A critical systematic review and meta-analyses of risk factors for fertility problems in a globalized world

Bayoumi, Rasha R., Hurt, Lisa ORCID: https://orcid.org/0000-0002-2741-5383, Zhang, Ning, Jun Law, Yin, Venetis, Christos, Fatemi, Human M., Serour, Gamal I., van der Poel, Sheryl and Boivin, Jacky ORCID: https://orcid.org/0000-0001-9498-1708 2024. A critical systematic review and meta-analyses of risk factors for fertility problems in a globalized world. Reproductive BioMedicine Online 48 (3) , 103217. 10.1016/j.rbmo.2023.04.008

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Abstract

Globally fertility awareness efforts include well-established risk factors (RFs) for fertility-problems. However, risks disproportionately affecting females in the Global South are neglected. To address this gap, we conducted systematic reviews and meta-analysis of relevant RFs, to examine association between RFs and fertility-problems. We searched Medline, Embase, Cochrane library, regional databases and key organizational websites. Three authors screened and extracted data independently. We included studies assessing exposure to risk (clinical, community-based samples) and excluded studies without control groups. Outcome of interest was fertility-problems (inability to achieve pregnancy, live-birth, neonatal death). Newcastle-Ottawa Scale used to assess study quality. We identified 3843 studies, and included 62 (58 in meta-analyses, 115,810 patients). Results revealed nine-fold risk of inability to become pregnant in genital-tuberculosis (OR=8.91, CI=1.89-42.12), almost threefold in HIV (OR=2.93, CI=1.95-4.42) and bacterial-vaginosis (OR=2.81, CI=1.85-4.27). Twofold risk of tubal-factor infertility in Female Genital Mutilation/Cutting–Type II/III (OR=2.06, CI=1.03-4.15) and post-natal mortality in consanguinity (stillbirth, OR=1.28, CI=1.04-1.57; neonatal death, OR=1.57, CI=1.22-2.02). It appears RFs impacted reproductive processes through multiple pathways. Health promotion encompassing relevant health indicators could enhance prevention and early detection of fertility-problems in the Global South and disproportionately affected populations. The multifactorial risk-profile reinforces the need to place fertility within global health initiatives.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Psychology Schools > Medicine
Publisher:	Elsevier
ISSN:	1472-6483
Date of First Compliant Deposit:	16 May 2023
Date of Acceptance:	11 April 2023
Last Modified:	12 Feb 2024 14:27
URI:	https://orca.cardiff.ac.uk/id/eprint/159362

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