Prevalence and risk factors associated with adverse birth outcome in Ethiopia: systematic review and meta-analysis

Adverse pregnancy outcomes represent a major public health challenge in developed and resource-limited countries. Globally, approximately 60-80% of neonatal deaths occur in low birth weight infants, and more than 2 million infants die before birth each year and the burden of the problem is significant in Ethiopia. Therefore, the aim of this study was to determine the combined incidence and risk factors for poor birth outcomes in Ethiopia.

International databases (PubMed, Google scholar, web of science and scopus) were searched. A funnel plot and Begg test were used to see the publication bias. The heterogeneity of studies was checked using I-square statistics with a cut of point 75% and the Newcastle Ottawa (NCO) quality assessment tool was applied to ensure the quality of the included articles. A random-effect model was applied to pool the adverse birth outcome. The sub-group analysis and Meta-regression analysis were conducted by region in the country and year of publication to control heterogeneity and to show variation.

A total of 16636 study participants were used to estimate the pooled prevalence of adverse fetal outcomes. The overall pooled prevalence of adverse fetal outcomes in Ethiopia was 28 (95% CI; 24-32; 12 = 97.44 percent, Pv= 0.001). Low birth weight 10.06% (95% CI; 7.21-12.91) and preterm birth 8.76% (95% CI; 5.4-12.11) were the most common adverse birth outcome at the national level. Rural in residency (AOR = 2.31; 95% CI: 1.64-3.24), lack of antenatal care follow up (AOR = 3.84; 95% CI: 2.76-5.35), pregnancy-induced hypertension (AOR = 7.27; 95% CI: 3.95-13.39), advanced maternal age ≥ 35(AOR = 2.72; 95% CI: 1.62-4.58, and having current complication of pregnancy (AOR = 4.98; 95% CI: 2.24-11.07) were the factors associated with adverse birth outcome.

The pooled prevalence of adverse fetal outcomes in Ethiopia was high. Rural in residency, lack of antenatal care follow up, pregnancy-induced hypertension, advanced maternal age ≥ 35, and having current complications of pregnancy were the factors associated with adverse fetal outcome.

Identifier: CRD42022327072.