Epidemiology of preterm birth in Ethiopia: systematic review and meta-analysis

Abstract

Background Globally, complications of preterm birth are among the most common cause of neonatal mortality. In Ethiopia, the neonatal mortality reduction is not worthy of attention. Hence, this study reviewed the prevalence of preterm birth and factors associated with preterm birth in Ethiopia. Methods The review protocol of this study has been registered in PROSPERO (CRD42017077356). The PRISMA guideline was followed for this review. Studies that assessed the prevalence and/or associated factors of preterm birth in Ethiopia and published from Jan 01, 2009 to Dec 31, 2019 were considered. Studies were searched from the PubMed and Science Direct among medical electronic databases and Google Scholar. Random-effects model was used for detected heterogeneity among studies. Publication bias and sensitivity analysis were assessed. Pooled estimates with its 95% confidence interval were reported using forest plots. The quality of evidence from the review was assessed using GRADE approach. Results Twenty-two studies involving a total of 12,279 participants were included. The overall pooled prevalence of preterm birth in Ethiopia was 10.48% (95% CI: 7.98–12.99). Pooled odds ratio showed rural residence (AOR = 2.34, 95% CI: 1.35–4.05), being anemic (AOR = 2.59, 95% CI: 1.85–3.64), < 4 antenatal care visits (AOR = 2.34, 95%CI: 1.73–3.33), pregnancy induced hypertension (AOR = 3.49, 95% CI: 2.45–4.97), prelabor rapture of membrane (AOR = 4.42, 95% CI: 2.28–8.57), antepartum hemorrhage (AOR = 5.02, 95% CI: 2.90–8.68), multiple pregnancies (AOR = 3.89, 95% CI: 2.52–5.99), past adverse birth outcomes (AOR = 3.24, 95% CI: 2.53–4.15) and chronic illness (AOR = 4.89, 95%CI: 3.12–7.66) were associated with increased likelihood of preterm birth. Further, support during pregnancy was associated with reduced occurrence of preterm birth. Conclusion The pooled national level prevalence of preterm birth in Ethiopia is high. Socio demographic, nutritional, health care, obstetric and gynecologic, chronic illness and medical conditions, behavioral and lifestyle factors are the major associated factors of preterm birth in Ethiopia. This evidence is graded as low grade. Thus, efforts should be intensified to address reported risk factors to relieve the burden of preterm birth in the study setting, Ethiopia.

Is preterm birth associated with intimate partner violence and maternal malnutrition during pregnancy in Ethiopia? A systematic review and meta analysis

“…Currently, there is growing national attention focused on reducing neonatal mortality in Ethiopia; however, information regarding the relative importance of preventative strategies and predictors for newborn morbidity and mortality remains limited in Ethiopia. A meta-analysis reported on preterm birth and the effect of hypertension, multiple pregnancies, antepartum hemorrhage, and chronic illness on preterm birth [ 32 ], yet the pooled prevalence was limited to only four of the nine regions in the country and did not address modifiable risk factors for preterm birth such as intimate partner violence (IPV) and maternal malnutrition. Hence, there was inconclusive and inconsistent findings across the country [ 29 , 30 , 33 , 34 , 35 , 36 , 37 , 38 ].…”

Analysis of maternal and newborn training curricula and approaches to inform future trainings for routine care, basic and comprehensive emergency obstetric and newborn care in the low- and middle-income countries: Lessons from Ethiopia and Nepal

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