ABSTRACT
Several studies have been conducted regarding the prevalence of Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in pregnant Iranian women. However, it is necessary to combine the previous results to present a general assessment. We conducted the present study based on systematic review and meta-analysis studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA]. We searched the national and international online databases of MagIran, Iran Medex, SID, MedLib, IranDoc, Scopus, PubMed, ISI Web of Knowledge, and Google Scholar search engine for certain MeSH keywords until June 16, 2017. In addition, heterogeneity, sensitivity analysis, subgroup analysis, and publication bias were performed. The data were analyzed using random-effects model and Comprehensive Meta-Analysis version 2 and P value was considered lower than 0.05. The prevalence of Chlamydia trachomatis in 11 surveyed articles that assessed 2864 pregnant Iranian women was 8.74% [95% confidence interval [CI]: 5.40-13.84]. The prevalence of Chlamydia trachomatiswas estimated 5.73% [95% CI: 2.09-14.73] and 13.55% [95% CI: 11.23-16.25] by enzyme-linked immunosorbent assay [ELISA] and polymerase chain reaction [PCR], respectively which the difference was not significant [P=0.082]. The lowest and highest prevalence of Chlamydia trachomatis was estimated in Tehran province [4.96% [95% CI: 2.45-9.810]] and Ardabil province [28.60% [95% CI: 20.61-38.20]], respectively. This difference was statistically significant [P<0.001]. Meta-regression for the prevalence of Chlamydia trachomatis based on year of the studies was significant with increasing slope [P=0.017]. According to the systematic review, the prevalence of Mycoplasma hominis and Urea plasma urealyticum indicated 2 to 22.8% [from 4 articles] and 9.1 to 19.8% [from 3 articles], respectively. There was no evidence of publication bias [P value for Begg and Eggers' tests was 0.161 and 0.173, respectively]. The prevalence of Chlamydia trachomatis is high among pregnant Iranian women. Screening pregnant women as part of preventive measures seem necessary considering the potential for maternal and fetal complications
ABSTRACT
Background: The clinical consequences of hypothyroidism and hypothyroxinemia during pregnancy such as preterm birth are not still clear
Objective: The aim of this meta-analysis was to estimate the relation of clinical and subclinical hypothyroidism and hypothyroxinemia during pregnancy and preterm birth
Materials and Methods: In this meta-analysis, Preferred Reporting Items for Systematic review and Meta-Analysis were utilized. Searching the 83T cohort studies 83T were done by two researchers independently without any restrictions on Scopus, PubMed, Science Direct, Embase, Web of Science, CINAHL, Cochrane, EBSCO and Google Scholar databases up to 2017. The heterogeneity of the studies was checked by the Cochran's Q test and IP2P index. Both random and fixed-effects models were used for combining the relative risk and 95% confidence intervals. Data were analyzed using Comprehensive Meta-Analysis software version 2
Results: Twenty-three studies were included in the meta-analysis. The relative risks of the clinical hypothyroidism, subclinical hypothyroidism and hypothyroxinemia during pregnancy on preterm birth was estimated 1.30 [95% CI: 1.05-1.61, p=0.013, involving 20079 cases and 2452817 controls], 1.36 [95% CI: 1.09-1.68, p=0.005, involving 3580 cases and 64885 controls] and 1.31 [95% CI: 1.04-1.66, p=0.020, involving 1078 cases and 44377 controls], respectively
Conclusion: The incidence of preterm birth was higher among mothers with clinical and subclinical hypothyroidism or hypothyroxinemia during pregnancy compared to euthyroid mothers, and these relations were significant. Therefore, 83T gynecologists and endocrinologists 83T should manage these patients to control the incidence of 83T adverse pregnancy outcomes 83T such as preterm birth