Abebe Mesfin, Tebeje Tsion Mulat, Yimer Nebiha, Temesgen Tesfaye, Melaku Getnet, Hareru Habtamu Endashaw
Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia.
School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia.
Front Glob Womens Health. 2025 Apr 28;6:1452114. doi: 10.3389/fgwh.2025.1452114. eCollection 2025.
Second-trimester induced abortion refers to the termination of a pregnancy occurring between 13 and 28 weeks of gestation in Africa. These abortions are particularly concerning due to the heightened risk of complications and maternal mortality. In Ethiopia, there is a lack of nationally representative data regarding the magnitude and associated factors of second-trimester induced abortions. This systematic review and meta-analysis aimed to ascertain the pooled magnitude and identify the factors associated with second-trimester induced abortions in Ethiopia.
The PRISMA guidelines were used to review and report this study. A systematic literature search was conducted to identify relevant articles from online databases, including PubMed/MEDLINE, Web of Science, Google Scholar, and Ethiopian University online repositories. Data were extracted using an Excel data extraction format, and analysis was performed using Stata version 17. A meta-analysis was conducted using a random-effects model, and subgroup analysis was performed based on the year of publication and sample size to identify the source of heterogeneity. To determine publication bias, a funnel plot, and Egger's regression test were conducted.
In this review, a total of ten articles encompassing 4,466 participants were analyzed. The pooled prevalence of second-trimester induced abortion in Ethiopia was found to be 29.10% (95% CI: 19.96-38.24; ² = 97.84, < 0.000). Delay in confirming pregnancy (POR = 4.33, 95% CI: 2.25, 8.32), nature of the menstrual cycle (POR = 0.32, 95% CI: 0.18, 0.56), residence (POR = 0.38, 95% CI: 0.30, 0.49), and pregnancy intention (POR = 0.28, 95% CI: 0.18, 0.42) were significantly associated with second-trimester induced abortion.
The magnitude of induced second-trimester abortions in Ethiopia is significantly higher than global data. This meta-analysis identifies factors associated with second-trimester abortions, including delayed pregnancy confirmation, irregular menstrual cycles, rural residency, and unplanned pregnancies. The findings highlight the urgent need for targeted interventions to address these factors and decrease the incidence of second-trimester abortions. Encouraging early pregnancy testing and confirmation to reduce delays, raising awareness about the importance of regular menstrual cycles and seeking medical advice for irregularities, improving healthcare services in rural areas to reduce disparities, and strengthening family planning and counseling services can help mitigate unplanned pregnancies and induced abortions.
PROSPERO (CRD42022383559).
在非洲，孕中期人工流产是指在妊娠13至28周之间终止妊娠。由于并发症风险和孕产妇死亡率增加，这些流产尤其令人担忧。在埃塞俄比亚，缺乏关于孕中期人工流产的规模及其相关因素的全国代表性数据。本系统评价和荟萃分析旨在确定埃塞俄比亚孕中期人工流产的合并规模，并识别与之相关的因素。
本研究采用PRISMA指南进行综述和报告。通过系统的文献检索，从在线数据库中识别相关文章，包括PubMed/MEDLINE、科学网、谷歌学术和埃塞俄比亚大学在线知识库。使用Excel数据提取格式提取数据，并使用Stata 17版本进行分析。采用随机效应模型进行荟萃分析，并根据发表年份和样本量进行亚组分析，以识别异质性来源。为确定发表偏倚，进行了漏斗图分析和Egger回归检验。
在本综述中，共分析了10篇文章，涉及4466名参与者。埃塞俄比亚孕中期人工流产的合并患病率为29.10%（95%CI：19.96 - 38.24；I² = 97.84，P < 0.000）。妊娠确认延迟（比值比 = 4.33，95%CI：2.25，8.32）、月经周期性质（比值比 = 0.32，95%CI：0.18，0.56）、居住地（比值比 = 0.38，95%CI：0.30，0.49）和妊娠意愿（比值比 = 0.28，95%CI：0.18，0.42）与孕中期人工流产显著相关。
埃塞俄比亚孕中期人工流产的规模显著高于全球数据。这项荟萃分析确定了与孕中期流产相关的因素，包括妊娠确认延迟、月经周期不规律、农村居住和意外怀孕。研究结果凸显了针对性干预措施的迫切需求，以解决这些因素并降低孕中期流产的发生率。鼓励早期妊娠检测和确认以减少延迟，提高对规律月经周期重要性的认识并为月经不规律寻求医疗建议，改善农村地区的医疗服务以减少差距，以及加强计划生育和咨询服务，有助于减少意外怀孕和人工流产。
PROSPERO（CRD42022383559）
