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Meta-Analysis
. 2020 Mar 24;20(1):135.
doi: 10.1186/s12887-020-02039-3.

Perinatal asphyxia and its associated factors in Ethiopia: a systematic review and meta-analysis

Fikadu Waltengus Sendeku  1 , Getnet Gedefaw Azeze  2 , Selamawit Lake Fenta  3
Affiliations
Meta-Analysis

Perinatal asphyxia and its associated factors in Ethiopia: a systematic review and meta-analysis

Fikadu Waltengus Sendeku et al. BMC Pediatr. .

Abstract

Background: Despite different preventive strategies that have been implemented in different health institutions in the country, neonatal mortality and morbidity are still significantly increasing in Ethiopia. Perinatal asphyxia is the leading cause of neonatal morbidity and mortality worldwide. As a result, this systematic review and meta-analysis aimed to assess the prevalence and associated factors of perinatal asphyxia in Ethiopia.

Methods: Online databases (PubMed, HINARI, EMBASE, Google Scholar and African Journals), other gray and online repository accessed studies were searched using different search engines. Newcastle-Ottawa Quality Assessment Scale (NOS) was used for critical appraisal of studies. The analysis was done using STATA 11 software. The Cochran Q test and I2 test statistics were used to test the heterogeneity of studies. The funnel plot and Egger's test were used to detect publication bias of the studies. The pooled prevalence of perinatal asphyxia and the odds ratio (OR) with a 95% confidence interval was presented using forest plots.

Result: Nine studies were included in this review, with a total of 12,249 live births in Ethiopia. The overall pooled prevalence of perinatal asphyxia in Ethiopia was 24.06% (95 95%CI: 18.11-30.01). Associated factors of perinatal asphyxia included prolonged labor (OR = 2.79, 95% CI: 1.98, 3.93), low birth weight (OR = 6.52, 95% CI: 4.40, 9.65), meconium-stained amniotic fluid (OR = 5.91, 95% CI: 3.95, 8.83) and instrumental delivery (OR = 4.04, 95% CI: 2.48, 6.60) were the determinant factors of perinatal asphyxia in Ethiopia.

Conclusions: The overall pooled prevalence of perinatal asphyxia was remarkably high. Duration of labor, meconium-stained amniotic fluid, instrumental deliveries, and birth weight were the associated factors of perinatal asphyxia in Ethiopia. Therefore, efforts should be made to improve the quality of intrapartum care service to prevent prolonged labor and fetal complications and to identify and make a strict follow up of mothers with meconium-stained amniotic fluid. This finding is important to early recognition and management of its contributing factors, might modify hypoxic-ischemic encephalopathy and may improve the implementation of the standard guideline effectively and consistently.

Keywords: And mortality; Birth outcomes; Meta-analysis; Morbidity; Neonatal; Systemic review.

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Conflict of interest statement

All authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA Flow chart of study selection for systematic review and meta-analysis of determinant factors of perinatal asphyxia in Ethiopia
Fig. 2
Fig. 2
Forest plot displaying the pooled prevalence of perinatal asphyxia in Ethiopia
Fig. 3
Fig. 3
Forest plot of the sub group analysis based on the study area (region)
Fig. 4
Fig. 4
Forest plot of the sub group analysis based on the sample size of the study
Fig. 5
Fig. 5
Funnel plot test for publication bias for perinatal asphyxia in Ethiopia
Fig. 6
Fig. 6
Forest plot displaying the association between low birth weight and perinatal asphyxia in Ethiopia
Fig. 7
Fig. 7
Forest plot displaying the association between MSAF and perinatal asphyxia in Ethiopia
Fig. 8
Fig. 8
Forest plot displaying the association between assisted instrumental delivery and perinatal asphyxia in Ethiopia
Fig. 9
Fig. 9
Forest plot displaying the association between prolonged labor and perinatal asphyxia in Ethiopia
See this image and copyright information in PMC

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