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Review
. 2021 May 26:8:2333794X211019699.
doi: 10.1177/2333794X211019699. eCollection 2021.

The Burden of Adverse Neonatal Outcome among Antenatal Substance Users in Ethiopia: A Systematic Review and Meta-Analysis

Wubet Alebachew Bayih  1   2 , Metadel Yibeltal Ayalew  3   4 , Melaku Tadege  1   5 , Maru Mekie  1   6 , Teklehaimanot Kiros  1   7 , Eshetie Molla Alemu  1   6 , Efrem Fenta Alemnew  1   8 , Lemma Getacher  9   10 , Demeke Mesfin Belay  1   11 , Binyam Minuye Birhane  1   2 , Dr Kassaw Demilie Alemu  1   12 , Getachew Yideg Yitbarek  1   13 , Belayneh Kefale  1   14
Affiliations
Review

The Burden of Adverse Neonatal Outcome among Antenatal Substance Users in Ethiopia: A Systematic Review and Meta-Analysis

Wubet Alebachew Bayih et al. Glob Pediatr Health. .

Abstract

Background. Substances mainly khat, alcohol and cigarette are used during pregnancy in Ethiopia. However, to this date, there is no pooled evidence about the burden of adverse neonatal outcomes among the substance users during pregnancy in the country. Methods. Eligible primary studies were accessed from 4 international data bases (Google Scholar, Science Direct, Scopus, and PubMed). The required data were extracted from these studies and then exported to stata version 14 for analysis. Subgroup analyses were conducted for evidence of heterogeneity. Results. A total of 2298 neonates were included from 7 studies. Among these neonates, 530(23.06%) were those whose mothers used substance during pregnancy (exposed group) whereas 1768 neonates were those whose mothers didn't use substance during pregnancy (controls group). The pooled prevalence of adverse neonatal outcome among the exposed mothers was 38.32% (95% CI: 29.48%, 47.16%; I2 = 76.3%) whereas it was 16.29% (95% CI: 9.45%, 23.13%) among the controls. Adverse neonatal outcome was most burdensome among cigarette smokers 45.20% (95% CI: 37.68%, 52.73%; I2 = .00%) when compared with khat chewers 34.00% (95% CI: 20.87%, 47.13%) and alcohol drinkers 38.47% (95% CI: 17.96%, 58.98%). Low birth weight 42.00% (95% CI: 18.01%, 65.99%; I2 = 91.8%) was the most common adverse birth outcome. Conclusion. It was found that adverse neonatal outcomes were much more burdensome among antenatal substance users than the controls. Therefore, mothers should be enabled to quit using substance before pregnancy. Besides, strict comprehensive screening of every pregnant mother should be made at antenatal care clinics for early identification and management of antenatal substance use.

Keywords: Ethiopia; birth outcome; meta-analysis; pregnancy; substance use.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The pooled burden of adverse neonatal outcome among substance users during pregnancy, 2020, Ethiopia.
Figure 2.
Figure 2.
The pooled burden of adverse neonatal outcome among non-substance users (controls) during pregnancy, 2020, Ethiopia.
Figure 3.
Figure 3.
Categories of adverse neonatal outcome among substance users during pregnancy, 2020, Ethiopia.
Figure 4.
Figure 4.
Regional subgroup analysis of the pooled burden of adverse neonatal outcome among substance users during pregnancy, 2020, Ethiopia.
Figure 5.
Figure 5.
Subgroup analysis of the pooled burden of adverse neonatal outcome among substance users during pregnancy by substance type, 2020, Ethiopia.
Figure 6.
Figure 6.
Sensitivity analysis of the pooled burden of adverse neonatal outcome among substance users during pregnancy, 2020, Ethiopia.
See this image and copyright information in PMC

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