Beyene Girma Alemayehu, Ayele Nitsuh D, Kasahun Abebaw Wasie
Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Welkite, Ethiopia.
Department of Internal Medicine, College of Medicine and Health Sciences, Wolkite University, Welkite, Ethiopia.
PLoS One. 2024 Dec 3;19(12):e0314783. doi: 10.1371/journal.pone.0314783. eCollection 2024.
Studies focusing on the occurrence and correlates of hyperemesis gravidarum in Ethiopia have reported varied values in different regions of the country. Additionally, there is no systematic review and meta-analysis summarizing the prevalence of hyperemesis gravidarum and its determinants in Ethiopia. Hence, this systematic review and meta-analysis aimed to estimate the overall prevalence of hyperemesis gravidarum and explore its determinants in Ethiopia.
Cross-sectional or case-control studies conducted in Ethiopia, written in English, and reporting the prevalence or the determinant of hyperemesis gravidarum among pregnant women were included in the review. International databases (PubMed, Scopus, Cochrane Library, Google Scholar, Science Direct, African Journal Online, Directory of Open Access Journal, and African Index Medicus) and Ethiopian university repositories (Jimma, Addis Ababa, Haramaya, Hawassa, and Gondar Universities) were searched from September 4-15, 2023, to identify articles published on the topic. The pooled prevalence of hyperemesis gravidarum with a 95% confidence interval was presented using the forest plots. The heterogeneity of the studies was checked by I2 with its corresponding p-values and the Galbraith plot. Subgroup analysis and meta-regression were performed to identify sources of heterogeneity. Funnel plot, Egger, and Begg's tests were used to assess publication bias.
A total of 11 articles with a 3510-sample size were included in this systematic review and meta-analysis. The pooled prevalence of hyperemesis gravidarum among pregnant women in Ethiopia was 7.12% with a 95% CI (4.09-10.15) and a high level of heterogeneity (I2 = 86.5%, p<0.001). Subgroup analyses revealed the overall prevalence of hyperemesis gravidarum was highest in the Amhara region with 11.30%, 95% CI (8.20-14.40), and lowest in Oromia with 3.40%, 95% CI (1.94-4.85). Having a previous history of hyperemesis gravidarum (POR = 3.828, 95% CI: 1.673-5.983), being in the first trimester of pregnancy (POR = 8.476, 95% CI: 5.047-11.905), and Helicobacter pylori infection (POR = 3.924, 95% CI: 2.027-5.821) were found to be significantly associated with hyperemesis gravidarum in Ethiopia.
The prevalence of hyperemesis gravidarum among pregnant women in Ethiopia is high. Targeting pregnant women in the first trimester, with a previous history of hyperemesis gravidarum, and those with Helicobacter pylori infection during prenatal counseling on how to manage and reduce hyperemesis gravidarum is very helpful to avert related complications.
The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number "CRD42023461808", on September 19, 2023.
针对埃塞俄比亚妊娠剧吐的发生情况及其相关因素的研究报告显示，该国不同地区的数值有所不同。此外，尚无系统评价和荟萃分析总结埃塞俄比亚妊娠剧吐的患病率及其决定因素。因此，本系统评价和荟萃分析旨在估计埃塞俄比亚妊娠剧吐的总体患病率，并探讨其决定因素。
纳入在埃塞俄比亚进行的、用英文撰写、报告孕妇妊娠剧吐患病率或决定因素的横断面研究或病例对照研究。于2023年9月4日至15日检索国际数据库（PubMed、Scopus、Cochrane图书馆、谷歌学术、科学Direct、非洲在线期刊、开放获取期刊目录和非洲医学索引）以及埃塞俄比亚大学知识库（吉姆马大学、亚的斯亚贝巴大学、哈拉马亚大学、哈瓦萨大学和贡德尔大学），以识别发表在该主题上的文章。使用森林图呈现妊娠剧吐的合并患病率及其95%置信区间。通过I²及其相应的p值和加尔布雷斯图检查研究的异质性。进行亚组分析和荟萃回归以识别异质性来源。使用漏斗图、Egger检验和Begg检验评估发表偏倚。
本系统评价和荟萃分析共纳入11篇文章，样本量为3510。埃塞俄比亚孕妇妊娠剧吐的合并患病率为7.12%，95%置信区间为（4.09 - 10.15），异质性较高（I² = 86.5%，p < 0.001）。亚组分析显示，阿姆哈拉地区妊娠剧吐的总体患病率最高，为11.30%，95%置信区间为（8.20 - 14.40），奥罗米亚地区最低，为3.40%，95%置信区间为（1.94 - 4.85）。既往有妊娠剧吐病史（比值比 = 3.828，95%置信区间：1.673 - 5.983）、处于妊娠早期（比值比 = 8.476，95%置信区间：5.047 - 11.905）以及幽门螺杆菌感染（比值比 = 3.924，95%置信区间：2.027 - 5.821）被发现与埃塞俄比亚的妊娠剧吐显著相关。
埃塞俄比亚孕妇妊娠剧吐的患病率较高。在产前咨询中，针对妊娠早期、有妊娠剧吐病史以及感染幽门螺杆菌的孕妇，就如何管理和减少妊娠剧吐进行指导，对于避免相关并发症非常有帮助。
该评价于2023年9月19日在国际前瞻性系统评价注册库（PROSPERO）注册，注册号为“CRD42023461808”。
