埃塞俄比亚的孕前保健和计划生育与既往不良生育结局的关系：系统评价和荟萃分析。
Association between preconception care and family planning and previous adverse birth outcomes in Ethiopia: systematic review and meta-analysis.
机构信息
Amhara Public Health Institute, Gondar, Ethiopia
Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
出版信息
BMJ Open. 2024 May 7;14(5):e078299. doi: 10.1136/bmjopen-2023-078299.
OBJECTIVES
Inconsistent findings on the associations of preconception care with the utilisation of family planning and previous adverse birth outcomes have not been systematically reviewed in Ethiopia. Thus, this review aims to estimate the pooled association of preconception care with the utilisation of family planning and previous adverse birth outcomes in Ethiopia.
DESIGN
Systematic review and meta-analysis of observational studies.
DATA SOURCES
MEDLINE Complete, CINAHL Complete, Scopus and Global Health were searched from inception to 28 July 2023.
ELIGIBILITY CRITERIA
Observational studies that reported preconception care as an outcome variable and the use of family planning before pregnancy or previous adverse birth outcomes as exposure variables were included.
DATA EXTRACTION AND SYNTHESIS
Two reviewers independently conducted study screening, data extraction and quality assessment. A fixed-effects model was used to determine the pooled association of preconception care with the utilisation of family planning and previous adverse birth outcomes.
RESULTS
Eight studies involving a total of 3829 participants were included in the review. The pooled meta-analysis found that women with a history of family planning use had a higher likelihood of using preconception care (OR 2.09, 95% CI 1.74 to 2.52) than those women who did not use family planning before their current pregnancy. Likewise, the pooled meta-analysis found that women with prior adverse birth outcomes had a higher chance of using preconception care (OR 3.38, 95% CI 1.06 to 10.74) than women with no history of prior adverse birth outcomes.
CONCLUSION
This review indicated that utilisation of preconception care had a positive association with previous use of family planning and prior adverse birth outcomes. Thus, policymakers and other relevant stakeholders should strengthen the integration of preconception care with family planning and other maternal healthcare services.
PROSPERO REGISTRATION NUMBER
CRD42023443855.
目的
在埃塞俄比亚，关于孕前保健与计划生育利用和先前不良生育结局之间关联的研究结果不一致，尚未进行系统评价。因此，本综述旨在评估孕前保健与计划生育利用和先前不良生育结局之间的关联。
设计
对观察性研究进行系统评价和荟萃分析。
数据来源
从建库到 2023 年 7 月 28 日，检索 MEDLINE Complete、CINAHL Complete、Scopus 和 Global Health。
纳入标准
报告孕前保健为结局变量，且将计划生育的使用或先前不良生育结局作为暴露变量的观察性研究。
数据提取和综合
两名评审员独立进行研究筛选、数据提取和质量评估。采用固定效应模型确定孕前保健与计划生育利用和先前不良生育结局之间的关联。
结果
综述共纳入 8 项研究，总计 3829 名参与者。汇总荟萃分析发现，有计划生育使用史的女性比没有在当前妊娠前使用计划生育的女性更有可能使用孕前保健（OR 2.09，95%CI 1.74 至 2.52）。同样，汇总荟萃分析发现，有先前不良生育结局的女性比没有先前不良生育结局的女性更有可能使用孕前保健（OR 3.38，95%CI 1.06 至 10.74）。
结论
本综述表明，孕前保健的利用与先前计划生育的使用和先前不良生育结局呈正相关。因此，政策制定者和其他相关利益攸关方应加强将孕前保健与计划生育和其他孕产妇保健服务相结合。
PROSPERO 注册号：CRD42023443855。
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