Perinatal Epidemiology, Systematic Reviews and Meta-analyses

About the Program

A systematic review refers to the entire process of identifying, selecting, evaluating, and synthesizing all available evidence in order to provide a reliable answer to a specific research question. Systematic reviews will often, but not always, contain a meta-analysis. The term “meta-analysis” refers to the use of statistical methods to combine data from the examined individual research studies in order to derive a pooled estimate of the effect of the measure under analysis on a particular outcome. By systematically assessing primary research, systematic reviews aim to provide an up-to-date summary of the state of research knowledge on an intervention, diagnostic or predictive test, prognostic factor or other health or healthcare topic. Well done systematic reviews are considered to provide the highest quality of evidence on a research topic, and, hence, are positioned at the top of the evidence hierarchy.

The Perinatal Epidemiology, Systematic Reviews and Meta-analyses Unit compiles and critically appraises existing evidence on:

  • The efficacy and safety of preventive and therapeutic interventions in obstetrics and maternal-fetal medicine, mainly those related with the “great obstetrical syndromes”, through the use of formal methods for systematic reviews and meta-analyses of randomized controlled trials and non-randomized studies
  • The accuracy of tests proposed for the prediction and diagnosis of obstetrical and maternal-fetal conditions through the use of formal methods for systematic reviews and meta-analyses of predictive/diagnostic studies
  • The effect of exposure(s) on obstetrical and maternal-fetal conditions through the use of formal methods for systematic reviews and meta-analyses of observational studies

Our aim is to translate evidence from systematic reviews and meta-analyses into clinical practice.

Objectives

  • To conduct systematic reviews and meta-analyses of randomized controlled trials, non-randomized studies, predictive and diagnostic test studies, and observational studies in the field of obstetrics and maternal-fetal medicine

Research Highlights

  • Demonstrated that kangaroo mother care, defined as skin-to-skin contact between a mother and her newborn, frequent and exclusive or nearly exclusive breastfeeding, and early discharge from the hospital reduces morbidity and mortality in low-birthweight and premature infants.
  • Demonstrated that vaginal progesterone administration to asymptomatic women with a singleton or twin gestation and a mid-trimester sonographic short cervix reduces the risk of preterm birth and improves perinatal outcomes.
  • Showed that vaginal progesterone and cervical cerclage are equally effective for preventing preterm birth and improving perinatal outcomes in women with a singleton gestation, previous spontaneous preterm birth, and a mid-trimester sonographic short cervix.
  • Demonstrated that magnesium sulfate administration to women at risk of preterm delivery before 34 weeks of gestation reduces the risk of cerebral palsy in their offspring.
  • Reported that a single measurement of cervical length with transvaginal ultrasound before 25 weeks of gestation is a good test to predict preterm birth in asymptomatic women with a twin gestation.
  • Showed that nifedipine meets most criteria to be considered the tocolytic agent of choice.
  • Reported that uterine balloon tamponade devices have a high success rate for treating severe postpartum hemorrhage, mainly that due to uterine atony and placenta previa.
  • Developed an evidence-based contemporary approach for the management of clinical chorioamnionitis.

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Faculty