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Background <p>Perinatal asphyxia remains a leading cause of neonatal morbidity and mortality in Ethiopia, yet comprehensive and up-to-date evidence on its incidence and associated risk factors is limited. Thus, this study was conducted to identify the epidemiology of perinatal asphyxia among newborns in Ethiopia: a systematic review and meta-analysis of incidence and risk factors.</p> Methods <p>This systematic review and meta-analysis was carried out based on a pre-written and registered protocol on International Prospective Register of Systematic Reviews (PROSPERO) registration number (CRD42024589974). A comprehensive search of databases was conducted from PubMed/Medline, Scopus, Web of Science, Science Direct, African Journal Online, Google Scholar, and the Wiley Online Library, Cochrane Library. Population, Intervention, Comparator, Outcome, Context, and Other factors (PICOCO) and Population, Intervention, Comparator, Outcome (PICO) framework was applied. Studies were screened, and their quality was assessed using the Newcastle–Ottawa Scale. Data were extracted into Excel and then exported to STATA version 17 for analysis. Subgroup analyses were performed to identify potential sources of heterogeneity, and meta-regression was conducted to examine the influence of study-level covariates on effect sizes. Publication bias was assessed visually using funnel plots for asymmetry and statistically using Egger’s test.</p> Results <p>After removing 2,815 duplicates from the initial 4,740 collected studies, the pooled incidence of prenatal asphyxia in Ethiopia was 15% (95% Confidence Interval [CI]: 12–18%, <i>p</i> &lt; 0.001). The most commonly identified pooled risk factors included lack of antenatal care visits (Adjusted Odds Ratio [AOR] = 1.60; 95% CI: 1.12–2.29), rural residence (AOR = 1.56; 95% CI: 1.18–2.07), low birth weight (AOR = 2.33; 95% CI: 1.53–3.54), antepartum hemorrhage (AOR = 2.09; 95% CI: 1.12–3.90), preterm birth (AOR = 2.21; 95% CI: 1.65–2.96), and neonatal Intensive Care Unit (ICU) admission (AOR = 1.88; 95% CI: 1.09–3.25).</p> Conclusion and recommendation <p>This systematic review and meta-analysis identified a high incidence of perinatal asphyxia in Ethiopia, with regional variations. Several key risk factors were found to be significantly associated with the condition. Addressing these factors is crucial for preventing birth asphyxia and improving neonatal outcomes.</p>

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Epidemiology of perinatal asphyxia among newborns in Ethiopia: a systematic review and meta-analysis of incidence and risk factors

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  • 发表日期：

    2025年12月2日

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  • Birhanu Jikamo,
  • Zewditu Denu Abdissa,
  • Belayneh Hamdela Jena,
  • Alemu Earsido Addila,
  • Samson Mideksa Legesse,
  • Tesfahun Hailemariam

摘要

Background

Perinatal asphyxia remains a leading cause of neonatal morbidity and mortality in Ethiopia, yet comprehensive and up-to-date evidence on its incidence and associated risk factors is limited. Thus, this study was conducted to identify the epidemiology of perinatal asphyxia among newborns in Ethiopia: a systematic review and meta-analysis of incidence and risk factors.

Methods

This systematic review and meta-analysis was carried out based on a pre-written and registered protocol on International Prospective Register of Systematic Reviews (PROSPERO) registration number (CRD42024589974). A comprehensive search of databases was conducted from PubMed/Medline, Scopus, Web of Science, Science Direct, African Journal Online, Google Scholar, and the Wiley Online Library, Cochrane Library. Population, Intervention, Comparator, Outcome, Context, and Other factors (PICOCO) and Population, Intervention, Comparator, Outcome (PICO) framework was applied. Studies were screened, and their quality was assessed using the Newcastle–Ottawa Scale. Data were extracted into Excel and then exported to STATA version 17 for analysis. Subgroup analyses were performed to identify potential sources of heterogeneity, and meta-regression was conducted to examine the influence of study-level covariates on effect sizes. Publication bias was assessed visually using funnel plots for asymmetry and statistically using Egger’s test.

Results

After removing 2,815 duplicates from the initial 4,740 collected studies, the pooled incidence of prenatal asphyxia in Ethiopia was 15% (95% Confidence Interval [CI]: 12–18%, p < 0.001). The most commonly identified pooled risk factors included lack of antenatal care visits (Adjusted Odds Ratio [AOR] = 1.60; 95% CI: 1.12–2.29), rural residence (AOR = 1.56; 95% CI: 1.18–2.07), low birth weight (AOR = 2.33; 95% CI: 1.53–3.54), antepartum hemorrhage (AOR = 2.09; 95% CI: 1.12–3.90), preterm birth (AOR = 2.21; 95% CI: 1.65–2.96), and neonatal Intensive Care Unit (ICU) admission (AOR = 1.88; 95% CI: 1.09–3.25).

Conclusion and recommendation

This systematic review and meta-analysis identified a high incidence of perinatal asphyxia in Ethiopia, with regional variations. Several key risk factors were found to be significantly associated with the condition. Addressing these factors is crucial for preventing birth asphyxia and improving neonatal outcomes.