Is preterm birth associated with intimate partner violence and maternal malnutrition during pregnancy in Ethiopia? A systematic review and meta analysis

Melaku Desta; Temesgen Getaneh; Peter Memiah; Tadesse Yirga Akalu; Wondimeneh Shibabaw Shiferaw; Nigus Bililign Yimer; Biachew Asmare; Kirsten I Black

doi:10.1016/j.heliyon.2021.e08103

Is preterm birth associated with intimate partner violence and maternal malnutrition during pregnancy in Ethiopia? A systematic review and meta analysis

Heliyon. 2021 Oct 6;7(10):e08103. doi: 10.1016/j.heliyon.2021.e08103. eCollection 2021 Oct.

Authors

Melaku Desta¹, Temesgen Getaneh¹, Peter Memiah², Tadesse Yirga Akalu³, Wondimeneh Shibabaw Shiferaw⁴, Nigus Bililign Yimer⁵, Biachew Asmare⁶, Kirsten I Black⁷

Affiliations

¹ Department of Midwifery, College of Health Sciences, Debre Markos University, Ethiopia.
² Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland, School of Medicine, Baltimore, Maryland, USA.
³ Department of Nursing, College of Health Sciences, Debre Markos University, Ethiopia.
⁴ College of Health Sciences, Debre Birhan University, Debre Birhan, Ethiopia.
⁵ Department of Midwifery, College of Health Sciences, Woldia University, Ethiopia.
⁶ Department of Human Nutrition and Food Science, College of Health Sciences, Debre Markos University, Ethiopia.
⁷ Professor, Speciality Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health The University of Sydney, Australia.

Abstract

Background: Despite remarkable progress in the reduction of under-five mortality, preterm birth associated mortality and morbidity remains a major public health problem in Sub-saharan Africa. In Ethiopia, study findings on the association of preterm birth with intimate partner violence and maternal malnutrition have been inconsistent. Therefore, this systematic review and meta-analysis estimates the pooled effect of intimate partner violence and maternal malnutrition on preterm birth.

Methods: International databases including PubMed, Web of Science, SCOPUS, CINAHL, PsycINFO, Google Scholar, Science Direct, and the Cochrane Library, were systematically searched. All identified observational studies and/or predictors were included. I² statistics and Egger's test were used to assess the heterogeneity and publication biases of the studies. A random-effects model was computed to estimate the prevalence and its determinants of preterm birth.

Results: The random effects meta-analysis showed that a pooled national prevalence of preterm birth was 13% (95% CI: 10.0%, 16.0%). The highest prevalence of preterm birth was 25% (95% CI: 21.0%, 30.0%) in Harar, and the lowest prevalence was 8% in Southern Nations Nationalities People of Representatives. The meta-analysis suggested a decrease in preterm birth of up to 61% among women receiving antenatal care [POR = 0.39 (95% CI: 0.21, 0.72)]. Women who experienced intimate partner violence [POR = 2.52 (95% CI: 1.68, 3.78)], malnutrition during pregnancy [POR = 2.00 (95% CI: 1.16, 3.46)], and previous preterm birth [POR = 3.73 (95% CI: 2.37, 5.88)] had significantly higher odds of preterm birth.

Conclusion: One in every eight live births in Ethiopia were preterm. Women who experienced intimate partner violence, malnutrition, and had previous preterm exposure were significantly associated with preterm birth. Thus, improving antenatal care visits and screening women who experience previous preterm birth are key interventions. The Federal Ministry of Health could be instrumental in preventing intimate partner violence and improving the nutritional status of pregnant women through proper and widespread implementation of programs to reduce preterm birth.

Keywords: Antenatal care visit; Ethiopia; Meta-analysis; Preterm birth.