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Meta-Analysis
. 2023 Jul;7(1):e002022.
doi: 10.1136/bmjpo-2023-002022.

Congenital anomalies and risk factors in Africa: a systematic review and meta-analysis

Natnael Moges  1 , Denekew Tenaw Anley  2 , Melkamu Aderajew Zemene  2 , Getachew Asmare Adella  3 , Yenealem Solomon  4 , Berihun Bantie  5 , Sefineh Fenta Felek  6 , Tadesse Asmamaw Dejenie  7 , Wubet Alebachew Bayih  8   9 , Ermiase Sisay Chanie  8 , Fekadeselassie Belege Getaneh  10 , Amare Kassaw  8 , Anteneh Mengist Dessie  2
Affiliations
Meta-Analysis

Congenital anomalies and risk factors in Africa: a systematic review and meta-analysis

Natnael Moges et al. BMJ Paediatr Open. 2023 Jul.

Abstract

Objective: To evaluate the pooled prevalence and identify risk factors of congenital anomalies among neonates in Africa.

Methods: The pooled birth prevalence of congenital anomalies was the first outcome of this review, and the pooled measure of association between congenital anomalies and related risk factors in Africa was the second. We conducted a thorough search of the databases PubMed/ Medline, PubMed Central, Hinary, Google, Cochrane Library, African Journals Online, Web of Science and Google Scholar up to 31 January 2023. The JBI appraisal checklist was used to evaluate the studies. STATA V.17 was used for the analysis. The I2 test and Eggers and Beggs tests were used to measure study heterogeneity and publication bias respectively. The pooled prevalence of congenital anomalies was calculated using DerSimonian and Laird random-effect model. Subgroup analysis, sensitivity analysis and meta-regression were also performed.

Result: This systematic review and meta-analysis includes 32 studies with a total of 626 983 participants. The pooled prevalence of congenital anomalies was 23.5 (95% CI 20 to 26.9) per 1000 newborns. Not taking folic acid (pooled OR=2.67; 95% CI (1.42 to 5.00)), history of maternal illness (pooled OR=2.44, 95% CI (1.2 to 4.94)), history of drug use (pooled OR=2.74, 95% CI (1.29 to 5.81)), maternal age (>35 years.) (Pooled OR=1.97, 95% CI (1.15 to 3.37)), drinking alcohol (pooled OR=3.15, 95% CI (1.4 to 7.04)), kchat chewing (pooled OR=3.34, 5% CI (1.68 to 6.65)) and urban residence (pooled OR=0.58, 95% CI (0.36 to 0.95)) were had significant association with congenital anomalies.

Conclusion: The pooled prevalence of congenital abnormalities in Africa was found to be substantial, with significant regional variation. Appropriate folate supplementation during pregnancy, proper management of maternal sickness, proper antenatal care, referring healthcare personnel before using drugs, avoiding alcohol intake and kchat chewing are all important in lowering the occurrence of congenital abnormalities among newborns in Africa.

Keywords: epidemiology; neonatology.

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Conflict of interest statement

Competing interests: No, there are no competing interests.

Figures

Figure 1
Figure 1
Study selection flow diagram; a figure adapted from the PRISMA group statement for thi review. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2
Forest plot showing prevalence of congenital anomalies in Africa, 2023.
Figure 3
Figure 3
Subgroup analysis based on study desing in Africa.
Figure 4
Figure 4
Subgroup analysis based on birth outcomes in Africa. LB, live birth; SB, still birth.
Figure 5
Figure 5
Sensitivity analysis to see the influence of each study in Africa.
Figure 6
Figure 6
(A) A funnel plot with a pseudo 95% confidence limits used to test for publication bias. (B) A funnel plot with a pseudo 95% confidence limit after a trim-and-fill analysis two studies have a been imputed.
See this image and copyright information in PMC

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