METHODS AND ANALYSIS: All observational studies, including descriptive, descriptive-analytic, case-control, and cohort studies published between 1990 and 2019, will be included in the study. Review articles, case studies, case reports, letter to editors, pilot studies, and editorial will be excluded from the study. The search will be conducted in the Cochrane Central Register, MEDLINE, Google Scholar, EMBASE, ProQuest, Scopus, WOS, and CINAHL databases. Eligible studies should assess at least one of the sexual dysfunction symptoms in pregnant women or in the first year postpartum. Quality assessment of studies will be performed by two authors independently based on the NOS checklist. This checklist is designed to assess the quality of observational studies. Data will be analyzed using Stata software ver. 11. Considering that the index investigated in the present study will be the level of sexual disorder, standard error will be calculated for each study using binomial distribution. The heterogeneity level will be investigated using Cochran's Q statistic and I2 index in a chi-square test at a significance level of 1.1. Predictable limitations of this study included a small number and unacceptable quality of studies.
DISCUSSION: This systematic review addresses the factors associated with sexual dysfunction during pregnancy and postpartum. Considering the high prevalence of sexual dysfunction among women, the treatment of this problem has been highly sought after by the World Health Organization in recent years. The results of this study can help discover new strategies by introducing factors affecting women's sexual dysfunction, thereby eliminating or diminishing these factors, and play an important role in improving the quality of life of women during pregnancy and postpartum periods.
SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018083554.
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.
OBJECTIVES: To determine the efficacy of desmopressin acetate in preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders.
SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coaguopathies Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant and abstract books of conferences proceedings. We also searched for any randomised controlled trials in a registry of ongoing trials and the reference lists of relevant articles and reviews.Date of most recent search: 18 June 2015.
SELECTION CRITERIA: Randomised and quasi-randomised controlled trials investigating the efficacy of desmopressin acetate versus tranexamic acid or factor VIII or rFactor VII or fresh frozen plasma in preventing and treating congenital bleeding disorders during pregnancy were eligible.
DATA COLLECTION AND ANALYSIS: No trials matching the selection criteria were eligible for inclusion.
MAIN RESULTS: No trials matching the selection criteria were eligible for inclusion.
AUTHORS' CONCLUSIONS: The review did not identify any randomised controlled trials investigating the relative effectiveness of desmopressin acetate for bleeding during pregnancy in women with congenital bleeding disorders. In the absence of high quality evidence, clinicians need to use their clinical judgement and lower level evidence (e.g. from observational trials) to decide whether or not to treat women with congenital bleeding disorders with desmopressin acetate.Given the ethical considerations, future randomised controlled trials are unlikely. However, other high quality controlled studies (such as risk allocation designs, sequential design, parallel cohort design) to investigate the risks and benefits of using desmopressin acetate in this population are needed.