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Periconception endogenous and exogenous maternal sex steroid hormones and risk of asthma and allergy in offspring: protocol for a systematic review and meta-analysis
  1. Merhunisa Talovic1,
  2. Aziz Sheikh1,
  3. Nicola McCleary1,
  4. Maijaliisa Erkkola2,
  5. Minna Kaila3,
  6. Suvi M Virtanen4,5,6,7,
  7. Bright I Nwaru1,4
  1. 1 Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
  2. 2 Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
  3. 3 Department of Pediatrics, Public Health Medicine, University of Helsinki and Helsinki University Hospital, University of Helsinki, Tampere University Hospital, Helsinki, Finland
  4. 4 School of Health Sciences, University of Tampere, Tampere, Finland
  5. 5 Department of Lifestyle and Participation, Nutrition Unit, National Institute for Health and Welfare, Helsinki, Finland
  6. 6 Tampere Centre for Child Health Research, Tampere University Hospital, Tampere, Finland
  7. 7 Science Centre of Pirkanmaa Hospital District, Tampere University Hospital and University of Tampere, Tampere, Finland
  1. Correspondence to Merhunisa Talovic; %E2%80%83merhunisa.talovic{at}


Introduction Pregnancy is associated with several hormonal changes which influence the developing fetus. Variations in maternal endogenous hormones and prepregnancy use of hormonal preparations have been linked to asthma and allergy in the offspring, but findings are inconsistent. We plan to undertake a systematic review to synthesise the evidence on the association between endogenous and exogenous maternal sex hormones and the risk of asthma and allergy in the offspring.

Methods and analysis We will search Medline, Embase, Cochrane Library, Institute of Scientific Information Web of Science, Cumulative Index of Nursing and Allied Health, Scopus, Google Scholar, Allied and Complementary Medicine Database, Global Health, Psychological Information (PsycINFO), Centre for Agriculture and Bioscience (CAB) International and WHO Global Health Library from inception until 2016 to identify relevant studies on the topic. Additional studies will be identified by searching databases of proceedings of international conferences, contacting international experts in the field and searching the references cited in identified studies. We will include analytical epidemiological studies. Two researchers will independently screen identified studies, undertake data extraction and assess risk of bias in eligible studies, while a third reviewer will arbitrate any disagreement. We will use the Effective Public Health Practice Project tool to assess the risk of bias in the studies. We will perform a random-effects meta-analysis to synthesise the evidence. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to rate the strength and quality of the overall evidence with respect to each outcome.

Ethics and dissemination Ethical approval is not required since the study is a systematic review of published literature. Our findings will be reported in a peer-reviewed scientific journal.

PROSPERO registration number CRD42016048324

  • asthma
  • allergy
  • children
  • oestrogen
  • hormonal contraceptives
  • pregnancy
  • progesterone
  • systematic review
  • testosterone

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  • Contributors BN conceived the idea for this work and is the guarantor. AS contributed subject expertise to the development of the protocol. The protocol was drafted by MT and BN and was then revised after several rounds of critical comments from AS and additional feedback from MK, ME, SV and NM. All authors are involved in the systematic review process.

  • Funding MT undertakes this work as part of the requirement for her dissertation for the award of a Master’s in Public Health at The University of Edinburgh. The work received no specific funding. BN was supported by the Institute for Advanced Social Research Fellowship, University of Tampere, Finland; School of Health Sciences, University of Tampere, Finland. Additional support was received from the Farr Institute and Asthma UK Centre for Applied Research. The views presented here are those of the authors and not necessarily those of the Universities of Tampere and Edinburgh.

  • Competing interests None declared.

  • Ethics approval Level 1 ethics form from Edinburgh Institutional Review Board was completed for this study, which indicated that no ethics approval is required since it is based only on the published literature.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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