Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Int J Gynaecol Obstet. 2024 Jul;166(1):204-213. doi: 10.1002/ijgo.15276. Epub 2023 Nov 27.
The pain that women experience during labor and childbirth is the central feature of parturition in humans. Despite improvement in the development of standards for pain assessment and treatment, labor pain is mostly ignored especially in low- and middle-income countries resulting in unmeasured suffering from childbirth for mothers.
We aimed to provide a comprehensive estimation of the pooled magnitude and associated factors of labor pain management practices in Ethiopian public health facilities.
A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Electronic databases including Google Scholar, Web of Science, Excerpta Medica Database (EMBASE), PubMed/MEDLINE, and Scopus were searched from database inception to June 30, 2023.
The inclusion criteria were established prior to article review and follows the population, intervention, comparison and outcome criterions.
We evaluated publication bias by means of funnel plots and Egger's test. Heterogeneity between studies was assessed using I statistics. For each associated factors in meta-regressions, the pooled odds ratio (OR) and its 95% confidence interval (CI) were extracted. A P value of 0.05 was used to determine the significance of the small study effect.
Our search terms yielded 17 studies with 5735 participants. The pooled prevalence of labor pain management practices in Ethiopia was 45.73% (95% CI: 39.13, 52.32; I = 96.4). Having adequate knowledge regarding labor pain management (OR: 3.74; 95% CI: 2.74, 5.11; I = 53.8%), a favorable attitude toward labor pain management (OR: 2.90; 95% CI: 2.03, 4.14; I = 63.8%), availability of labor analgesics (OR: 3.23; 95% CI: 2.18, 4.79; I = 46.2%), and clinical experience of 10 or more years (OR: 3.45; 95% CI: 2.06, 5.78; I = 19.0%) were factors that were statistically associated with the use of labor pain management practices.
We concluded that the routine practices of labor pain management by obstetric health providers in Ethiopia are still low. Therefore, it remains important to call for holistic and inclusive interventions targeting maternity health providers and hospital officials to update their long-standing practices.
Registered in PROSPERO under protocol number CRD42023429140.
女性在分娩过程中所经历的疼痛是人类分娩的核心特征。尽管在疼痛评估和治疗标准的发展方面有所改善，但分娩疼痛在很大程度上仍未得到重视，尤其是在中低收入国家，导致母亲在分娩时遭受无法衡量的痛苦。
我们旨在全面评估埃塞俄比亚公立卫生机构中分娩疼痛管理实践的综合程度及其相关因素。
根据系统评价和荟萃分析的首选报告项目进行了系统评价和荟萃分析。从数据库成立到 2023 年 6 月 30 日，我们在电子数据库（包括 Google Scholar、Web of Science、EMBASE 数据库、PubMed/MEDLINE 和 Scopus）中进行了搜索。
纳入标准是在文章审查之前制定的，遵循人群、干预、比较和结局标准。
我们通过漏斗图和 Egger 检验评估发表偏倚。使用 I 统计量评估研究之间的异质性。对于荟萃回归中的每个相关因素，提取了汇总优势比（OR）及其 95%置信区间（CI）。使用 P 值为 0.05 来确定小样本效应的显著性。
我们的检索词产生了 17 项研究，涉及 5735 名参与者。埃塞俄比亚分娩疼痛管理实践的综合流行率为 45.73%（95%CI：39.13，52.32；I=96.4）。对分娩疼痛管理有足够的知识（OR：3.74；95%CI：2.74，5.11；I=53.8%）、对分娩疼痛管理有良好的态度（OR：2.90；95%CI：2.03，4.14；I=63.8%）、有分娩镇痛剂（OR：3.23；95%CI：2.18，4.79；I=46.2%）和 10 年以上临床经验（OR：3.45；95%CI：2.06，5.78；I=19.0%）是与分娩疼痛管理实践使用相关的统计学因素。
我们得出结论，埃塞俄比亚产科卫生提供者常规进行分娩疼痛管理的做法仍然很低。因此，仍然有必要呼吁针对产妇保健提供者和医院官员采取全面和包容的干预措施，以更新他们长期以来的做法。
在 PROSPERO 中根据协议编号 CRD42023429140 进行了注册。
