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Burden, causes, and risk factors of perinatal mortality in Eastern Africa: a protocol for systematic review and
Yohanis Alemeshet Asefa1,2, Lars Åke Persson1,3, Anna C Seale1,2,4
1London School of Hygiene & Tropical Medicine, London, UK.
Insights
This systematic review synthesizes evidence on perinatal mortality in East Africa, focusing on burden, causes, and risk factors. The goal is to reduce stillbirths and neonatal deaths through comprehensive data analysis.
Area of Science:
- Public Health
- Maternal and Child Health
- Epidemiology
Background:
- Global under-5 mortality has decreased, yet millions of stillbirths and neonatal deaths persist annually.
- East Africa bears a significant burden of these perinatal deaths.
- Understanding the specific causes and risk factors is crucial for effective interventions.
Purpose of the Study:
- To systematically review and synthesize existing evidence on the burden of perinatal mortality in East Africa.
- To identify and analyze the primary causes and determinants contributing to perinatal deaths in the region.
- To provide evidence-based recommendations for reducing perinatal mortality in East Africa.
Main Methods:
- Comprehensive literature search across multiple databases (Medline, Web of Science, EMBASE, etc.) and grey literature.
- Inclusion of studies from 2010-2022, focusing on fetuses from ≥22 weeks gestation to 7 days postpartum.
- Quality assessment using Joanna Briggs Institute tools and data analysis with STATA, assessing heterogeneity and publication bias.
Main Results:
- This section is to be populated upon completion of the review.
- The review will identify key statistics on the burden of perinatal mortality.
- Specific causes and risk factors will be elucidated based on the synthesized data.
Conclusions:
- This systematic review will provide a comprehensive overview of perinatal mortality in East Africa.
- Identified gaps in evidence will guide future research and policy.
- The ultimate aim is to inform strategies for reducing stillbirths and neonatal deaths in the region.
Background:
Although global mortality rates in children under 5 years have decreased substantially in the last 30 years, there remain around 2.6 million stillbirths and 2.9 million neonatal deaths each year. The majority of these deaths occur in Africa and South Asia. To reduce perinatal deaths in East Africa, knowledge of the burden, but also the risk factors and causes of perinatal deaths are crucial. To the best of our knowledge, reviews have previously focused on the burden of perinatal deaths; here we aim to synthesize evidence on the burden, causes, and risk factors for perinatal mortality in East Africa.
Methods:
We will conduct a systematic literature search in Medline, Web of Science, EMBASE, Global Health, SCOPUS, Cochrane Library, CINAHL, HINARI, African Index Medicus, African Journals Online (AJOL), and WHO African Regional Office (AFRO) Library. The study population includes all fetuses and newborns from ≥22 weeks of gestation (birth weight ≥500gm) to 7 days after birth, with reported causes or/and determinants as exposure, and perinatal mortality (stillbirths and/or early neonatal deaths) as an outcome. We will include studies from 2010 to 2022, and to facilitate the inclusion of up-to-date data, we will request recent data from ongoing surveillance in the region. To assess the quality of included studies, we will use the Joanna Briggs Institute quality assessment tool for observational and trial studies. We will analyze the data using STATA version 17 statistical software and assess heterogeneity and publication bias by Higgins' I 2 and funnel plot, respectively.
Conclusions:
This systematic review will search for published studies, and seek unpublished data, on the burden, causes, and risk factors of perinatal mortality in East Africa. Findings will be reported, and gaps in the evidence base identified, with recommendations, with the ultimate aim of reducing perinatal deaths.
Protocol Registration:
PROSPERO-CRD42021291719.
