Bayoumi, Rasha R., Hurt, Lisa ![]() ![]() ![]() |
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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 |
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Date Type: | Publication |
Status: | Published |
Schools: | Psychology 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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