Israel Eskinder, Abraham Awoke, Tesfaw Mihiret, Geta Temesgen, Kercho Melkamu Worku, Dubale Samson, Yakob Tagese, Jambo Endale, Elfios Eshetu
School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia.
Department of Public Health, Marie-stopes International (MSI) Ethiopia Reproductive Choices, Hawassa, Ethiopia.
Front Glob Womens Health. 2024 Sep 10;5:1432729. doi: 10.3389/fgwh.2024.1432729. eCollection 2024.
Stillbirth always resulted in a multi-dimensional impact from the individual level to the country level at large. It causes psychological depression, social stigmatization, and decreased quality of life for women. Despite several studies conducted in Ethiopia, no national pooled estimates were done. Therefore, this systematic review and meta-analysis sought to assess intrapartum stillbirth and associated factors among women who had childbirth in Ethiopia using the available published evidence.
The current review included studies conducted in Ethiopia. The databases used primarily were Medline/PubMed, Google Scholar, Scopus, Web of Science, Ethiopian University Repository Online, CINAHL, African Journals Online and Cochrane Library. All cross-sectional studies conducted in English and met eligibility criteria were included in the final review. A random-effects meta-analysis was performed. Data extraction and analysis were also performed using Microsoft Excel and STATA version 14 software respectively.
In the current review, eleven studies were included, and their quality was assessed before being chosen for the final review. The pooled prevalence of intrapartum stillbirth among women who had childbirth in Ethiopia was 9.21% [95% CI (7.03%, 11.39%); = 90.2, = 0.000]. Women with a previous history of stillbirth [OR = 5.14, 95% CI (3.53-6.75), = 60.0%, = 0.04] and had no use of antenatal care {[OR = 0.43, 95% CI (0.18-0.68) = 85.3%, = 0.001]} were significantly associated with intrapartum stillbirth among women who gave childbirth.
Nearly one-tenth of women who had childbirth in Ethiopia had an intrapartum SB. Revitalizing the existing health extension package particularly family health services with emphasis on focused antenatal care and counselling as well as with prompt referral system would reduce intrapartum SB. This review calls for the need to assess the quality of ANC provision and tailor targeted interventions to best improve the service quality.
死产始终会对从个人层面到整个国家层面产生多方面的影响。它会导致女性出现心理抑郁、社会污名化以及生活质量下降。尽管埃塞俄比亚开展了多项研究，但尚未进行全国性的汇总估计。因此，本系统评价和荟萃分析旨在利用现有的已发表证据，评估埃塞俄比亚分娩女性的产时死产及相关因素。
本次评价纳入了在埃塞俄比亚开展的研究。主要使用的数据库有Medline/PubMed、谷歌学术、Scopus、科学网、埃塞俄比亚大学在线知识库、CINAHL、非洲期刊在线和考科蓝图书馆。所有以英文发表且符合纳入标准的横断面研究均纳入最终评价。进行了随机效应荟萃分析。数据提取和分析分别使用Microsoft Excel和STATA 14软件进行。
在本次评价中，纳入了11项研究，并在选择纳入最终评价之前对其质量进行了评估。埃塞俄比亚分娩女性中产时死产的汇总患病率为9.21% [95%置信区间(7.03%, 11.39%); = 90.2, = 0.000]。有死产史的女性[比值比 = 5.14, 95%置信区间(3.53 - 6.75), = 60.0%, = 0.04]以及未接受产前护理的女性{[比值比 = 0.43, 95%置信区间(0.18 - 0.68), = 85.3%, = 0.001]}与分娩女性的产时死产显著相关。
在埃塞俄比亚分娩的女性中，近十分之一有产时死产情况。振兴现有的健康推广计划，特别是注重重点产前护理和咨询以及快速转诊系统的家庭健康服务，将减少产时死产。本评价呼吁有必要评估产前护理的提供质量，并制定有针对性的干预措施以最佳地提高服务质量。
