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Blanco E, Marcela M, Nuñez L, Retamal E, Ossa X, Woolley KE, Oludotun T, Bartington SE, Delgado-Saborit JM, Harrison RM, Ruiz-Rudolph P, Quinteros ME. Adverse pregnancy and perinatal outcomes in Latin America and the Caribbean: systematic review and meta-analysis. Rev Panam Salud Publica 2022; 46:e21. [PMID: 35509645 PMCID: PMC9060182 DOI: 10.26633/rpsp.2022.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/15/2022] [Indexed: 12/04/2022] Open
Abstract
Objective. To estimate the point prevalence and likely ranges of pregnancy-induced hypertension, pre-eclampsia, gestational diabetes, low birth weight and preterm delivery in Latin America and the Caribbean, and evaluate the heterogeneity of the estimates. Methods. We conducted a systematic review and meta-analysis of observational studies reporting the prevalence of maternal and perinatal adverse outcomes in populations in Latin American and the Caribbean published between 2000 and 2019 in English, Spanish, or Portuguese. We searched PubMed, Embase, and LILACS. We estimated the point prevalence and evaluated overall heterogeneity and, in sub-group analyses, heterogeneity by study design and level of bias. Results. Of 1087 records retrieved, 50 articles were included in the review: two on hypertensive disorders of pregnancy, 14 on pre-eclampsia, six on gestational diabetes, nine on low birth weight and 19 on preterm birth. No meta-analysis for hypertensive disorders of pregnancy could be done because of the small number of studies. Point prevalence estimates and 95% confidence intervals (CIs) for pre-eclampsia, gestational diabetes, low birth weight, and preterm birth were: 6.6% (95% CI: 4.9%, 8.6%), 8.5% (95% CI: 3.9%, 14.7%), 8.5% (95% CI: 7.2%, 9.8%), and 10.0% (95% CI: 8.0%, 12.0%), respectively. We observed substantial heterogeneity overall and by study design. No major differences in estimates were observed by level of bias. Conclusions. The results of this study provide updated estimates of some of the most prevalent adverse pregnancy and perinatal outcomes in Latin America and the Caribbean. They highlight that important heterogeneity exists in prevalence estimates, which may reflect the diversity of populations in the region.
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Affiliation(s)
- Estela Blanco
- Facultad de Medicina, Pontifica Universidad Católica, Santiago, Chile
| | - Marin Marcela
- Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Loreto Nuñez
- Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Erika Retamal
- Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Ximena Ossa
- Departamento de Salud Pública y Centro de Excelencia CIGES, Universidad de la Frontera, Temuco, Chile
| | - Katherine E. Woolley
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Tosin Oludotun
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Suzanne E. Bartington
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | | | - Roy M. Harrison
- School of Geography, Earth & Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Pablo Ruiz-Rudolph
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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van Zijl MD, Koullali B, Oudijk MA, Ravelli ACJ, Mol BWJ, Pajkrt E, Kazemier BM. Trends in preterm birth in singleton and multiple gestations in the Netherlands 2008-2015: A population-based study. Eur J Obstet Gynecol Reprod Biol 2020; 247:111-115. [PMID: 32087421 DOI: 10.1016/j.ejogrb.2020.02.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/05/2020] [Accepted: 02/13/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Preterm birth is the most important cause of perinatal morbidity and mortality. Over the past years several preventive measures have been studied and implemented. Preterm birth percentage in 2015 in the Netherlands was 6.9 %, according to data from the European Peristat project, reporting on perinatal health in Europe. Various preventive measures might have influenced the incidence and outcome of preterm birth. Our aim was to give an overview of the trends in preterm births for both singleton and multiple gestations in the Netherlands in order to guide future research. STUDY DESIGN We studied a nationwide cohort including both singleton and multiple gestations without congenital anomalies between 2008 and 2015. Outcomes were total preterm birth (defined as birth before 37 weeks of gestation), spontaneous and iatrogenic preterm birth < 37 weeks, spontaneous and iatrogenic preterm birth percentages between 34-36 weeks, 32-34 weeks, 28-31 weeks and ≤ 27 weeks using a moving average technique. Trend analysis was performed using the Cochran Armitage test. Singleton and multiple gestations were analyzed separately. RESULTS Our final study population comprised 1,303.786 women with a singleton and 44,951 women with a multiple pregnancy. Preterm birth < 37 weeks in singletons decreased from 5.6 % in 2008 to 5.3 % in 2015 (P < 0.0001), in both spontaneous and iatrogenic preterm birth. Preterm birth ≤ 27 weeks increased from 0.40 % to 0.45 % (P for trend <0.0001). The number of multiple gestations decreased over the years, as well as the percentage of multiples conceived through IVF/ICSI. There was an increase in total and iatrogenic preterm birth < 37 weeks from 36.7-38.2% (P < 0.0001) in multiples. The number of multiples <32 decreased, in both the spontaneous and iatrogenic group. CONCLUSION In the Netherlands preterm birth risk in singletons decreased between 2008 and 2015 but an increase was noted in preterm birth ≤ 27 weeks. In multiples the total preterm birth risk increased, due to an increase in indicated preterm birth.
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Affiliation(s)
- Maud D van Zijl
- Department of Obstetrics & Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Bouchra Koullali
- Department of Obstetrics & Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Martijn A Oudijk
- Department of Obstetrics & Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Anita C J Ravelli
- Department of Obstetrics & Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Ben W J Mol
- Department of Obstetrics and Gynaecology, School of Medicine, Monash University, Melbourne, Australia.
| | - Eva Pajkrt
- Department of Obstetrics & Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Brenda M Kazemier
- Department of Obstetrics & Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
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Justo N, Espinoza MA, Ratto B, Nicholson M, Rosselli D, Ovcinnikova O, García Martí S, Ferraz MB, Langsam M, Drummond MF. Real-World Evidence in Healthcare Decision Making: Global Trends and Case Studies From Latin America. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:739-749. [PMID: 31198192 DOI: 10.1016/j.jval.2019.01.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/19/2018] [Accepted: 01/30/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Real-world evidence (RWE) is increasingly used to inform health technology assessments for resource allocation, which are valuable tools for emerging economies such as in America. Nevertheless, the characteristics and uses in South America are unknown. OBJECTIVES To identify sources, characteristics, and uses of RWE in Argentina, Brazil, Colombia, and Chile, and evaluate the context-specific challenges. The implications for future regulation and responsible management of RWE in the region are also considered. METHODS A systematic literature review, database mapping, and targeted gray literature search were conducted to identify the sources and characteristics of RWE. Findings were validated by key opinion leaders attending workshops in 4 South American countries. RESULTS A database mapping exercise revealed 407 unique databases. Geographic scope, database type, population, and outcomes captured were reported. Characteristics of national health information systems show efforts to collect interoperable data from service providers, insurers, and government agencies, but that initiatives are hampered by fragmentation, lack of stewardship, and resources. In South America, RWE is mainly used for pharmacovigilance and as pure academic research, but less so for health technology assessment decision making or pricing negotiations and not at all to inform early access schemes. CONCLUSIONS The quality of real-world data in the case study countries vary and RWE is not consistently used in healthcare decision making. Authors recommend that future studies monitor the impact of digitalization and the potential effects of access to RWE on the quality of patient care.
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Affiliation(s)
- Nahila Justo
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden; Real World Evidence, Strategy and Analytics, ICON plc, Stockholm, Sweden.
| | - Manuel A Espinoza
- Department of Public Health, Pontificia Universidad Católica del Chile, Santiago, Chile
| | - Barbara Ratto
- Novartis Pharmaceuticals Corp, East Hanover, NJ, USA
| | - Martha Nicholson
- Real World Evidence, Strategy and Analytics, ICON plc, Stockholm, Sweden
| | - Diego Rosselli
- Clinical Epidemiology and Biostatistics Department, Pontificia Universidad Javeriana, Bogatá, Colombia
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Seijo M, Minckas N, Cormick G, Comandé D, Ciapponi A, BelizÁn JM. Comparison of self-reported and directly measured weight and height among women of reproductive age: a systematic review and meta-analysis. Acta Obstet Gynecol Scand 2018; 97:429-439. [DOI: 10.1111/aogs.13326] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/05/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Mariana Seijo
- Department of Mother and Child Health Research; Institute for Clinical Effectiveness and Health Policy (IECS-CONICET); Buenos Aires Argentina
| | - Nicole Minckas
- Department of Mother and Child Health Research; Institute for Clinical Effectiveness and Health Policy (IECS-CONICET); Buenos Aires Argentina
| | - Gabriela Cormick
- Department of Mother and Child Health Research; Institute for Clinical Effectiveness and Health Policy (IECS-CONICET); Buenos Aires Argentina
- Department of Human Biology; Faculty of Health Sciences; University of Cape Town; Cape Town South Africa
| | - Daniel Comandé
- Argentine Cochrane Center; Institute for Clinical Effectiveness and Health Policy (IECS-CONICET); Buenos Aires Argentina
| | - Agustín Ciapponi
- Argentine Cochrane Center; Institute for Clinical Effectiveness and Health Policy (IECS-CONICET); Buenos Aires Argentina
| | - José M. BelizÁn
- Department of Mother and Child Health Research; Institute for Clinical Effectiveness and Health Policy (IECS-CONICET); Buenos Aires Argentina
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Leneuve-Dorilas M, Favre A, Carles G, Louis A, Nacher M. Risk factors for premature birth in French Guiana: the importance of reducing health inequalities. J Matern Fetal Neonatal Med 2017; 32:1388-1396. [PMID: 29130760 DOI: 10.1080/14767058.2017.1403578] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES French Guiana has the highest birth rate in South America. This French territory also has the highest premature birth rate and perinatal mortality rate of all French territories. The objective was to determine the premature birth rate and to identify the prevalence of risk factors of premature birth in French Guiana. METHODS A retrospective study of all births in French Guiana was conducted between January 2013 and December 2014 using the computerized registry compiling all live births over 22 weeks of gestation on the territory. RESULTS During this period 12 983 live births were reported on the territory. 13.5% of newborns were born before 37 (1755/12 983). The study of the registry revealed that common sociodemographic risk factors of prematurity were present. In addition, past obstetrical history was also important: a scarred uterus increased the risk of prematurity adjusted odds ratio =1.4, 95%CI (1.2-1.6). Similarly, obstetrical surveillance, the absence of preparation for birth or of prenatal interview increased the risk of prematurity by 2.4 and 2.3, the excess fraction in the population was 69% and 72.2%, respectively. CONCLUSIONS Known classical risk factors are important. In the present study excess fractions were calculated in order to prioritize interventions to reduce the prematurity rate.
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Affiliation(s)
| | - Anne Favre
- a Centre Hospitalier Andree Rosemon , Cayenne , French Guiana
| | - Gabriel Carles
- b Centre Hospitalier de l'Ouest Guyanais , Saint-Laurent du Maroni , French Guiana
| | - Alphonse Louis
- a Centre Hospitalier Andree Rosemon , Cayenne , French Guiana
| | - Mathieu Nacher
- a Centre Hospitalier Andree Rosemon , Cayenne , French Guiana
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Longitud cervical en el segundo trimestre por ecografía transperineal para la predicción de parto pretérmino. PERINATOLOGÍA Y REPRODUCCIÓN HUMANA 2016. [DOI: 10.1016/j.rprh.2016.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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