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2023年撒哈拉以南非洲地区孕妇妊娠间隔短对围产期和孕产妇结局的影响:系统评价与荟萃分析

Effect of short inter-pregnancy interval on perinatal and maternal outcomes among pregnant women in SSA 2023: Systematic review and meta-analysis.

作者信息

Beyene Fentahun Yenealem, Wudineh Kihinetu Gelaye, Bantie Simachew Animen, Tesfu Azimeraw Arega

机构信息

Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

出版信息

PLoS One. 2025 Jan 7;20(1):e0294747. doi: 10.1371/journal.pone.0294747. eCollection 2025.

Abstract

BACKGROUND

After a live birth, the recommended interval before attempting the next pregnancy is at least 24 months (birth to pregnancy interval) in order to reduce the risk of adverse maternal, perinatal and infant outcomes. Short inter pregnancy interval associated with adverse perinatal and maternal outcomes.

OBJECTIVE

The objective of this review was to determine the effect of short inter pregnancy interval on perinatal and maternal outcomes in Sub-Saharan Africa 2023.

METHODS

A systematic and a comprehensive literature searching mechanism were used without any restriction, through Google scholar, PubMed, Scopus, Web of Sciences, and Grey literature databases for reporting the effect of short inter pregnancy interval. The JBI approach to critical appraisal, study selection, data extraction, and data synthesis was used for this review. All statistical analyses were done using STATA version17 software for windows, and meta-analysis was used with a random-effects method. The results are presented using texts, tables and forest plots with measures of effect and 95% confidence interval.

RESULTS

Thirteen studies were included in this review and most of the studies level of heterogeneity across the study was considerable, mainly due to methodological variations, Statistical heterogeneity, and population and intervention variations of included studies. The effect of short inter pregnancy interval on perinatal and maternal outcome were low birth weight(RR (RR (95% CI) 1.98 (1.48, 2.47); I2:62.97%, preterm birth (RR (95% CI) 1.67 (1.31, 2.03); I2:51%, intra uterine growth retardation(RR (95% CI) 3.78 (2.07, 5.49); I2: 8.52%, low APGAR score(RR (95% CI) 3.49 (1.41, 5.57)); I2: 71.11%, premature rapture of membrane(RR (95% CI) 2.87 (1.22, 4.51)); I2: 49.22%, perinatal mortality(RR (95% CI) 2.95 (1.10, 4.81)); I2: 54.37% and maternal anemia(RR (95% CI) 3.06 (2.12, 3.99)); I2: 74.74%.

CONCLUSIONS

As per our review the main effect of short inter pregnancy interval is low birth weight, preterm birth, intra uterine growth retardation, low APGAR score, premature rapture of membrane, perinatal mortality and maternal anemia. This might be very useful for healthcare policymakers and NGOs to emphasize on it.

摘要

背景

活产之后,为降低孕产妇、围产期和婴儿不良结局的风险,建议在下一次怀孕前的间隔时间至少为24个月(从分娩到怀孕的间隔时间)。怀孕间隔时间短与围产期和孕产妇不良结局相关。

目的

本综述的目的是确定2023年撒哈拉以南非洲地区怀孕间隔时间短对围产期和孕产妇结局的影响。

方法

采用系统且全面的文献检索机制,无任何限制,通过谷歌学术、PubMed、Scopus、科学网和灰色文献数据库来报告怀孕间隔时间短的影响。本综述采用JBI批判性评价、研究选择、数据提取和数据合成方法。所有统计分析均使用适用于Windows的STATA 17版软件完成,荟萃分析采用随机效应方法。结果以文本、表格和森林图呈现,并给出效应量和95%置信区间。

结果

本综述纳入了13项研究,研究间的异质性水平大多相当可观,主要是由于方法学差异、统计异质性以及纳入研究的人群和干预措施差异。怀孕间隔时间短对围产期和孕产妇结局的影响包括低出生体重(RR(95%CI)1.98(1.48,2.47);I²:62.97%)、早产(RR(95%CI)1.67(1.31,2.03);I²:51%)、宫内生长迟缓(RR(95%CI)3.78(2.07,5.49);I²:8.52%)、低阿氏评分(RR(95%CI)3.49(1.41,5.57));I²:71.11%)、胎膜早破(RR(95%CI)2.87(1.22,4.51));I²:49.22%)、围产期死亡率(RR(95%CI)2.95(1.10,4.81));I²:54.37%)和孕产妇贫血(RR(95%CI)3.06(2.12,3.99));I²:74.74%)。

结论

根据我们的综述,怀孕间隔时间短的主要影响是低出生体重、早产、宫内生长迟缓、低阿氏评分、胎膜早破、围产期死亡率和孕产妇贫血。这对医疗保健政策制定者和非政府组织强调这一点可能非常有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8188/11706456/432cdbb210b2/pone.0294747.g001.jpg

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