Assefa Ebrahim Msaye, Kassaw Altaseb Beyene, Belete Mekonnen, Tareke Amare Abera, Alem Addis, Bihonegn Mohammed Derso, Temam Ahmed Juhar, Abebe Gashaw, Mankelkl Gosa, Kassaw Abdulaziz Kebede, Abdu Seid Mohammed
Department of Biomedical Sciences, School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
Department of Biomedical Sciences, School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
BMJ Open. 2025 Oct 20;15(10):e104398. doi: 10.1136/bmjopen-2025-104398.
Gestational trophoblastic disease, characterised by abnormal proliferation of trophoblastic tissue in the placenta during pregnancy, contributes to maternal morbidity and mortality. This study aimed to estimate the pooled prevalence and histopathological patterns of gestational trophoblastic disease in Africa, where previous studies have reported inconsistent findings.
Systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.
We searched PubMed, ScienceDirect, Hinari and Google Scholar for studies published between January 2000 and January 2024.
Institution-based observational studies from African countries reporting the prevalence and/or histopathological patterns of gestational trophoblastic disease, using total deliveries as the denominator.
Data were extracted into Excel and analysed using Stata V.17. Pooled estimates were calculated using a random-effects model with Knapp-Hartung adjustment. Heterogeneity was assessed with Cochran's Q test and the I² statistic, and study quality was evaluated using the Joanna Briggs Institute tool.
Of the 2252 studies identified, 33 were included, comprising 2885 gestational trophoblastic disease cases from eight countries. The pooled prevalence of gestational trophoblastic disease in Africa was 4.35 per 1000 deliveries (95% CI 3.26 to 5.45, I=99.8%). The pooled prevalence of hydatidiform mole, invasive mole and choriocarcinoma in Africa was 3.49 per 1000 deliveries (95% CI 2.45 to 4.52, I=99.7%), 0.47 per 1000 deliveries (95% CI 0.14 to 0.79, I=72.2%) and 0.97 per 1000 deliveries (95% CI 0.54 to 1.40, I=99.1%), respectively.
This review indicated the prevalence of gestational trophoblastic disease was high. Hydatidiform mole was the predominant histopathological pattern observed. Routine antenatal screening is needed for early detection. Further research should be conducted to identify risk factors and evaluate strategies for the prevention and management of the disease.
CRD42024504268.
妊娠滋养细胞疾病以孕期胎盘滋养层组织异常增殖为特征，可导致孕产妇发病和死亡。本研究旨在估计非洲妊娠滋养细胞疾病的合并患病率及组织病理学模式，此前的研究报告结果并不一致。
系统评价和荟萃分析遵循《系统评价和荟萃分析优先报告项目2020指南》。
我们在PubMed、ScienceDirect、Hinari和谷歌学术上检索了2000年1月至2024年1月发表的研究。
来自非洲国家的基于机构的观察性研究，报告妊娠滋养细胞疾病的患病率和/或组织病理学模式，以总分娩数作为分母。
数据提取到Excel中，并使用Stata V.17进行分析。采用带有Knapp-Hartung校正的随机效应模型计算合并估计值。使用Cochran's Q检验和I²统计量评估异质性，并使用乔安娜·布里格斯研究所工具评估研究质量。
在检索到的2252项研究中，纳入了33项，包括来自8个国家的2885例妊娠滋养细胞疾病病例。非洲妊娠滋养细胞疾病的合并患病率为每1000例分娩4.35例（95%可信区间3.26至5.45，I=99.8%）。非洲葡萄胎、侵蚀性葡萄胎和绒毛膜癌的合并患病率分别为每1000例分娩3.49例（95%可信区间2.45至4.52，I=99.7%）、每1000例分娩0.47例（95%可信区间0.14至0.79，I=72.2%）和每1000例分娩0.97例（95%可信区间0.54至1.40，I=99.1%）。
本综述表明妊娠滋养细胞疾病的患病率较高。葡萄胎是观察到的主要组织病理学模式。需要进行常规产前筛查以早期发现。应进一步开展研究以确定危险因素，并评估该疾病的预防和管理策略。
PROSPERO注册号：CRD42024504268。
