Erythropoietin and retinopathy of prematurity: a meta-analysis.

UNLABELLED: We performed a meta-analysis to study the association between erythropoietin (EPO) and the development of retinopathy of prematurity (ROP) in preterm newborn infants. Studies were identified through PubMed (1966-) and ISI databases (1965-) literature searches. Results and effect sizes are expressed as odds ratio (OR) with 95 % confidence intervals (CI). Fourteen studies identified to the meta-analysis, including 3,484 preterm newborn infants. A total of 563 of 1,221 babies treated with EPO had ROP (46.1 %) vs. 420 of 1,134 babies without EPO (37.0 %). No significant difference was found in the ROP risk between the two groups, with the OR 1.592 (95 % CI 0.901-2.812). A total of 192 of 1,298 babies treated with EPO had severe ROP (stage 3-4) (14.8 %) vs. 166 of 1,199 babies without EPO (13.8 %). The OR was 1.203 (95 % CI 0.763-1.896). No significant publication bias was found. Sensitivity analyses showed the results were robust. CONCLUSION: Our meta-analysis indicates that EPO treatment is not associated with the development of ROP in preterm infants. But this conclusion should be confirmed by further high-quality researches.

Violence as a risk factor for postpartum depression in mothers: a meta-analysis.

The objective of this paper is to examine the association between violence and postpartum depression (PPD). The data sources of this study are: Web of Science, PubMed, Elsevier, Springer Link were examined from their start date through July1, 2011. "Violence", "domestic violence", "physical violence", "sexual violence", "domestic violence", "postpartum depression", "postnatal depression", and "puerperal depression" were some of the terms included in the purview of MeSH terms. Relevant studies from reference lists were also scanned. Studies examining the association between violence and postpartum depression have been included. A total of 679 studies were included in this screening. Essential information of these included studies was independently extracted by two raters. Newcastle-Ottawa scale was used to assess the clinical data of these research studies. Random-effects model was chosen in this meta-analysis for maintaining significant heterogeneity. Publication bias was evaluated with the help of a funnel plot. Six studies involving 3,950 participants were included in this clinical study. Violence was one of the factors responsible for PPD [OR = 3.47; 95% confidence interval (CI; 2.13-5.64)]. Significant heterogenity was found in this meta-analysis (P < 0.00001; I (2) = 79%)and publication bias was detected through a funnel plot. A sensitivity analysis of 3.00, 95%CI (2.44-3.68), p < 0.00001 indicated that our findings were robust and reliable. Our meta-analysis indicated a positive correlation between violence and PPD. In women of reproductive age, PPD induced through violence can be prevented through early identification. In addition, due to heterogeneity and wide CIs in this meta-analysis, further research is evidently required.

Prevalence, correlates, and network analysis of Internet addiction symptoms among Chinese pregnant and postpartum women.

OBJECTIVE: Excessive Internet use is a common health problem globally. This study aimed to assess the prevalence, correlates, and network structure of Internet addiction symptoms (Internet addiction hereafter) among Chinese pregnant and postpartum women. METHODS: This was a multicenter cross-sectional study using Internet Addiction Test (IAT) and the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) to evaluate Internet addiction and quality of life (QOL), respectively. Univariate analyses, multivariate logistic regression analyses, and network analyses were performed. RESULTS: Of a total of 1,060 women who completed the study, 320 (30.19%, 95% CI=27.42%-32.96%) women reported Internet addiction during or after pregnancy. Women with previous adverse pregnancy experiences (OR=1.831, P=0.001) and physical comorbidities (OR=1.724, P=0.004) had a higher likelihood of developing Internet addiction. Internet addiction was significantly associated with poor QOL in all domains. Network analyses revealed that IAT item 16 (request an extension for longer time spent online) was the most central symptom in the analyses, and also one of the strongest bridging symptoms linking the Internet addiction and QOL communities. LIMITATIONS: This was a cross-sectional study, all study findings were based on self-reported data, and possible recall bias and selection bias may exist. CONCLUSION: Internet addiction is common among Chinese pregnant and postpartum women, and is significantly associated with lower QOL. Effective strategies, especially focusing on central symptoms, are needed to reduce the impact of Internet addiction and improve QOL in pregnant and postpartum women.

Secondhand smoking exposure and quality of life among pregnant and postnatal women: a network approach.

OBJECTIVE: This study examined the prevalence of exposure to secondhand smoke, its correlates and its association with quality of life (QOL) among pregnant and postnatal Chinese women. DESIGN: This was a multicentre, cross-sectional study. SETTING: Participants were consecutively recruited from eight tertiary hospitals located in eight municipalities or provinces in China. PARTICIPANTS: A total of 1140 women were invited to join this study and 992 (87.02%) completed all measures. PRIMARY AND SECONDARY OUTCOME: Measures women's secondhand smoking behaviour (frequency and location of exposure to secondhand smoking), and their QOL measured by the WHO Quality of Life Questionnaire. RESULTS: A total of 211 women (21.3%, 95% CI 18.7% to 23.8%) had been exposed to secondhand smoking. Exposure to secondhand smoking was most common in public areas (56.4%), and residential homes (20.5%), while workplaces had the lowest rate of exposure (13.7%). Women with physical comorbidities were more likely to report secondhand smoking exposure, while older women, women living in urban areas, those with college or higher education level, and women in their second trimester were less likely to report exposure to secondhand smoking. Network analysis revealed that there were six significant links between secondhand smoke and QOL items. The strongest negative edge was the connection between secondhand smoke and QOL9 ('physical environment health', edge weight=-0.060), while the strongest positive edge was the connection between secondhand smoke and QOL3 ('pain and discomfort', edge weight=0.037). CONCLUSION: The prevalence of exposure to secondhand smoking is becoming lower among pregnant and postnatal women in China compared with findings reported in previous studies. Legal legislation should be maintained and promptly enforced to establish smoke-free environments in both public and private urban/rural areas for protection of pregnant and postnatal women, especially those who are physically vulnerable and less educated.

The Prevalence of Depression and Its Association With Quality of Life Among Pregnant and Postnatal Women in China: A Multicenter Study.

Background: This study examined the prevalence of depressive symptoms (depression hereafter) and its association with quality of life (QOL) among pregnant and postnatal women in China. Methods: In this multi-center, cross-sectional study, 1,060 pregnant and postnatal women from eight hospitals were assessed. Depression and QOL were measured using the Edinburgh Postnatal Depression Scale and the World Health Organization Quality of Life Questionnaire - brief version, respectively. Results: The prevalence of depression was 7.45% (95% CI: 5.87-9.04%) in the sample. Women with depression had lower QOL in physical, psychological, social and environmental domains compared to those without. Women with physical comorbidities were more likely to suffer from depression (OR = 2.391, 95% CI = 1.384-4.130, P = 0.002). Conclusion: Due to its negative association with QOL, increased attention should be paid to depression in pregnant and postnatal women. Regular screening assessment and preventive measures should be adopted to reduce risk of depression in this population.

Superiority of 5% NaHCO3 for preoperative hair removal in patients undergoing coronary artery bypass graft surgery with a limb vein: a randomized controlled trial†.

OBJECTIVES: Compared with a dry environment with talcum powder, a wet, alkaline environment with NaHCO3 solution is better for hair removal, as it can soften and expand the hair, decrease the friction and shear forces on the skin, and make hair removal easier and more efficient. The purpose of this study was to compare the effects of a preoperative skin preparation of 5% NaHCO3 with that of talcum powder for softening hair in patients undergoing coronary artery bypass graft (CABG) surgery with the saphenous vein. METHODS: A prospective randomized, single-blinded, controlled study was established. Between March 2012 and June 2013, 120 patients who met the inclusion and exclusion criteria underwent elective CABG surgery with the saphenous vein in our hospital. The same doctor obtained the saphenous vein of each patient by a uniform method. CABG surgery was performed through an open or endoscopic technique, according to each patient's condition. Patients were divided into two groups of 60 patients each, according to whether the preoperative skin preparation procedure was performed with a 5% solution of NaHCO3 at 45-50°C (experimental group) or with talcum powder (control group). Main outcome measures were the incision inflammation rate, skin preparation time, presence of shaving-induced macroscopic haemorrhagic spots, verbal rating scale (VRS) pain score and satisfaction. RESULTS: Neither group had any evidence of incision inflammation. The average (mean ± standard deviation) skin preparation time of the experimental group was shorter than that of the control group (5.58 ± 1.52 vs 9.74 ± 1.23 min, P < 0.001). Three patients in the experimental group and 17 in the control group had shaving-induced macroscopic haemorrhagic spots after skin preparation (P = 0.001). The VRS pain scores were different between the two groups (P < 0.001). In the control group, 40% of patients and 37% of nurses were satisfied with the skin preparation procedure, compared with 95 and 90%, respectively, in the experimental group (both P < 0.001). CONCLUSIONS: Hair softening with a 5% NaHCO3 solution protected the skin integrity, alleviated pain and improved patient satisfaction to a greater extent than talcum powder. Nurses found the 5% NaHCO3 solution to be more convenient and less time-consuming to use.

Pressure-redistribution surfaces for prevention of surgery-related pressure ulcers: a meta-analysis .

Pressure-redistribution surfaces are generally recommended to prevent pressure ulcers (PUs) in high-risk patients, but their use in surgery-related PU prevention remains controversial. A meta-analysis was conducted to assess the relative preventive impact of pressure-redistribution surfaces versus standard hospital mattresses (usually a hospital-issue, foam-based mattress) on the incidence of surgery-related PUs. Systematic literature searches were performed using the terms pressure ulcer, operation, surgery, mattress, foam, polymer, pad, overlay, surface, and interface. Country, race, language, and publication year of articles was not restricted; randomized or quasi-randomized controlled trials were eligible for analysis. Odds ratio (OR) with 95% confidence intervals (CIs) for surgery-related PU incidence in patients using support surfaces versus standard mattress were calculated by random-effects model. Of the 316 studies identified, 10 involving a total of 1,895 patients were eligible for inclusion in the meta-analysis. Seven studies were randomized, controlled and three were quasi-randomized controlled trials. Patients who were provided a support surface had a significantly decreased incidence of surgery-related PUs (OR 0.31 [95% CI 0.17-0.59]) compared to patients using a standard mattress. Subgroup analysis showed pressure-redistribution surfaces used intra-operatively did not decrease the incidence of surgery-related PUs (OR 0.59, [95% CI 0.34-1.01]), but PU incidence decreased with postoperative (OR 0.07 [95% CI 0.01-0.49]) as well as with intra-operative and postoperative use (OR 0.20 [95% CI 0.06-0.73]). Funnel plot diagrams suggest a minimal risk of bias. Sensitivity analysis did not materially change the result of the main metaanalysis. Postoperative use of pressure-redistribution surfaces can effectively decrease the incidence of surgery-related PUs, but evidence to substantiate intra-operative use is insufficient. Patients at high risk for surgery-related PUs should be placed on a pressure-redistribution surface during the postoperative period, but intra-operative use can remain prudent until more well-designed, adequately powered, urgently needed studies are performed.