School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University Geelong, Melbourne, Victoria, Australia.
Amhara Public Health Institute, Bahir Dar, Ethiopia.
BMC Pregnancy Childbirth. 2024 Nov 28;24(1):802. doi: 10.1186/s12884-024-06998-8.
The maternity continuum of care is a strategy to provide timely and quality maternal and child healthcare through preconception, pregnancy, childbirth, postnatal, and the early childhood periods. The maternity continuum of care effectively reduces global maternal and neonatal deaths. However, several factors are reported to cause low completion of the maternity continuum of care in sub-Saharan Africa. There has been substantial debate in the literature as to whether pregnancy intention influences the completion of the maternity continuum of care. Although several studies have been conducted to determine the influence of pregnancy intention on the completion of the maternity continuum of care, findings are inconsistent and have not been systematically reviewed. Therefore, this review aims to determine the effect of pregnancy intention on the completion of the maternity continuum of care in sub-Saharan African countries.
A systematic search of articles was performed from MEDLINE Complete, CINAHL Complete, PsycINFO, EMBASE, Maternity & Infant Care, Global Health, Scopus, and Web of Science. The identified articles were imported into Covidence and independently screened by two researchers for abstract and title, and then full-text. The quality of the studies was evaluated using the Newcastle-Ottawa Scale. The Cochran's Q test and I were used for assessing the potential heterogeneity of the studies. Publication bias was assessed using Egger's regression test and inspection of a funnel plot. A fixed-effects meta-analysis model was used to compute the effect of pregnancy intention on the completion of the maternity continuum of care.
Ten studies involving 343,932 participants were included in the final analysis. The pooled estimate of the meta-analysis found that women with intended pregnancy had 2.12 times higher odds of completing the maternity continuum of care (pooled odds ratio: 2.12, 95% CI: 1.33, 3.36) as compared to women with unintended pregnancy.
Intended pregnancy has a statistically significant positive effect on completing the maternity continuum of care. Policymakers and healthcare providers need to implement strategies to encourage women to plan their pregnancies through the strengthening of pre-conception care and contraceptive counselling to prevent unintended pregnancies.
PROSPERO CRD42023409134.
母婴连续护理是一项通过孕前、孕期、分娩、产后和儿童早期等阶段提供及时和高质量母婴保健的策略。母婴连续护理有效地降低了全球孕产妇和新生儿死亡人数。然而，据报道，在撒哈拉以南非洲地区，有几个因素导致母婴连续护理的完成率较低。文献中有大量关于妊娠意向是否影响母婴连续护理完成的争论。尽管已经进行了几项研究来确定妊娠意向对母婴连续护理完成的影响，但研究结果不一致，且尚未进行系统审查。因此，本综述旨在确定妊娠意向对撒哈拉以南非洲国家母婴连续护理完成的影响。
从 MEDLINE Complete、CINAHL Complete、PsycINFO、EMBASE、Maternity & Infant Care、Global Health、Scopus 和 Web of Science 中进行了系统搜索文章。将确定的文章导入 Covidence，并由两名研究人员独立筛选摘要和标题，然后筛选全文。使用纽卡斯尔-渥太华量表评估研究质量。使用 Cochran's Q 检验和 I 检验评估研究的潜在异质性。使用 Egger 回归检验和漏斗图检查评估发表偏倚。使用固定效应荟萃分析模型计算妊娠意向对母婴连续护理完成的影响。
最终分析纳入了 10 项涉及 343932 名参与者的研究。荟萃分析的汇总估计发现，与意外怀孕的女性相比，有计划怀孕的女性完成母婴连续护理的可能性高出 2.12 倍（汇总优势比：2.12，95%置信区间：1.33，3.36）。
计划妊娠对完成母婴连续护理有统计学上的显著积极影响。政策制定者和医疗保健提供者需要通过加强孕前保健和避孕咨询来实施鼓励女性计划怀孕的策略，以防止意外怀孕。
PROSPERO CRD42023409134。
