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Meta-Analysis
. 2020 Sep 29;20(1):574.
doi: 10.1186/s12884-020-03271-6.

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

Kindie Fentahun Muchie  1 , Ayenew Molla Lakew  2 , Destaw Fetene Teshome  2 , Melaku Kindie Yenit  2 , Malede Mequanent Sisay  2 , Fantahun Ayenew Mekonnen  2 , Yohanes Ayanaw Habitu  3
Affiliations
Meta-Analysis

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

Kindie Fentahun Muchie et al. BMC Pregnancy Childbirth. .

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.

Keywords: Associated factors; Ethiopia; Meta-analysis; Preterm birth; Prevalence; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the review search results
Fig. 2
Fig. 2
Forest plot displaying random-effects meta-analysis of the prevalence of PTB in Ethiopia
Fig. 3
Fig. 3
Forest plot displaying fixed effects meta-analysis of the association between past adverse birth outcomes and PTB in Ethiopia
Fig. 4
Fig. 4
Forest plot showing the association of chronic diseases with PTB in Ethiopia
See this image and copyright information in PMC

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