The effect of gestational age, low birth weight and parity on birth asphyxia among neonates in sub-Saharan Africa: systematic review and meta-analysis: 2021

Abstract

Background Despite simple and proven cost-effective measures were available to prevent birth asphyxia; studies suggested that there has been limited progress in preventing birth asphyxia even in healthy full-term neonates. In Sub-Saharan Africa, Inconsistency of magnitude of birth asphyxia and its association gestational age, Low birth Weight and Parity among different studies has been observed through time. Objective This study aimed to estimate the Pooled magnitude of birth asphyxia and its association with gestational age, Low birth Weight and Parity among Neonates in Sub-Saharan Africa. Method PubMed, Cochrane library and Google scholar databases were searched for relevant literatures. In addition, reference lists of included studies were retrieved to obtain birth asphyxia related articles. Appropriate search term was established and used to retrieve studies from databases. Searching was limited to cohort, cross-sectional, and case-control studies conducted in Sub-Saharan africa and published in English language. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. Heterogeneity across the included studies was evaluated by using the inconsistency index (I2) test. Funnel plot and the Egger’s regression test were used to test publication bias. A weighted inverse variance random effects- model was used to estimate the pooled prevalence of birth asphyxia among neonates in Sub-Saharan Africa. STATA™ version 11softwarewasused to conduct the meta-analysis. Result A total of 40 studies with 176,334 study participants were included in this systematic review and meta-analysis. The overall pooled magnitude of birth asphyxia in Sub-Saharan Africa was 17.28% (95% CI; (15.5, 19.04). low birth weight (AOR = 2.58(95% CI: 1.36, 4.88)), primigravida (AOR = 1.15 (95% CI: 0.84, 1.46) andMeconium-stained amniotic fluid (AOR = 6(95% CI: 3.69, 9.74)) werevariables significantly associated with the pooled prevalence of birth asphyxia. Conclusion The pooled magnitude of birth asphyxia was found to be high in Sub-Saharan Africa. Low birthweight and Meconium-stained amniotic fluid were variables significantly associated with birth asphyxia in Sub-Saharan Africa. Hence, it is better to develop early detection and management strategies for the affected neonates with low birth weight and born from mothers intrapartum meconium stained amniotic fluid.

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“…Such an approach has been implemented in India and has been shown to be associated with reduced mortality [ 27 ]. Furthermore, our analysis showed that lower gestational age, prematurity, referred mothers, and advanced maternal age were associated with birth asphyxia, while few retrospective studies have shown variable results; the majority of pooling studies were consistent with our findings [ 18 , 28 ].…”

Intimate partner violence during pregnancy and its association with birth asphyxia in hospitals of Tigray region, Ethiopia

“…Similarly, our findings show that babies born with low birth weight has four times increased risk of birth asphyxia compared to normal weight babies. This finding is supported by multiple other studies including the ones done in Beijing Obstetrics and Gynecology Hospital and sub Saharan African, [ 31 , 32 ]. The pathophysiology for this is likely similar to that of preterm babies in which the respiratory systems are not fully developed [ 30 ].…”

Facteurs prédicteurs de la mortalité périnatale suite à l’asphyxie & environnement de naissance : étude cas-témoins

“…Outre, ils connaissent une chute rapide du PH sanguin foetal. Ce qui les expose d'avantage aux problèmes d'asphyxie périnatale, d'adaptation cardiorespiratoire à la naissance, et du décès néonatal précoce [4,21,22,23]. Dans la même logique de réflexion, l'étude de Goodwin et al a confirmé qu'avec un ph sanguin inférieure 7 le foetus est à haut risque de développer des complications organiques.…”

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