STILLBIRTH AND ITS ASSOCIATION WITH EARLY RUPTURE OF MEMBRANES IN SUB SAHARAN AFRICA: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Background: The stillbirth rate could be a crucial indicator of access to quality antenatal and delivery care services. Many previous pocket studies were conducted to assess the magnitude of stillbirth and its association with premature rupture of the membrane. However, the extent of stillbirth, furthermore as its relationship with premature rupture of membrane (PROM), varies from study to review. Objectives: This systematic review and meta-analysis was conducted to estimate the pooled prevalence of stillbirth and its association with the early rupture of membranes in sub-Saharan Africa. Method: Electronic databases like PubMed, Cochrane library, Medline via Virtual Health Library (VHL), HINARI (Health Inter Network Access to Research Initiative) portal, and Google scholar were used for searching for original articles. The heterogeneity of the studies was checked by I-squared statistics. A Random-effects method was applied to estimate the pooled prevalence of stillbirth and the effect size of the primary rupture of membranes in Black Africa. Subgroup analysis was performed supported region (East, West, Central, and Southern Africa) and year of study (before 2015 and after 2015). A funnel plot and Egger 's regression test were accustomed see publication bias. Result: Pooled prevalence of stillbirth in nation was 7.9 % (95% CI: 7.1 – 8.8). In sub-group analysis, Central African regions had the subsequent stillbirth prevalence and the western and Southern African regions had a below East and Central Africa. The prevalence of stillbirth within the region is increased from 5.20% (95% CI: 3.09 – 7.31) before 2015 to 9.95% (95% CI: 7.43 – 12.46) after 2015. The pooled odds ratio results from seven studies showed the significant effect of early rupture of membrane on stillbirth (pooled OR = 2.00, 95% CI: 1.25 - 2.75). In step with the regression test (Egger test), there are no small study effects or publication bias (P = 0.11). Conclusions and Recommendation: The pooled prevalence of stillbirth in countryside was relativity high. The analysis establishes the great effects of early rupture of membrane on stillbirth. Therefore, strengthening the testing intervention is crucial to chop back the still relatively high stillbirths. Systematic review registration number: CRD42020171329.