埃塞俄比亚孕妇选择家庭分娩的偏好及其相关因素的流行情况：系统评价和荟萃分析。

BACKGROUND: Homebirth preference is the intention/plan to give birth outside health facilities with the help of unskilled birth attendants. The preference to give birth at home without a skilled birth attendant leads to care-seeking delays, intrapartum mortality, multiple stillbirths, and postpartum morbidities and mortality. Therefore, this study aimed to estimate the pooled prevalence of homebirth preference and associated factors among pregnant women in Ethiopia. METHODS: Search of Google Scholar, Medline, PubMed, Cochrane Library and Web of Science were done for this study from 20th August 2022 to 6th November 2022. For data extraction and analysis, the standardized data extraction checklist and Stata version 14 were used respectively. Sentence as "Cochrane Q test statistics and I2 statistics were used to check heterogeneity of the studies. The pooled prevalence of homebirth preference was estimated using a random-effects model. The association between homebirth preference and independent variables was determined using an odd ratio with a 95% confidence interval. A funnel plot and Egger's test were used to assess publication bias. RESULTS: A total of 976 research articles were identified. Seven studies that fulfilled eligibility criteria were included in this systematic review and meta-analysis. The pooled prevalence of homebirth preference in Ethiopia was 39.62% (95% CI 27.98, 51.26). The current meta-analysis revealed that average monthly income <1800 ETB (OR = 2.66, 95% CI 1.44, 4.90) lack of ANC follow-up (OR = 2.57, 95%CI 1.32, 5.01), being multipara (OR = 1.77, 95%CI 1.39, 2.25), poor knowledge about obstetric danger sign (OR = 5.75, 95%CI 1.o2, 32.42), and not discussing the place of delivery with a partner (OR = 5.89 (95%CI 1.1, 31.63) were significantly associated with homebirth preference. CONCLUSION: This systematic review and meta-analysis examined the substantial prevalence of homebirth preference in Ethiopia which may contribute maternal and child health crisis. The homebirth preference was associated with low average monthly income (<1800 ETB), lack of ANC follow-up, multipara, poor knowledge about obstetric danger signs, and not discussing with their partner the place of delivery. Improving knowledge of pregnant women about the benefit of health facility delivery and obstetric danger signs is necessary to decrease the prevalence of homebirth preference; for these can reduce negative outcomes occurred during delivery.

背景：在家分娩偏好是指在未经训练的助产妇帮助下，选择在医疗机构之外分娩的意图/计划。选择在家中由非专业人员接生会导致寻求护理的延误、分娩期死亡、多次死产以及产后发病率和死亡率增加。因此，本研究旨在估计埃塞俄比亚孕妇中在家分娩偏好的总体流行率及其相关因素。

方法：本研究于 2022 年 8 月 20 日至 2022 年 11 月 6 日在 Google Scholar、Medline、PubMed、Cochrane 图书馆和 Web of Science 上进行了搜索。使用标准化数据提取清单和 Stata 版本 14 分别进行数据提取和分析。

结果：共确定了 976 篇研究文章。本系统评价和荟萃分析共纳入了 7 项符合纳入标准的研究。埃塞俄比亚在家分娩偏好的总体流行率为 39.62%（95%CI 27.98,51.26）。目前的荟萃分析表明，平均月收入<1800 埃比尔（OR=2.66，95%CI 1.44,4.90）、缺乏 ANC 随访（OR=2.57，95%CI 1.32,5.01）、多产妇（OR=1.77，95%CI 1.39,2.25）、缺乏对产科危险信号的了解（OR=5.75，95%CI 1.02,32.42）和未与伴侣讨论分娩地点（OR=5.89（95%CI 1.1,31.63）与在家分娩偏好显著相关。

结论：本系统评价和荟萃分析检查了埃塞俄比亚在家分娩偏好的显著流行率，这可能导致母婴健康危机。在家分娩偏好与低收入（<1800 埃比尔）、缺乏 ANC 随访、多产妇、对产科危险信号的了解不足以及未与伴侣讨论分娩地点有关。提高孕妇对医疗机构分娩和产科危险信号益处的认识是必要的，以降低在家分娩偏好的流行率；因为这可以降低分娩期间发生的不良后果。