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Background: Congo Red Dot Paper Test (CRDPT) appears to be a simple, cost-effective, non-invasive diagnostic tool for hypertensive disorders of pregnancy (HDP). The main objective of the study is to assess the effectiveness of CRDPT in detecting HDP. Methods: This is a systemic review and meta-analysis of published studies on the effectiveness of CRDPT in the detection of HDP. The study was conducted in line with the PRISMA-DTA guidelines. The PICOS framework was used to search for relevant articles using Medline, PubMed, Google Scholar, Web of Science, and the Cochrane Library databases. The articles were screened against a set of inclusion and exclusion criteria and analysed using the Review Manager 5.4 software. Results: A title, abstract and full article screening was conducted on 18,153 potential articles based on the inclusion and exclusion criteria. The screening yielded five articles for meta-analysis. The total number of normotensive pregnant women (n = 3,380) in the included studies was five times higher than the total number of women with pre-eclampsia (n = 535). A difference between the HDP and normotensive group was noted. This is indicated by a significantly decreased in the effectiveness of CRDPT in detecting HDP as compared to normotensive group [Risk Ratio (RR) = 6.32 (2.17, 18.43) p < 0.00001]. The included studies had a high nature of heterogeneity (I 2 = 98%, p < 0.00001) partially due to different study designs included in the analysis and different regions where studies were conducted given that none of these studies were conducted in African countries where HDP is prominent. Conclusions: According to results generated from 5 studies in this meta-analysis, it was found that CRDPT might not be effective in the detection of hypertensive disorder of pregnancy. Moreover, more research, especially in African women where hypertensive disorders of pregnancy are prevalent, are re-quired to ascertain these findings. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021283679, identifier: CRD42021283679.
RESUMO
INTRODUCTION: Aspirin is widely used to prevent pregnancy related vascular disorders such as preeclampsia (PE), intrauterine growth restriction and maternal disorders. However, the indications for the use of aspirin during pregnancy is currently controversial because the dosage of aspirin used and the sample sizes in various studies differ considerably. Furthermore, women of African ancestry are more likely to have higher rates of PE and more severe cases than those of their Caucasian counterparts. Yet, there are very few studies in this population group. Therefore, the aim of this review will be to determine the effect of low-dose aspirin (LDA) for prevention of PE in women of African ancestry. METHODS AND ANALYSIS: This is a protocol for a systematic review and meta-analysis of published studies on the effect of LDA for prevention of PE. Relevant information will be accessed from the following databases; PubMed, Cochrane Central Register of Controlled Trials, Google Scholar, Google, EBSCO Host, and the Web of Science. The studies will be mapped in 2 stages: stage 1 will map studies descriptively by focus and method; stage 2 will involve additional inclusion criteria, quality assessment and data extraction undertaken by 2 reviewers in parallel. Evidence will be synthesized using relevant systematic research tools. Meta-analysis and subgroup analysis will be conducted using RevMan whilst Stata 13 will be used for meta-regressions. We will follow recommendations described in the preferred reporting items for systematic reviews and meta-analyses statement and the Cochrane Handbook for Intervention Reviews. DISCUSSION: The use of LDA as a prophylactic treatment has been considered for the prevention of PE. However, studies evaluating the use of LDA in women of African ancestry are few. Therefore, with the increase in the prevalence of PE in the African population, it is critical to further investigate the use of LDA in pregnant women of African ancestry. ETHICS AND DISSEMINATION: The review and meta-analysis will not require ethical approval and the findings will be published in peer-reviewed journals and presented at local and international conferences. The findings of this review will inform all stakeholders on current and future guidelines on the use of aspirin in pregnancy, especially in populations of African ancestry. SYSTEMATIC REVIEW REGISTRATION: International prospective Register of Systematic Reviews (PROSERO) number: (CRD42020213213).
