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Adverse fetal outcomes and its associated factors in Ethiopia: a systematic review and meta-analysis

Getnet Gedefaw1, Birhan Alemnew2, Asmamaw Demis3

  • 1Department of Midwifery, College of health sciences, Woldia University, Woldia, Ethiopia. gedefawget@gmail.com.

BMC Pediatrics
|June 5, 2020
PubMed

Insights

Adverse fetal outcomes are a significant challenge in Ethiopia, affecting over a quarter of births. Key risk factors include rural residence, lack of antenatal care, pregnancy-induced hypertension, advanced maternal age, and current pregnancy complications.

Area of Science:

  • Public Health
  • Maternal and Child Health
  • Epidemiology

Background:

  • Neonatal morbidity and mortality remain a challenge in Ethiopia, despite global efforts to reduce child deaths.
  • Adverse fetal outcomes, such as low birth weight, stillbirth, prematurity, and congenital defects, are primary contributors to neonatal mortality.
  • Addressing these outcomes is crucial for achieving Sustainable Development Goal 3 in Ethiopia.

Purpose of the Study:

  • To systematically review and meta-analyze the pooled prevalence of adverse fetal outcomes in Ethiopia.
  • To identify and analyze factors associated with adverse fetal outcomes within the Ethiopian context.

Main Methods:

  • A systematic search of international databases (PubMed, Google Scholar, Web of Science, Science Direct) was conducted.
  • Seventeen studies (14 cross-sectional, 3 case-control) were included in the meta-analysis.
  • Publication bias was assessed using funnel plots and Egger's test, and heterogeneity was evaluated using the I² statistic, with subgroup analysis performed as needed.

Main Results:

  • The overall pooled prevalence of adverse fetal outcomes in Ethiopia was 26.88% (95% CI: 20.73-33.04).
  • Low birth weight (10.06%) and prematurity (8.76%) were the most prevalent adverse birth outcomes.
  • Factors significantly associated with adverse fetal outcomes included rural residency, lack of antenatal care, pregnancy-induced hypertension, advanced maternal age (≥35 years), and current pregnancy complications.

Conclusions:

  • Adverse fetal outcomes present a substantial public health burden in Ethiopia.
  • Interventions targeting rural populations, improving antenatal care access, managing pregnancy-induced hypertension, and addressing risks associated with advanced maternal age are critical.
  • Addressing these identified factors is essential for reducing adverse fetal outcomes and improving neonatal health in Ethiopia.
Abstract

Keywords:
Meta-analysisNeonatal outcomesSystematic review

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