pp. 147997311990123 ◽  
Author(s):  
Maryam Navaie ◽  
Carole Dembek ◽  
Soojin Cho-Reyes ◽  
Karen Yeh ◽  
Bartolome R Celli
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
English Language ◽  
Meta Analysis ◽  
Chronic Obstructive Lung Disease ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Random Effects Models ◽  
Bronchodilator Treatment ◽  
Device Use

Inhaled bronchodilators are the cornerstone of treatment for chronic obstructive pulmonary disease (COPD). Soft mist inhalers (SMIs) are devices that deliver bronchodilators. Although correct device use is paramount to successful medication delivery, patient errors are common. This global systematic literature review and meta-analysis examined device use errors with SMIs among patients with obstructive lung diseases. PubMed, EMBASE, PsycINFO, Cochrane, and Google Scholar were searched to identify studies published between 2010 and 2019 that met the following inclusion criteria: (a) English language; (b) a diagnosis of COPD, bronchitis, or emphysema; and (c) reported device use errors among adults receiving long-acting bronchodilator treatment with Respimat® SMI (i.e. Spiriva®, Stiolto®, Spiolto®, and Striverdi®). Descriptive statistics examined sociodemographics, clinical characteristics, and device use errors. Meta-analysis techniques were employed with random-effects models to generate pooled mean effect sizes and 95% confidence intervals (CIs) for overall and step-by-step errors. The I 2 statistic measured heterogeneity. Twelve studies ( n = 1288 patients) were included in this meta-analysis. Eighty-eight percent of patients had COPD, and most had moderate/very severe airflow limitation (Global Initiative for Chronic Obstructive Lung Disease spirometric stages II to IV). Aggregate results revealed that 58.9% (95% CI: 42.4–75.5; I 2 = 92.8%) of patients made ≥1 device use errors. Among 11 studies with step-by-step data, the most common errors were failure to (1) exhale completely and away from the device (47.8% (95% CI: 33.6–62.0)); (2) hold breath for up to 10 seconds (30.6% (95% CI: 17.5–43.7)); (3) take a slow, deep breath while pressing the dose release button (27.9% (95% CI: 14.5–41.2)); (4) hold the inhaler upright (22.6% (95% CI: 6.2–39.0)); and (5) turn the base toward the arrows until it clicked (17.6% (95% CI: 3.0–32.2)). Device use errors occurred in about 6 of 10 patients who used SMIs. An individualized approach to inhalation device selection and ongoing training and monitoring of device use are important in optimizing bronchodilator treatment.

scholarly journals Intralesional cryotherapy for hypertrophic scars and keloids: a review

2017 ◽  
Vol 3 ◽  
pp. 205951311770216 ◽  
Author(s):  
Ciaran P O’Boyle ◽  
Holleh Shayan-Arani ◽  
Maha Wagdy Hamada
Keyword(s):  
English Language ◽  
Meta Analysis ◽  
Case Series ◽  
Evidence Base ◽  
Treatment Modalities ◽  
Hypertrophic Scars ◽  
Published Evidence ◽  
Keloid Scarring ◽  
Comparative Trials ◽  
Scar Reduction

Introduction: Hypertrophic and keloid scarring remain notoriously troublesome for patients to tolerate and frustratingly difficult for clinicians to treat. Many different treatment modalities exist, signifying the failure of any method to achieve consistently excellent results. Intralesional cryotherapy is a relatively recent development that uses a double lumen needle, placed through the core of a keloid or hypertrophic scar, to deliver nitrogen vapour, which freezes the scar from its core, outwards. Methods: This article provides a comprehensive review of the literature on intralesional cryotherapy for hypertrophic scars and keloids. A systematic review or meta-analysis was not possible, since the existing articles did not permit this. Results: A search of English language, peer-reviewed literature was carried out. The evidence base was found to be low (level 4). In addition, much of the published evidence comes from a very few groups. Despite this, consistent findings from case series suggest that the technique is safe and achieves good scar reduction with very few treatments. Adverse effects include depigmentation, recurrence and pain. Pain and recurrence appear to be uncommon and depigmentation may be temporary. Discussion: Well-constructed, prospectively recruited comparative trials are absent from the literature. These are strongly encouraged, in order to strengthen general confidence in this technique and in the repeatability of outcomes reported thus far.

scholarly journals Remission and low disease activity in psoriatic arthritis publications: a systematic literature review with meta-analysis

Rheumatology ◽  
2020 ◽  
Vol 59 (8) ◽  
pp. 1818-1825 ◽  
Author(s):  
Benjamin Hagège ◽  
Elina Tan ◽  
Martine Gayraud ◽  
Bruno Fautrel ◽  
Laure Gossec ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Literature Review ◽  
Disease Activity ◽  
Systematic Literature Review ◽  
Activity Index ◽  
Meta Analysis ◽  
Random Effect ◽  
Disease Activity Index ◽  
Low Disease Activity ◽  
Pooled Prevalence

Abstract Objectives Remission (REM) or low disease activity (LDA) is the treatment target in psoriatic arthritis (PsA). The objective of this study was to assess the reporting and prevalence of REM/LDA in published studies of PsA. Methods This was a systematic literature review of all clinical papers published in PubMed, EMBASE or Cochrane database in English between 2012 and 2019 in the field of PsA. Data were collected regarding reporting of REM/LDA by very low disease activity/minimal disease activity (VLDA/MDA), Disease Activity index for Psoriatic Arthritis (DAPSA), or Disease Activity Score 28 joints (DAS28). The pooled rates of REM and LDA by each definition were calculated by random effect meta-analysis. Results In all, 258 publications (corresponding to 114 651 patients), of which 81 (31%) were randomized controlled trials, were analysed: patients’ mean age was 49.4 ( 4.4) years; with a mean disease duration of 8.5 ( 3.8) years. REM/LDA was reported in 91/258 (35.3%) publications. VLDA/MDA was used in 61/91 (67.0%) studies, DAPSA in 27/91 (29.6%) and DAS28 in 28/91 (30.7%), with 40/91 (43.9%) papers reporting several of these definitions. The pooled prevalence (lower–upper limits) of REM was 13.1% (10.9–15.4), 23.1% (16.8–30.1) and 42.1% (33.9–50.4) using VLDA, DAPSA-REM and DAS28, respectively. For LDA the pooled prevalence was 36.3% (32.3–40.5), 52.8% (41.8–63.6) and 60.4% (52.5–68.0) using MDA, DAPSA-LDA and DAS28, respectively. Conclusion REM/LDA status was reported in only1/3 of recent studies on PsA, with important variations in the frequency of these outcomes according to the definition used: 13.1–42.1% for REM, and 36.3–60.4% for LDA. This highlights the need for consensus.

Assessing risk of neurodevelopmental disorders after birth with oxytocin: a systematic review and meta-analysis

2018 ◽  
Vol 49 (6) ◽  
pp. 881-890 ◽  
Author(s):  
Nicole N. Lønfeldt ◽  
Frank C. Verhulst ◽  
Katrine Strandberg-Larsen ◽  
Kerstin J. Plessen ◽  
Eli R. Lebowitz
Keyword(s):  
Cognitive Impairment ◽  
English Language ◽  
Psychiatric Symptoms ◽  
Meta Analysis ◽  
Evidence Base ◽  
Autism Spectrum ◽  
Risk Estimate ◽  
Current Evidence ◽  
Language Studies ◽  
Meta Analyses

AbstractExperts have raised concerns that oxytocin for labor induction and augmentation may have detrimental effects on the neurodevelopment of children. To investigate whether there is the reason for concern, we reviewed and evaluated the available evidence by searching databases with no language or date restrictions up to 9 September 2018. We included English-language studies reporting results on the association between perinatal oxytocin exposure and any cognitive impairment, psychiatric symptoms or disorders in childhood. We assessed the quality of studies using the Newcastle–Ottawa Quality Assessment Scales. Independent risk estimates were pooled using random-effects meta-analyses when at least two independent datasets provided data on the same symptom or disorder. Otherwise, we provided narrative summaries. Two studies examined cognitive impairment, one examined problem behavior, three examined attention-deficit/hyperactivity disorder (ADHD) and seven focused on autism spectrum disorders (ASD). We provided narrative summaries of the studies on cognitive impairment. For ADHD, the pooled risk estimate was 1.17; 95% confidence interval (CI) 0.77–1.78, based on a pooled sample size of 5 47 278 offspring. For ASD, the pooled risk estimate was 1.10; 95% CI 1.04–1.17, based on 8 87 470 offspring. Conclusions that perinatal oxytocin increases the risks of neurodevelopmental problems are premature. Observational studies of low to high quality comprise the evidence-base, and confounding, especially by the genetic or environmental vulnerability, remains an issue. Current evidence is insufficient to justify modifying obstetric guidelines for the use of oxytocin, which state that it should only be used when clinically indicated.

Sign in / Sign up

Export Citation Format

Share Document