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Review
. 2020 Jan-Feb;14(1):35-47.

Determinants of birth asphyxia among newborns in Ethiopia: A systematic review and meta-analysis

Assefa Desalew  1 , Agumasie Semahgn  1 , Gezahegn Tesfaye  2
Affiliations
Review

Determinants of birth asphyxia among newborns in Ethiopia: A systematic review and meta-analysis

Assefa Desalew et al. Int J Health Sci (Qassim). 2020 Jan-Feb.

Abstract

Objective: The aim of this systematic review and meta-analysis was to estimate the pooled magnitude of birth asphyxia and its determinants in Ethiopia.

Methods: The databases, including PubMed, Medline, CINAHL, EMBASE, and other relevant sources, were used to search relevant articles. Both published and unpublished studies, written in English and carried out in Ethiopia, were included in the study. Quality of evidence was assessed by the relevant of the Joanna Briggs Institute tool. RevMan v5.3 statistical software was used to undertake the meta-analysis using a Mantel-Haenszel random-effects model. Heterogeneity was evaluated using the Cochran Q test, and I2 statistics was considered to assess its level. The outcome was measured using a 95% confidence interval (CI).

Results: The pooled prevalence of birth asphyxia was 22.8% (95% CI: 13-36.8%]. Illiterate mothers (adjusted odds ratio [AOR]; 1.96, 95% CI: 1.44-2.67), antepartum hemorrhage (APH) (AOR; 3.43, 95% CI: 1.74-6.77), cesarean section (AOR; 3.66, 95% CI: 1.35-9.91), instrumental delivery (AOR; 2.74, 95% CI: 1.48-5.08), duration of labor (AOR; 3.09, 95% CI: 1.60-5.99), pregnancy induced hypertension (AOR; 4.35, 95% CI: 2.98-6.36), induction of labor (AOR; 3.69, 95% CI: 2.26-6.01), parity (AOR; 1.29, 95% CI: 1.03-1.62), low birth weight (LBW) (AOR; 5.17, 95% CI: 2.62-10.22), preterm (AOR; 3.98, 95% CI: 3.00-5.29), non-cephalic presentation (AOR; 4.33, 95% CI: 1.97-9.51), and meconium staining (AOR; 4.59, 95% CI: 1.40-15.08) were significantly associated with birth asphyxia.

Conclusion: The magnitude of birth asphyxia was very high. Maternal education, APH, mode of delivery, prolonged labor, induction, LBW, preterm, meconium-staining, and non-cephalic presentation were determinants of birth asphyxia. Hence, to reduce birth asphyxia and associated neonatal mortality, attention should be directed to improve the quality of intrapartum service and timely communication between the delivery team. In addition, intervention strategies aimed at reducing birth asphyxia should target the identified determinants.

Keywords: Birth asphyxia; Ethiopia; determinant; newborn.

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Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Review and Meta-analysis 2009 flow diagram illustrating the screening process for the meta-analysis in identifying the determinant of birth asphyxia in Ethiopia
Figure 2
Figure 2
Overall pooled estimation of birth asphyxia using the random-effect model in Ethiopia
Figure 3
Figure 3
Association between low birth weights with birth asphyxia in Ethiopia
Figure 4
Figure 4
Association between preterm births with birth asphyxia in Ethiopia
Figure 5
Figure 5
Association between non-cephalic fetal presentations with birth asphyxia in Ethiopia
Figure 6
Figure 6
Association between maternal educations with birth asphyxia in Ethiopia
Figure 7
Figure 7
Association between cesarean section with birth asphyxia in Ethiopia
Figure 8
Figure 8
Association between instrumental deliveries with birth asphyxia in Ethiopia
Figure 9
Figure 9
Association between hypertension during pregnancy with birth asphyxia in Ethiopia
Figure 10
Figure 10
Association between antepartum hemorrhages with birth asphyxia in Ethiopia
Figure 11
Figure 11
Association between duration of labor with birth asphyxia in Ethiopia
Figure 12
Figure 12
Association between meconium-stained amniotic fluids with birth asphyxia in Ethiopia
Figure 13
Figure 13
Association between induction and augmentation of labor with birth asphyxia in Ethiopia
Figure 14
Figure 14
Association between parity with birth asphyxia in Ethiopia
Figure 15
Figure 15
Association between maternal anemia with birth asphyxia in Ethiopia
Figure 16
Figure 16
Association between antenatal care follow-up with birth asphyxia in Ethiopia, 2019
See this image and copyright information in PMC

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