Diabetic and hypertensive disorders following early pregnancy loss: a systematic review and meta-analysis.

Background: Spontaneous and induced abortions are common outcomes of pregnancy. There is inconsistent evidence of an association between early pregnancy loss and subsequent diabetic and hypertensive disorders in women. This systematic review and meta-analysis evaluated evidence on the risk of the subsequent development of pregnancy and non-pregnancy related diabetic and hypertensive disorders in women who experienced an early pregnancy loss. Methods: Systematic searches were conducted in seven electronic databases (CINAHL Plus, Ovid/EMBASE, Ovid/MEDLINE, ProQuest, PubMed, Scopus, and Web of Science) from inception to 22nd December 2023. Studies were included if they reported an exposure of spontaneous abortion (SAB), induced abortion (IA) or recurrent pregnancy loss (RPL) with an outcome of gestational diabetes mellitus, pre-eclampsia, gestational hypertension, and non-pregnancy related diabetic and hypertensive disorders. Risk of bias was assessed using Risk of Bias Instrument for Non-Randomized Studies of Exposures (ROBINS-E). Random effects meta-analysis was used to pool odds of developing diabetic and hypertensive disorders following an early pregnancy loss. This study is registered with PROSPERO (CRD42022327689). Findings: Of 20,176 records, 60 unique articles were identified for full-text review and 52 met the inclusion criteria, representing a total population of 4,132,895 women from 22 countries. Thirty-five studies were suitable for meta-analysis, resulting in a pooled odds ratio (OR) of 1.44 (95% confidence interval (CI) 1.23-1.68) for gestational diabetes mellitus following a prior SAB and a pooled OR of 1.06 (95% CI 0.90-1.26) for pre-eclampsia following a prior SAB. RPL increased the odds of developing pre-eclampsia (OR 1.37 95% CI 1.05-1.79). There was no association between IA and diabetic and hypertensive disorders. Interpretation: A prior SAB was associated with increased odds of gestational diabetes mellitus, but not pre-eclampsia. However, women who experienced RPL had an increased risk of subsequent pre-eclampsia. Future research is required to establish evidence for an association between early pregnancy loss with non-pregnancy related diabetic and hypertensive disorders. Funding: National Health and Medical Research Council.

Maternal Pregnancy and Pre-Pregnancy Weight and Behavioural Outcomes in Children.

Reported associations of pre-pregnancy weight and/or gestational weight gain with offspring behavioural outcomes are inconsistent. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), this study aimed to examine these associations at five developmental stages between the ages of 3 and 16. Over 6800 mother-offspring pairs at age 3 and 3925 pairs at age 16 were included. Pre-pregnancy underweight was associated with a 22% increased risk of total behavioural difficulties (OR = 1.22, 95% CI 1.02-1.45). In separate analyses using the SDQ subscales, pre-pregnancy underweight was linked to a 37% (OR = 1.37, 95% CI 1.14-1.65) and 33% (OR = 1.33, 95% CI 1.01-1.76) increased risk of emotional symptoms and prosocial behaviour problems over time, respectively. While pre-pregnancy overweight was associated with an 11% (OR = 1.11, 95% CI 1.03-1.20) and 18% (OR = 1.18, 95% CI 1.03-1.36) increased risk of conduct and peer relationship problems, respectively, pregnancy obesity was associated with a 43% increased risk of emotional problems (OR = 1.43, 95% CI 1.16-1.77). We found no evidence of associations between gestational weight gain and child behaviour except for a reduced risk in prosocial behaviour problems (OR = 0.82, 95% CI 0.70-0.96). Our findings provide insights into the link between preconception BMI and child behaviour, underscoring the necessity for further research to validate these associations and elucidate underlying mechanisms.

Evidence-based practice and its associated factors among medical laboratory professionals in West Amhara hospitals, Northwest Ethiopia.

BACKGROUND: Healthcare and clinical laboratory practices are constantly evolving, leading a need for evidence-based practice (EBP) among all laboratory professionals. However, EBP among laboratory professionals has not yet been studied in Ethiopia. AIMS: This study aimed to determine EBP and associated factors among medical laboratory professionals in West Amhara hospitals, Northwest Ethiopia. METHODS: An analytic and descriptive cross-sectional study was conducted in West Amhara hospitals from February to March 2014. Data were collected using a pretested, structured self-administered questionnaire. Bivariate and multivariate logistic regressions were performed to identify factors associated with evidence-based laboratory practice. Odds ratios with 95% confidence interval (CI) were computed and the level of significance determined. RESULTS: A total of 169 respondents completed the questionnaire (response rate 95.4%), 40.8% (n = 69) of whom had a good level of EBP. Knowledge about EBP [adjusted odds ratio (AOR) = 2.22, 95% CI: 1.10-4.49], internet access (AOR = 2.43, 95% CI: 1.12-5.29), adoption EBP (AOR = 2.79, 95% CI: 1.41-5.52) and being single in marital status (AOR = 2.21, 95% CI: 1.08-4.51) were factors associated with EBP in multivariable logistic regression after controlling the effects of the confounding variables. CONCLUSION: EBP among laboratory professionals was found to be low. Having good knowledge towards EBP, organizational adoption of EBP, having internet access in their organization and being single in marital status were factors associated with EBP.