KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi P.O. Box 230-80108, Kenya.
Department of Public Health, Pwani University, Kilifi P.O. Box 195-80108, Kenya.
Int J Environ Res Public Health. 2022 Aug 24;19(17):10537. doi: 10.3390/ijerph191710537.
Preterm births (PTB) are the leading cause of neonatal deaths, the majority of which occur in low- and middle-income countries, particularly those in Sub-Saharan Africa (SSA). Understanding the epidemiology of prematurity is an essential step towards tackling the challenge of PTB in the sub-continent. We performed a scoping review of the burden, predictors and outcomes of PTB in SSA. We searched PubMed, Embase, and three other databases for articles published from the database inception to 10 July 2021. Studies reporting the prevalence of PTB, the associated risk factors, and/or its outcomes were eligible for inclusion in this review. Our literature search identified 4441 publications, but only 181 met the inclusion criteria. Last menstrual period (LMP) was the most commonly used method of estimating gestational age. The prevalence of PTB in SSA ranged from 3.4% to 49.4%. Several risk factors of PTB were identified in this review. The most frequently reported risk factors (i.e., reported in ≥10 studies) were previous history of PTB, underutilization of antenatal care (<4 visits), premature rupture of membrane, maternal age (≤20 or ≥35 years), inter-pregnancy interval, malaria, HIV and hypertension in pregnancy. Premature babies had high rates of hospital admissions, were at risk of poor growth and development, and were also at a high risk of morbidity and mortality. There is a high burden of PTB in SSA. The true burden of PTB is underestimated due to the widespread use of LMP, an unreliable and often inaccurate method for estimating gestational age. The associated risk factors for PTB are mostly modifiable and require an all-inclusive intervention to reduce the burden and improve outcomes in SSA.
早产（PTB）是新生儿死亡的主要原因，其中大多数发生在低收入和中等收入国家，尤其是撒哈拉以南非洲（SSA）的国家。了解早产的流行病学是解决该大陆 PTB 挑战的重要步骤。我们对 SSA 早产的负担、预测因素和结局进行了范围性综述。我们在 PubMed、Embase 和另外三个数据库中搜索了从数据库创建到 2021 年 7 月 10 日发表的文章。符合纳入本综述条件的研究报告了 PTB 的流行率、相关危险因素和/或结局。我们的文献检索确定了 4441 篇出版物，但只有 181 篇符合纳入标准。末次月经（LMP）是最常用于估计胎龄的方法。SSA 的 PTB 流行率从 3.4%到 49.4%不等。本综述确定了几个 PTB 的危险因素。报告频率最高的危险因素（即报告≥10 项研究）是既往早产史、产前保健利用不足（<4 次就诊）、胎膜早破、母亲年龄（≤20 或≥35 岁）、孕次间隔、疟疾、HIV 和妊娠高血压。早产儿住院率高，生长发育不良风险高，发病率和死亡率也高。SSA 的 PTB 负担很重。由于广泛使用末次月经，这种估计胎龄的不可靠且通常不准确的方法，PTB 的真实负担被低估了。PTB 的相关危险因素大多是可改变的，需要采取全面的干预措施来减轻 SSA 的负担并改善结局。
