Dataset Information

Gestational triclosan exposure and infant birth weight: A systematic review and meta-analysis.

ABSTRACT:

Background

Exposure to triclosan, an antimicrobial chemical used in some personal care and cleaning products, has been associated with reduced birth weight in some, but not all epidemiological studies.

Objectives

We conducted a systematic review and meta-analysis to characterize the relation of gestational triclosan exposure with infant birth weight and identify sources of heterogeneity between studies.

Methods

We identified original studies measuring urinary triclosan concentrations during pregnancy and reporting their association with infant birth weight, gestational age (GA) adjusted birth weight (g), or GA-standardized birth weight z-scores. Using a random effects model, we estimated differences in these outcomes per 10-fold increase in triclosan concentrations and considered triclosan levels and infant sex as sources of heterogeneity. Using Navigation Guide Methods, we evaluated risk of bias within individual studies and across the body of evidence.

Results

Among thirteen studies, median triclosan concentrations varied by almost 2-orders of magnitude (0.6-29 ng/mL), with higher concentrations in North American and some European studies compared to Asian ones. Associations between triclosan and birth weight (β:-20 g; 95% CI:-65, 26; n = 6) were stronger than those for GA-adjusted birth weight (β:-12 g; 95% CI:-29, 5; n = 9). Triclosan was not associated with GA-standardized birth weight z-scores (β:-0.04; 95% CI:-0.16, 0.07; n = 5). The association between triclosan and GA-adjusted birth weight was stronger in studies with median triclosan values ≥10 ng/mL compared to studies with median values < 10 ng/mL (β:-27 g; 95% CI:-61, 7; n = 4 vs. β:6g; 95% CI:-20, 31; n = 5). With a limited number of studies, we observed suggestive evidence that inverse associations were more apparent in studies with ≥ 2 prospective triclosan measures compared to those with one measure.

Discussion

Available evidence, with "low" risk of bias, provides limited evidence that triclosan exposure and reduces infant birth weight. We observed stronger inverse associations between triclosan concentrations and birth weight in populations with higher triclosan exposure.

SUBMITTER: Patti MA

PROVIDER: S-EPMC8576608 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Publications

Gestational triclosan exposure and infant birth weight: A systematic review and meta-analysis.

Patti Marisa A MA Henderson Noelle B NB Gajjar Priya P Eliot Melissa M Jackson-Browne Medina M Braun Joseph M JM

Environment international 20210921

<h4>Background</h4>Exposure to triclosan, an antimicrobial chemical used in some personal care and cleaning products, has been associated with reduced birth weight in some, but not all epidemiological studies.<h4>Objectives</h4>We conducted a systematic review and meta-analysis to characterize the relation of gestational triclosan exposure with infant birth weight and identify sources of heterogeneity between studies.<h4>Methods</h4>We identified original studies measuring urinary triclosan conc ...[more]

PMID: 34560323

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Project description:ImportanceBody mass index (BMI) and gestational weight gain are increasing globally. In 2009, the Institute of Medicine (IOM) provided specific recommendations regarding the ideal gestational weight gain. However, the association between gestational weight gain consistent with theIOM guidelines and pregnancy outcomes is unclear.ObjectiveTo perform a systematic review, meta-analysis, and metaregression to evaluate associations between gestational weight gain above or below the IOM guidelines (gain of 12.5-18 kg for underweight women [BMI <18.5]; 11.5-16 kg for normal-weight women [BMI 18.5-24.9]; 7-11 kg for overweight women [BMI 25-29.9]; and 5-9 kg for obese women [BMI ≥30]) and maternal and infant outcomes.Data sources and study selectionSearch of EMBASE, Evidence-Based Medicine Reviews, MEDLINE, and MEDLINE In-Process between January 1, 1999, and February 7, 2017, for observational studies stratified by prepregnancy BMI category and total gestational weight gain.Data extraction and synthesisData were extracted by 2 independent reviewers. Odds ratios (ORs) and absolute risk differences (ARDs) per live birth were calculated using a random-effects model based on a subset of studies with available data.Main outcomes and measuresPrimary outcomes were small for gestational age (SGA), preterm birth, and large for gestational age (LGA). Secondary outcomes were macrosomia, cesarean delivery, and gestational diabetes mellitus.ResultsOf 5354 identified studies, 23 (n = 1 309 136 women) met inclusion criteria. Gestational weight gain was below or above guidelines in 23% and 47% of pregnancies, respectively. Gestational weight gain below the recommendations was associated with higher risk of SGA (OR, 1.53 [95% CI, 1.44-1.64]; ARD, 5% [95% CI, 4%-6%]) and preterm birth (OR, 1.70 [1.32-2.20]; ARD, 5% [3%-8%]) and lower risk of LGA (OR, 0.59 [0.55-0.64]; ARD, -2% [-10% to -6%]) and macrosomia (OR, 0.60 [0.52-0.68]; ARD, -2% [-3% to -1%]); cesarean delivery showed no significant difference (OR, 0.98 [0.96-1.02]; ARD, 0% [-2% to 1%]). Gestational weight gain above the recommendations was associated with lower risk of SGA (OR, 0.66 [0.63-0.69]; ARD, -3%; [-4% to -2%]) and preterm birth (OR, 0.77 [0.69-0.86]; ARD, -2% [-2% to -1%]) and higher risk of LGA (OR, 1.85 [1.76-1.95]; ARD, 4% [2%-5%]), macrosomia (OR, 1.95 [1.79-2.11]; ARD, 6% [4%-9%]), and cesarean delivery (OR, 1.30 [1.25-1.35]; ARD, 4% [3%-6%]). Gestational diabetes mellitus could not be evaluated because of the nature of available data.Conclusions and relevanceIn this systematic review and meta-analysis of more than 1 million pregnant women, 47% had gestational weight gain greater than IOM recommendations and 23% had gestational weight gain less than IOM recommendations. Gestational weight gain greater than or less than guideline recommendations, compared with weight gain within recommended levels, was associated with higher risk of adverse maternal and infant outcomes.

Project description:IntroductionAn increased metabolic demand during pregnancy is fulfilled by gaining sufficient gestational weight. Women who gain inadequate-weight are at a high-risk of premature birth or having a baby with low-birth weight. However, women who gain excessive-weight are at a high-risk of having a baby with macrosomia. The aim of this review was to determine the distribution of gestational weight gain and its association with birth-outcomes in Sub-Saharan Africa.MethodsFor this systematic review and meta-analysis, we performed a literature search using PubMed, Medline, Embase, Scopus, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. We searched grey-literature from Google and Google Scholar, and region-specific journals from the African Journals Online (AJOL) database. We critically appraised the included studies using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Two independent reviewers evaluated the quality of the studies and extracted the data. We calculated pooled relative-risks (RR) with 95% confidence intervals.ResultsOf 1450 retrieved studies, 26 met the inclusion criteria. Sixteen studies classified gestational weight gain according to the United States Institute of Medicine recommendations. The percentage adequate amount of gestational weight ranged from 3% to 62%. The percentage of inadequate weight was >50% among nine studies. Among underweight women, the percentage of women who gained inadequate gestational weight ranged from 67% to 98%. Only two studies were included in the meta-analyses to evaluate the association of gestational weight gain with pre-eclampsia and macrosomia. No difference was observed among women who gained inadequate and adequate gestational weight regarding experiencing pre-eclampsia (RR, 0.71; 95% CI: 0.22, 2.28, P = 0.57). Excessive gestational weight gain was not significantly associated with macrosomia compared to adequate weight gain (RR, 0.68; 95% CI: 0.38, 1.22, P = 0.20).ConclusionA substantial proportion of sub-Saharan African women gain inadequate gestational weight particularly high among underweight women. Future interventions would need to design effective pre-pregnancy weight management strategies.

Project description:BackgroundThe prevalence of excessive gestational weight gain (EGWG) during pregnancy is increasing, and it is extremely harmful to pregnant women and newborns. Previous studies have suggested that EGWG is associated with various factors. We conducted a systematic review and meta-analysis to identify, quantify and analyze determinants of EGWG and evaluate the effect of these determinants on EGWG.MethodsWe searched for articles, from January 2009 to November 2020, related to the determinants of EGWG during pregnancy using four Chinese and four English databases. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was utilized to guide the systematic review and meta-analysis process.ResultsSeventy studies, which identified EGWG factors in pregnant women (58 factors, 3 themes: individual [7 aspects, 37 factors]; family [4 aspects, 8 factors]; and social [4 aspects, 13 factors]), were included and analyzed in the systematic review. A meta-analysis was conducted for 13 factors (including 10 individual factors, 2 family factors, and 1 social factor) and revealed that pre-pregnancy overweight (including obesity), younger age (≤ 30 years old), unemployed, primiparity, smoking, and being unmarried (including divorced) were risk factors for EGWG, while prepregnancy underweight and inadequate antenatal care were protective factors for EGWG. There was no significant correlation between EGWG and education level, alcohol consumption, planning pregnancy, food security, and whether access to nutrition guidance during pregnancy.ConclusionsEGWG was prevalent in pregnant women, and its prevalence seemed to be high and similar in many countries. Based on observational studies with medium-level and high-level evidence, some individual, family, and social factors were found to be associated with EGWG using qualitative and quantitative methods. In the future, exposure of pregnant women to risk factors for EGWG should be avoided, and interventions should be developed around the identified factors.

Project description:BackgroundGroup visits for chronic medical conditions in non-pregnant populations have demonstrated successful outcomes including greater weight loss compared to individual visits for weight management. It is plausible that group prenatal care can similarly assist women in meeting gestational weight gain goals. The purpose of this study was to evaluate the effect of group vs. traditional prenatal care on gestational weight gain.MethodsA keyword search of Medline, Embase, Scopus, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, clinicaltrials.gov, and Google Scholar was performed up to April 2017. Studies were included if they compared gestational weight gain in a group prenatal care setting to traditional prenatal care in either randomized controlled trials, cohort, or case-control studies. The primary and secondary outcomes were excessive and adequate gestational weight gain according to the Institute of Medicine guidelines. Heterogeneity was assessed with the Q test and I2 statistic. Pooled relative risks (RRs) and confidence intervals (CI) were reported with random-effects models from the randomized controlled trials (RCT) and cohort studies.ResultsOne RCT, one secondary analysis of an RCT, one study with "random assignment", and twelve cohort studies met the inclusion criteria for a total of 13,779 subjects. Thirteen studies used the CenteringPregnancy model, defined by 10 sessions that emphasize goal setting and self-monitoring. Studies targeted specific populations such as adolescents, African-Americans, Hispanics, active-duty military or their spouses, and women with obesity or gestational diabetes. There were no significant differences in excessive [7 studies: pooled rates 47% (1806/3582) vs. 43% (3839/8521), RR 1.09, 95% CI 0.97-1.23] or adequate gestational weight gain [6 studies: pooled rates 31% (798/2875) vs. 30% (1410/5187), RR 0.92, 95% CI 0.79-1.08] in group and traditional prenatal care among the nine studies that reported categorical gestational weight gain outcomes in the meta-analysis.ConclusionsGroup prenatal care was not associated with excessive or adequate gestational weight gain in the meta-analysis. Since outcomes were overall inconsistent, we propose that prenatal care models (e.g., group vs. traditional) should be evaluated in a more rigorous fashion with respect to gestational weight gain.

Project description:BackgroundGestational weight gain has been associated with some adverse perinatal outcomes, but few studies have examined the association between gestational weight gain and offspring's cognition and their conclusions are inconsistent. Our systematic review and meta-analysis aimed to synthesize the evidence regarding the association between gestational weight gain and offspring's cognitive skills.MethodsIn this systematic review and meta-analysis (PROSPERO number, CRD42017073266), we systematically searched MEDLINE, EMBASE, Web of Science and the Cochrane Library for studies examining association between gestational weight gain and offspring's cognitive skills, without restriction in study design or language. Two reviewers extracted in an independent way the data. The Quality of Reporting of Observational Longitudinal Research scale was used to assess the quality of included studies. Effect size (ES) for adjusted models and their corresponding 95% confidence intervals were calculated for (i) intelligence quotient, (ii) language related skills and (iii) mathematic related skills comparing offspring's cognitive skills when gestational weight gain was within recommendations (as reference) with those from mothers whose gestational weight gain was above or below the recommendations.ResultsThirteen studies were included. There was a positive trend that associated gestational weight gain above recommendations with better offspring's intelligence quotient, although not statistically significant (ES 0.02, 95% CI -0.00, 0.05; I2 = 0.00%).ConclusionsThere is a not significant positive association between gestational weight gain above recommendations and intelligence quotient and some studies reported associations between gestational weight gain and offspring's cognitive skills. Our analyses confirm a wide variability in the results of studies published so far and highlights the need for conducting studies including specific samples of pregnant women by pre-pregnancy body mass index and trimester of pregnancy.

Dataset Information

Gestational triclosan exposure and infant birth weight: A systematic review and meta-analysis.

Background

Objectives

Methods

Results

Discussion

Publications

Gestational triclosan exposure and infant birth weight: A systematic review and meta-analysis.

Similar Datasets

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