埃塞俄比亚孕中期人工流产的规模及相关因素：一项系统评价与荟萃分析。
The magnitude of second-trimester induced abortion and associated factors in Ethiopia: a systematic review and meta-analysis.
作者信息
Mekie Maru, Fenta Setegn Muche, Ferede Wassie Yazie, Yehuala Enyew Dagnew, Dagnaw Eyaya Habtie, Ayele Alemu Degu, Mengistu Temesgen Dessie, Mengistie Belaynew Alemye, Tadesse Selamawit Girma, Addisu Dagne
机构信息
Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Statistics, College of Natural and Computational Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
出版信息
Front Glob Womens Health. 2025 Jul 1;6:1535329. doi: 10.3389/fgwh.2025.1535329. eCollection 2025.
BACKGROUND
Even though Ethiopia has a non-restrictive abortion law, abortion complications are one of the top five maternal morbidity and mortality causes in the country. Most women visit health facilities for pregnancy termination at second-trimester which leads to higher abortion-related complications than first-trimester abortion. There is no national evidence regarding the level of second-trimester-induced abortion in Ethiopia. This study aimed to determine the magnitude of second-trimester induced abortion and its determinant factors.
METHODS
Online searches using different online bases such as PubMed, HINARI, SCOPUS, Google Scholar, and University digital libraries were conducted to identify candidate studies to be included in this systematic review and meta-analysis. The Newcastle-Ottawa Quality Assessment Scale (NOS) was used to assess the quality of studies to be included in this review. Data extraction and analysis were performed using Microsoft Excel and Stata 17 software respectively. The heterogeneity of studies was assessed using Cochran (Q test) and I test statistics. We assessed publication bias using a funnel plot and Egger's regression asymmetry test.
RESULTS
Eight studies with a total study population of 3,659 were included in this review. The pooled prevalence of second-trimester induced abortion was 25.96% (95%, CI 14.42%, 37.49%) in Ethiopia. The finding of this systematic review indicated that being single [(OR = 5.20, 95%, CI 3.04, 8.90), = 0.00%, = 0.69], delay in the diagnosis of pregnancy [(OR = 3.01, 95%, CI 1.23, 7.38), = 80.74%, = 0.01], no formal/low education level [(OR = 3.54, 95%. CI 1.84, 6.78), = 69.71, 57.15%, = 0.04], and being rural resident [(OR = 2.16, 95%, CI 1.61, 2.92), = 0.00%, = 0.53] were factors significantly associated with second trimester induced abortion in Ethiopia.
CONCLUSION
The prevalence of second-trimester abortion was found to be high in Ethiopia. Being single, delay in the diagnosis of pregnancy, having no formal/low education level, and being rural residents were factors significantly associated with second-trimester induced abortion in Ethiopia. Enhancing the sexual and reproductive health literacy of reproductive-age women as well as access to safe abortion services are relevant measures to be taken to reduce late visits to health institutions for abortion services.
背景
尽管埃塞俄比亚有一项非限制性堕胎法，但堕胎并发症仍是该国孕产妇发病和死亡的五大原因之一。大多数女性在孕中期前往医疗机构终止妊娠，这导致与孕早期堕胎相比，堕胎相关并发症更高。埃塞俄比亚没有关于孕中期人工流产水平的全国性证据。本研究旨在确定孕中期人工流产的规模及其决定因素。
方法
使用不同的在线数据库，如PubMed、HINARI、SCOPUS、谷歌学术和大学数字图书馆进行在线搜索，以确定纳入本系统评价和荟萃分析的候选研究。使用纽卡斯尔-渥太华质量评估量表（NOS）评估纳入本评价的研究质量。分别使用Microsoft Excel和Stata 17软件进行数据提取和分析。使用Cochran（Q检验）和I检验统计量评估研究的异质性。我们使用漏斗图和Egger回归不对称检验评估发表偏倚。
结果
本评价纳入了8项研究，总研究人群为3659人。埃塞俄比亚孕中期人工流产的合并患病率为25.96%（95%，CI 14.42%，37.49%）。本系统评价的结果表明，单身[(OR = 5.20，95%，CI 3.04，8.90)，P = 0.00%，I² = 0.69]、妊娠诊断延迟[(OR = 3.01，95%，CI 1.23，7.38)，P = 80.74%，I² = 0.01]、未接受正规教育/教育水平低[(OR = 3.54，95%，CI 1.84，6.78)，P = 69.71，57.15%，I² = 0.04]以及为农村居民[(OR = 2.16，95%，CI 1.61，2.92)，P = 0.00%，I² = 0.53]是与埃塞俄比亚孕中期人工流产显著相关的因素。
结论
埃塞俄比亚孕中期堕胎的患病率很高。单身、妊娠诊断延迟、未接受正规教育/教育水平低以及为农村居民是与埃塞俄比亚孕中期人工流产显著相关的因素。提高育龄妇女的性健康和生殖健康素养以及提供安全堕胎服务是减少晚期前往医疗机构寻求堕胎服务的相关措施。
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