Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2019 Sep 6;14(9):e0221712. doi: 10.1371/journal.pone.0221712. eCollection 2019.
Malnutrition in pregnancy remains unacceptably high across all regions of Africa though promising progresses have been made globally. Primary studies might not be sufficient to portrait a comprehensive picture of malnutrition during pregnancy and its main risk factors. Therefore, we intended to review the burden of malnutrition, for this specific review implies to protein energy malnutrition, during pregnancy in Africa to present its magnitude and determinant factors.
We did a systematic review of observational studies published from January 1/2008 to January 31/2018. The CINAHL(EBSCO), MEDLINE (via Ovid), Emcare, PubMed databases and Google scholar were searched. Articles quality was assessed using the Newcastle-Ottawa Scale and studies with fair to good quality were included. We pooled malnutrition prevalence and an odds ratio estimates for risk factors after checking for heterogeneity and publication bias. This review has been registered in Prospero with a protocol number CRD42018114949.
23 studies involving 20,672 pregnant women were included. Using a random effect model, the overall pooled prevalence of malnutrition among pregnant women in Africa was 23.5% (95%CI: 17.72-29.32; I2 = 98.5%). Based on the current review pooled odds ratio finding; rural residency (POR = 2.6%; 95%CI: 1.48-4.65; I2 = 0%), low educational status of partners (POR = 1.7%; 95%CI: 1.19-2.53; I2 = 54.8%), multiple pregnancy (POR = 2.15%; 95%CI: 1.27-3.64; I2 = 0%) and poor nutritional indicators (POR = 2.03%; 95%CI: 1.72-2.4, I2 = 0%) were positively determine maternal malnutrition. On contrary, better household economic status (POR = 0.47%; 95%CI: 0.36-0.62; I2 = 24.2%) negatively determine maternal malnutrition.
A significant number of the pregnant population in Africa are suffering of malnutrition, above 10% of the standard acceptable malnutrition rate. Thus, efforts should be renewed to ensure a proper and widespread implementation of programs that would address issues identified in the current review to reduce the burden of malnutrition.
尽管全球范围内在改善母婴营养方面取得了令人鼓舞的进展，但整个非洲地区的妊娠营养不良问题仍然严重。原始研究可能不足以全面描绘妊娠期间营养不良及其主要危险因素的情况。因此，我们旨在综述非洲妊娠营养不良的负担，以了解其严重程度和决定因素。
我们对 2008 年 1 月 1 日至 2018 年 1 月 31 日期间发表的观察性研究进行了系统综述。我们检索了 CINAHL（EBSCO）、MEDLINE（通过 Ovid）、Emcare、PubMed 数据库和 Google Scholar。使用纽卡斯尔-渥太华量表评估文章质量，纳入质量为良好至中等的研究。我们对危险因素的营养不良患病率和比值比估计值进行了汇总，同时检查了异质性和发表偏倚。本综述已在 Prospero 注册，注册号为 CRD42018114949。
共有 23 项涉及 20672 名孕妇的研究被纳入。使用随机效应模型，非洲孕妇营养不良的总体合并患病率为 23.5%（95%CI：17.72-29.32；I2 = 98.5%）。根据本次综述的汇总比值比发现；农村居住（POR = 2.6%；95%CI：1.48-4.65；I2 = 0%）、配偶教育程度低（POR = 1.7%；95%CI：1.19-2.53；I2 = 54.8%）、多胎妊娠（POR = 2.15%；95%CI：1.27-3.64；I2 = 0%）和营养指标差（POR = 2.03%；95%CI：1.72-2.4，I2 = 0%）与产妇营养不良呈正相关。相反，家庭经济状况较好（POR = 0.47%；95%CI：0.36-0.62；I2 = 24.2%）与产妇营养不良呈负相关。
非洲相当一部分孕妇患有营养不良，超过了可接受的营养不良标准率的 10%。因此，应重新努力确保适当和广泛实施各项方案，以解决本次综述中确定的问题，从而减轻营养不良的负担。
