Displaying publications 41 - 53 of 53 in total

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  1. Kaur S, Teoh AN, Shukri NHM, Shafie SR, Bustami NA, Takahashi M, et al.
    BMC Pregnancy Childbirth, 2020 Feb 11;20(1):96.
    PMID: 32046676 DOI: 10.1186/s12884-020-2797-2
    BACKGROUND: Circadian rhythm plays an important role as our internal body's clock that synchronizes behavior and physiology according to the external 24-h light-dark cycle. Past studies have associated disrupted circadian rhythm with higher risk of miscarriages, preterm birth and low birth weights. This paper described the protocol of a prospective cohort study which aims to determine the circadian rhythm in pregnant women, identify its association with maternal factors during pregnancy, gestational weight gain, birth and infant outcomes.

    METHODS: Ten government maternal and child health clinics in Kuala Lumpur, Malaysia will be randomly selected. Sample size of 438 first-trimester pregnant women will be followed-up until the birth of their infant. Salivary melatonin and cortisol concentration among subsample will be determined using enzyme-linked immunosorbent assay. Data on sleep quality, psychological distress and morningness/eveningness chronotype of pregnant women will be collected using validated questionnaires. Pedometer will be used to measure 5-day physical activity data. Total gestational weight gain will be determined at the end of pregnancy. Utilization of 3-day food record is to capture meal timing and nutrient intake. All measurements will be done in 2nd and 3rd trimester. Birth outcomes will be collected through clinic records and Centers for Disease Control and Prevention (CDC) Neonatal questionnaire. Infants will be followed-up at 6 and 12 months old to obtain anthropometric measurements.

    DISCUSSION: There is a growing recognition of the role of maternal circadian rhythm, which entrains fetal circadian rhythms that may subsequently have long-term health consequences. The present study will identify the effect of circadian rhythm on pregnancy outcomes and infant growth in the first year of life.

  2. Norhayati MN, Nik Hazlina NH, Asrenee AR, Sulaiman Z
    BMC Pregnancy Childbirth, 2017 Jun 15;17(1):189.
    PMID: 28619038 DOI: 10.1186/s12884-017-1377-6
    BACKGROUND: Maternal mortality has been the main way of ascertaining the outcome of maternal and obstetric care. However, maternal morbidities occur more frequently than maternal deaths; therefore, maternal near miss was suggested as a more useful indicator for the evaluation and improvement of maternal health services. Our study aimed to explore the experiences of women with maternal near miss and their perception of the quality of care in Kelantan, Malaysia.

    METHODS: A qualitative phenomenological approach with in-depth interview method was conducted in two tertiary hospitals in Kelantan, Malaysia. All women admitted to labour room, obstetrics and gynaecology wards and intensive care units in 2014 were screened for the presence of any vital organ dysfunction or failure based on the World Health Organization criteria for maternal near miss. Pregnancy irrespective of the gestational age was included. Women younger than 18 years old, with psychiatric disorder and beyond 42 days of childbirth were excluded.

    RESULTS: Thirty women who had experienced maternal near miss events were included in the analysis. All were Malays between the ages of 22 and 45. Almost all women (93.3%) had secondary and tertiary education and 63.3% were employed. The women's perceptions of the quality of their care were influenced by the competency and promptness in the provision of care, interpersonal communication, information-sharing and the quality of physical resources. The predisposition to seek healthcare was influenced by costs, self-attitude and beliefs.

    CONCLUSIONS: Self-appraisal of maternal near miss, their perception of the quality of care, their predisposition to seek healthcare and the social support received were the four major themes that emerged from the experiences and perceptions of women with maternal near miss. The women with maternal near miss viewed their experiences as frightening and that they experienced other negative emotions and a sense of imminent death. The factors influencing women's perceptions of quality of care should be of concern to those seeking to improve services at healthcare facilities. The addition of a maternal near miss case review programme, allows for understanding on the factors related to providing care or to the predisposition to seek care; if addressed, may improve future healthcare and patient outcomes.

  3. Shaiful Bahari I, Norhayati MN, Nik Hazlina NH, Mohamad Shahirul Aiman CAA, Nik Muhammad Arif NA
    BMC Pregnancy Childbirth, 2021 Dec 13;21(1):823.
    PMID: 34903212 DOI: 10.1186/s12884-021-04301-7
    BACKGROUND: Over the last two decades, there has been significant growth in public, political, and academic awareness of polygamy. Polygamous families have distinct household problems, usually stemming from jealousy between co-wives over the husband's affections and resources. This study aimed to ascertain the psychological impact of polygamous marriage on women and children worldwide.

    METHODS: A systematic search was performed in MEDLINE (PubMed), Scopus, CINAHL (EBSCOhost), Google Scholar, and ProQuest using search terms such as "marriage" and "polygamy." Studies published from the inception of the respective databases until April 2021 were retrieved to assess their eligibility for inclusion in this study. The Joanna Briggs Institute Critical Appraisal Checklist was used for data extraction and the quality assessment of the included studies. The generic inverse variance and odds ratios with 95% confidence intervals (CI) were calculated using RevMan software.

    RESULTS: There were 24 studies fulfilling the eligibility criteria, and 23 studies had a low risk of bias. The pooled meta-analysis showed women in polygamous marriages had a 2.25 (95% CI: 1.20, 4.20) higher chance of experiencing depression than in monogamous marriages. Children with polygamous parents had a significantly higher Global Severity Index with a mean difference of 0.21 (95% CI: 0.10, 0.33) than those with monogamous parents.

    CONCLUSIONS: The psychological impact of polygamous marriage on women and children was found to be relatively higher than monogamous marriage. Awareness of the proper practices for polygamy should be strengthened so that its adverse effects can be minimized. The agencies involved in polygamous practices should broaden and enhance their understanding of the correct practice of polygamy.

  4. Chi C, Loy SL, Chan SY, Choong C, Cai S, Soh SE, et al.
    BMC Pregnancy Childbirth, 2018 03 21;18(1):69.
    PMID: 29562895 DOI: 10.1186/s12884-018-1707-3
    BACKGROUND: We assessed the impact of adopting the 2013 World Health Organization (WHO) diagnostic criteria on the rates of gestational diabetes (GDM), pregnancy outcomes and identification of women at future risk of type 2 diabetes.

    METHODS: During a period when the 1999 WHO GDM criteria were in effect, pregnant women were universally screened using a one-step 75 g 2-h oral glucose tolerance test at 26-28 weeks' gestation. Women were retrospectively reclassified according to the 2013 criteria, but without the 1-h glycaemia measurement. Pregnancy outcomes and glucose tolerance at 4-5 years post-delivery were compared for women with GDM classified by the 1999 criteria alone, GDM by the 2013 criteria alone, GDM by both criteria and without GDM by both sets of criteria.

    RESULTS: Of 1092 women, 204 (18.7%) and 142 (13.0%) were diagnosed with GDM by the 1999 and 2013 WHO criteria, respectively, with 27 (2.5%) reclassified to GDM and 89 (8.2%) reclassified to non-GDM when shifting from the 1999 to 2013 criteria. Compared to women without GDM by both criteria, cases reclassified to GDM by the 2013 criteria had an increased risk of neonatal jaundice requiring phototherapy (relative risk (RR) = 2.78, 95% confidence interval (CI) 1.32, 5.86); despite receiving treatment for GDM, cases reclassified to non-GDM by the 2013 criteria had higher risks of prematurity (RR = 2.17, 95% CI 1.12, 4.24), neonatal hypoglycaemia (RR = 3.42, 95% CI 1.04, 11.29), jaundice requiring phototherapy (RR = 1.71, 95% CI 1.04, 2.82), and a higher rate of abnormal glucose tolerance at 4-5 years post-delivery (RR = 3.39, 95% CI 2.30, 5.00).

    CONCLUSIONS: Adoption of the 2013 WHO criteria, without the 1-h glycaemia measurement, reduced the GDM rate. Lowering the fasting glucose threshold identified women who might benefit from treatment, but raising the 2-h threshold may fail to identify women at increased risk of adverse pregnancy and future metabolic outcomes.

    TRIAL REGISTRATION: NCT01174875 . Registered 1 July 2010 (retrospectively registered).

  5. Vallikkannu N, Nadzratulaiman WN, Omar SZ, Si Lay K, Tan PC
    BMC Pregnancy Childbirth, 2014 Jan 28;14:49.
    PMID: 24468078 DOI: 10.1186/1471-2393-14-49
    BACKGROUND: External cephalic version (ECV) is offered to reduce the number of Caesarean delivery indicated by breech presentation which occurs in 3-4% of term pregnancies. ECV is commonly performed aided by the application of aqueous gel or talcum powder to the maternal abdomen. We sought to compare gel with powder during ECV on achieving successful version and increasing tolerability.

    METHOD: We enrolled 95 women (≥ 36 weeks gestation) on their attendance for planned ECV. All participants received terbutaline tocolysis. Regional anaesthesia was not used. ECV was performed in the standard fashion after the application of the allocated aid. If the first round (maximum of 2 attempts) of ECV failed, crossover to the opposing aid was permitted.

    RESULTS: 48 women were randomised to powder and 47 to gel. Self-reported procedure related median [interquartile range] pain scores (using a 10-point visual numerical rating scale VNRS; low score more pain) were 6 [5-9] vs. 8 [7-9] P = 0.03 in favor of gel. ECV was successful in 21/48 (43.8%) vs. 26/47 (55.3%) RR 0.6 95% CI 0.3-1.4 P = 0.3 for powder and gel arms respectively. Crossover to the opposing aid and a second round of ECV was performed in 13/27 (48.1%) following initial failure with powder and 4/21 (19%) after failure with gel (RR 3.9 95% CI 1.0-15 P = 0.07). ECV success rate was 5/13 (38.5%) vs. 1/4 (25%) P = 0.99 after crossover use of gel or powder respectively. Operators reported higher satisfaction score with the use of gel (high score, greater satisfaction) VNRS scores 6 [4.25-8] vs 8 [7-9] P = 0.01.

    CONCLUSION: Women find gel use to be associated with less pain. The ECV success rate is not significantly different.

    TRIAL REGISTRATION: The trial is registered with ISRCTN (identifier ISRCTN87231556).

  6. Jeganathan R, Karalasingam SD, Hussein J, Allotey P, Reidpath DD
    BMC Pregnancy Childbirth, 2017 Apr 08;17(1):110.
    PMID: 28390414 DOI: 10.1186/s12884-017-1293-9
    BACKGROUND: The neonatal Apgar score at 5 min has been found to be a better predictor of outcomes than the Apgar score at 1 min. A baby, however, must pass through the first minute of life to reach the fifth. There has been no research looking at predictors of recovery (Apgar scores ≥7) by 5 min in neonates with 1 min Apgar scores <4.

    METHODS: An analysis of observational data was conducted using live, singleton, term births recorded in the Malaysian National Obstetrics Registry between 2010 and 2012. A total of 272,472 live, singleton, term births without congential anomalies were recorded, of which 1,580 (0.59%) had 1 min Apgar scores <4. Descriptive methods and bi- and multi-variable logistic regression were used to identify risk factors associated with recovery (5 min Apgar score ≥7) from 1 min Apgar scores <4.

    RESULTS: Less than 1% of births have a 1 min Apgar scores <4. Only 29.4% of neonates with 1 min Apgar scores <4 recover to a 5 min Apgar score ≥7. Among uncomplicated vaginal deliveries, after controlling for other factors, deliveries by a doctor of neonates with a 1 min Apgar score <4 had odds of recovery 2.4 times greater than deliveries of neonates with a 1 min Apgar score <4 by a nurse-midwife. Among deliveries of neonates with a 1 min Apgar score <4 by doctors, after controlling for other factors, planned and unplanned CS was associated with better odds of recovery than uncomplicated vaginal deliveries. Recovery was also associated with maternal obesity, and there was some ethnic variation - in the adjusted analysis indigenous (Orang Asal) Malaysians had lower odds of recovery.

    CONCLUSIONS: A 1 min Apgar score <4 is relatively rare, and less than a third recover by five minutes. In those newborns the qualification of the person performing the delivery and the type of delivery are independent predictors of recovery as is maternal BMI and ethnicity. These are associations only, not necessarily causes, and they point to potential areas of research into health systems factors in the labour room, as well as possible biological and cultural factors.

  7. Tan PC, Ramasandran G, Sethi N, Razali N, Hamdan M, Kamarudin M
    BMC Pregnancy Childbirth, 2023 Jun 17;23(1):450.
    PMID: 37330467 DOI: 10.1186/s12884-023-05771-7
    BACKGROUND: Hyperemesis gravidarum (HG) affects about 2% of pregnancies and is at the severe end of the spectrum of nausea and vomiting of pregnancy. HG causes severe maternal distress and results in adverse pregnancy outcomes long after the condition may have dissipated. Although dietary advice is a common tool in management, trial evidence to base the advice on is lacking.

    METHODS: A randomized trial was conducted in a university hospital from May 2019 to December 2020. 128 women at their discharge following hospitalization for HG were randomized: 64 to watermelon and 64 to control arm. Women were randomized to consume watermelon and to heed the advice leaflet or to heed the dietary advice leaflet alone. A personal weighing scale and a weighing protocol were provided to all participants to take home. Primary outcomes were bodyweight change at the end of week 1 and week 2 compared to hospital discharge.

    RESULTS: Weight change (kg) at end of week 1, median[interquartile range] -0.05[-0.775 to + 0.50] vs. -0.5[-1.4 to + 0.1] P = 0.014 and to the end of week 2, + 0.25[-0.65 to + 0.975] vs. -0.5[-1.3 to + 0.2] P = 0.001 for watermelon and control arms respectively. After two weeks, HG symptoms assessed by PUQE-24 (Pregnancy-Unique Quantification of Emesis and Nausea over 24 h), appetite assessed by SNAQ (Simplified Nutritional Appetite Questionnaire), wellbeing and satisfaction with allocated intervention NRS (0-10 numerical rating scale) scores, and recommendation of allocated intervention to a friend rate were all significantly better in the watermelon arm. However, rehospitalization for HG and antiemetic usage were not significantly different.

    CONCLUSION: Adding watermelon to the diet after hospital discharge for HG improves bodyweight, HG symptoms, appetite, wellbeing and satisfaction.

    TRIAL REGISTRATION: This study was registered with the center's Medical Ethics Committee (on 21/05/2019; reference number 2019327-7262) and the ISRCTN on 24/05/2019 with trial identification number: ISRCTN96125404 . First participant was recruited on 31/05/ 2019.

  8. Teoh AN, Kaur S, Shafie SR, Shukri NHM, Bustami NA, Takahashi M, et al.
    BMC Pregnancy Childbirth, 2023 Jul 04;23(1):491.
    PMID: 37403031 DOI: 10.1186/s12884-023-05796-y
    Chrononutrition emerges as a novel approach to promote circadian alignment and metabolic health by means of time-of-the-day dietary intake. However, the relationship between maternal circadian rhythm and temporal dietary intake during pregnancy remains understudied. This study aimed to determine the change in melatonin levels in pregnant women across gestation and its association with temporal energy and macronutrient intake. This was a prospective cohort involving 70 healthy primigravidas. During the second and third trimesters, pregnant women provided salivary samples collected at 9:00, 15:00, 21:00, and 3:00 h over a 24 h day for melatonin assay. Data on chrononutrition characteristics were collected using a 3-day food record. Parameters derived from melatonin measurements including mean, amplitude, maximal level, area under the curve with respect to increase (AUCI), and area under the curve with respect to ground (AUCG) were computed. A rhythmic melatonin secretion over the day that remained stable across trimesters was observed among the pregnant women. There was no significant elevation in salivary melatonin levels as pregnancy advanced. In the second trimester, higher energy intake during 12:00-15:59 h and 19:00-06:59 h predicted a steeper melatonin AUCI (β=-0.32, p = 0.034) and higher AUCG (β = 0.26, p = 0.042), respectively. Macronutrient intake within 12:00-15:59 h was negatively associated with mean melatonin (Fat: β=-0.28, p = 0.041) and AUCG (Carbohydrate: β=-0.37, p = 0.003; Protein: β=-0.27, p = 0.036; Fat: β=-0.32, p = 0.014). As pregnant women progressed from the second to the third trimester, a flatter AUCI was associated with a reduced carbohydrate intake during 12:00-15:59 h (β=-0.40, p = 0.026). No significant association was detected during the third trimester. Our findings show that higher energy and macronutrient intakes particularly during 12:00-15:59 h and 19:00-06:59 h are associated with the disparities in maternal melatonin levels. Findings suggest the potential of time-based dietary approaches to entrain circadian rhythm in pregnant women.
  9. Salari N, Mohammadi A, Hemmati M, Hasheminezhad R, Kani S, Shohaimi S, et al.
    BMC Pregnancy Childbirth, 2023 Dec 02;23(1):830.
    PMID: 38042815 DOI: 10.1186/s12884-023-06151-x
    BACKGROUND: Back pain during pregnancy is often considered as an unavoidable problem and can reduce the quality of life or disability of pregnant women. The aim of this study is to determine the global prevalence of back pain in pregnancy based on a systematic review and meta-analysis.

    METHODS: In this study, Researchers systematically searched electronic databases PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar search engines for studies until September 2023. To analyze data, the random effects model was used, and the heterogeneity of the studies was checked with the I2 index. Data analysis was performed by software (Version 2 Comprehensive Meta-Analysis).

    RESULTS: In the review of 28 studies with a sample size of 12,908 people, the I2 heterogeneity test showed high heterogeneity (I2: 98.4). Based on this, the random effects method was used to analyze the results. Therefore, the meta-analysis reported the global prevalence of back pain at 40.5 (95% CI: 33-48.4) during pregnancy. Also, according to the meta-analysis, the global prevalence of back pain in the first trimester of pregnancy is 28.3 (95%CI: 10.5-57.1), in the second trimester is 36.8 (95%CI: 30.4-43.7) and in the third trimester of pregnancy was reported as 47.8 (95% CI: 37.2-58.6).

    CONCLUSION: In this meta-analysis, the overall prevalence of back pain in pregnant women was reported to be significant, so it is necessary for health policymakers to pay more attention to complications during pregnancy, in addition to increasing society's awareness of pregnant mothers, with timely diagnosis and treatment of such disorders, it can lead to improvement; and reduction in Complications caused by pregnancy and becoming more pleasant during pregnancy.

  10. Salari N, Mohamadi S, Hemmati M, Fallahi A, Rasoulpoor S, Zarei H, et al.
    BMC Pregnancy Childbirth, 2024 Dec 20;24(1):836.
    PMID: 39707279 DOI: 10.1186/s12884-024-07057-y
    BACKGROUND: Constipation is a common complication and an unpleasant experience during pregnancy. Due to hormonal factors, intestinal movements decrease during this time, causing the digestive system to malfunction. This study aims to explore the worldwide prevalence of constipation during pregnancy to prevent and minimize its complications.

    METHOD: Researchers conducted a meta-analysis of published data on the prevalence of constipation in pregnancy. The articles, which covered the period 1966 to 2024, were collected by searching Embase, PubMed, Scopus, Science Direct, Wos, and the Google Scholar search engine. The initial search was conducted on July 21, 2024, and the final update was made on August 10, 2024.

    RESULTS: Thirteen studies were identified to determine the prevalence of constipation during pregnancy. The results show that the global prevalence of constipation throughout pregnancy is 32.4%, with the first trimester at 21.1%, the second trimester at 34%, and the third trimester at 30.3%.

    CONCLUSION: According to a study, constipation is most common during the second trimester of pregnancy and the least common during the first trimester. Further research on the causes of constipation and prevention methods can help decrease its prevalence during pregnancy. Therefore, it is important to provide educational interventions on nutrition and encourage moderate physical activity during pregnancy to reduce the occurrence of constipation.

  11. Foong WC, Foong SC, Ho JJ, Gautam D, Leong JJ, Tan PY, et al.
    BMC Pregnancy Childbirth, 2023 Oct 03;23(1):706.
    PMID: 37789260 DOI: 10.1186/s12884-023-06021-6
    BACKGROUND: The updated World Health Organization (WHO) guideline recommends immediate kangaroo mother care (KMC) for all infants, particularly those born preterm. However, its uptake and sustainability have been unsatisfactory. Therefore, we aimed to gain deeper insight into factors influencing the uptake of KMC practice in our setting, and thereby identify possible solutions for the development of relevant interventions to improve its adoption and make KMC a routine practice for all infants.

    METHODS: Using the Triandis model of social behaviour as our framework, we conducted key informant interviews with parents and healthcare providers. Trained interviewers conducted interviews with nine parents, recruited via purposive sampling. These parents were parents of preterm infants who had been introduced to KMC. Data was transcribed and analysed based on Triandis' Theory of Interpersonal Behaviour. This paper only reports the results of the parent interviews.

    RESULTS: Major findings were how positive feelings like warmth and contentment, the sense of parenthood with KMC, the benefits of KMC for their infant and parents being enablers for KMC uptake. Conversely, the lack of KMC awareness, the initial negative feelings such as fear, uncertainty and embarrassment, the prioritization of time for milk expression, overcrowding in the ward, lack of space and privacy, limited visiting hours, lack of support and poor communication resulting in misapprehension about KMC were major barriers.

    CONCLUSION: A deeper understanding of the factors influencing the uptake of KMC using the Triandis behavioural model provided a way forward to help improve its uptake and sustainability in our settings.

    TRIAL REGISTRATION: This study was registered with the National Medical Research Registry (NMRR-17-2984-39191).

  12. Sethi N, Narayanan V, Saaid R, Ahmad Adlan AS, Ngoi ST, Teh CSJ, et al.
    BMC Pregnancy Childbirth, 2025 Jan 20;25(1):40.
    PMID: 39833700 DOI: 10.1186/s12884-025-07144-8
    INTRODUCTION: Bacterial vaginosis (BV) is one of the most common genital tract infections among women of reproductive age. The existence of BV among pregnant women has momentously attracted the attention of both clinicians and the scientific community due to its potential link with adverse clinical outcomes in pregnancy.

    METHODS: To evaluate the prevalence, risk factors, and adverse outcomes of bacterial vaginosis among pregnant women, a comprehensive systematic review was conducted based on the preferred reporting items for systematic review and meta-analyses (PRISMA) criteria. PubMed, ScienceDirect, ClinicalTrials.gov and Cochrane database searches were conducted independently by two authors until May 13th, 2023.

    RESULTS: The search strategies yielded a total of 2237 records; among them, 12 studies met the inclusion criteria and were included in the qualitative synthesis. Majority of the included studies demonstrated a high prevalence of BV among African women. The risk of developing BV during pregnancy was highest among women with multiple sexual partners. Additionally, factors including age, socioeconomic status, unhygienic practices, ethnicity, 2nd trimester, spontaneous abortion, vaginal douching, symptoms, and history of sexually transmitted infections (STIs) were also associated with a higher prevalence of BV. Overall, 7 studies reported adverse outcomes during pregnancy which was directly associated with BV. Based on the review, it was found that PROM, PTB, and LBW were the most frequently reported adverse outcomes in pregnant women with BV.

    CONCLUSION: In summary, the high prevalence of bacterial vaginosis necessitates a global surveillance approach to delineate the health risks imposed on both mother and child, and promote cost-effective strategic measures to alleviate the undesired consequences of BV during pregnancy.

  13. Salari N, Rahimi A, Zarei H, Abdolmaleki A, Rasoulpoor S, Shohaimi S, et al.
    BMC Pregnancy Childbirth, 2025 Jan 30;25(1):90.
    PMID: 39885489 DOI: 10.1186/s12884-025-07182-2
    BACKGROUND: Toxoplasmosis in pregnancy is associated with serious and irreversible maternal and fetal detrimental consequences. Also, different seroprevalence of Toxoplasma gondii in pregnancy is reported in many countries. The present systematic review and meta-analysis study aimed to determine the global seroprevalence of Toxoplasma gondii in pregnant women.

    METHODS: This study was conducted based on the PRISMA 2020 criteria. Initial searching was conducted using MeSH (Medical Subject Headings)-based keywords with no time limitation (by August 1, 2024). Collected papers were transferred to Citation Management Software (EndNote). Duplicate studies were merged and primary and secondary screenings were applied based on the inclusion/exclusion criteria. Validation was considered to find high-quality assessments. Finally, eligible extractable papers were enrolled for data collection. Data was analyzed using Comprehensive Meta-Analysis software (v.2) The random effects model was used in case of I2 index above 50%.In order to investigate the factors affecting the heterogeneity of studies, meta-regression tests were used to examine factors such as sample size and year of study.

    RESULTS: One hundred thirty-eight eligible studies with a total sample size of 135,098 pregnant women individuals were selected for data extraction and analysis. The heterogeneity index was found high (I2:98.9) and the random effect model was used for analysis. The egger test revealed the absence of publication bias in collected studies (p:0.088). Thus, the global seroprevalence of Toxoplasma gondii in pregnant women was reported at 36.6% (95%CI:33.7-39.6). the highest prevalence reported based on meta-analysis was reported in South America with 52.8% (95% CI:46.6-59), while only 15 studies were reviewed in this continent, most of which were in Brazil. Therefore, after the continent, the highest prevalence reported was reported in Africa with 46.8% (95% CI:39.5-54.3). Also, the lowest prevalence reported based on meta-analysis was in North America with 19.7% (95% CI:8.4-39.6) and Europe with 24.6% (95% CI:17.8-32.9).

    CONCLUSION: This study revealed a high level of seroprevalence of Toxoplasma gondii in pregnant women worldwide. This value mostly depends on the individual's age, lifestyle, and disease awareness regarding toxoplasmosis in pregnant women. Thus, public awareness, along with comprehensive health programs regarding the detrimental effects of toxoplasmosis in pregnant women, seems necessary for prevention or even early diagnosis of toxoplasmosis in pregnant women.

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