Abstract
Background: Dysmenorrhea or menstrual pain is a commonly occurring disorder in reproductive
age women with different proposed risk factors including body mass index.
Objective: This study aimed to investigate the association of body mass index and dysmenorrhea
using a systematic review and meta-analysis approach.
Methods: Academic databases Scopus, PubMed CENTRAL, Embase, ProQuest, Science Direct,
and ISI Web of Science as well as Google Scholar- were searched systematically from inception until
the end of February, 2020. Original researches published in English with observational designs
were included to examine the association of body mass index and dysmenorrhea as a primary outcome.
Newcastle Ottawa scale was used to evaluate the methodological quality of the studies. Due
to the variation of reported data across studies, all data were converted to Pearson correlation coefficient
and corrected by transforming to fisher’s Z score. Then meta-analysis was performed using a
random-effects model with Der-Simonian and Laird method.
Results: A total of 61 studies with 57,079 participants, of which 25,044 reported having dysmenorrhea
were included. The pooled estimated effect size of correlation showed trivial to small correlation
between body mass index and dysmenorrhea with corrected fisher’s z score of 0.12 (95% CI:
0.08; 0.17, I2=95%). While publication bias was probable, results were corrected using the fill &
trim method. The corrected results based on this method showed that pooled Fisher’s z-score for
the association of body mass index and dysmenorrhea was 0.04 (95% CI: -0.009; 0.085).
Conclusion: No association was found between body mass index and dysmenorrhea. But this finding
should be interpreted with caution considering the included studies' limitations.
Keywords:
Body mass index, dysmenorrhea, systematic review, meta-analysis, Fisher’s z-score, body mass index.
Graphical Abstract
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