The Burden of Adverse Neonatal Outcome among Antenatal Substance Users in Ethiopia: A Systematic Review and Meta-Analysis

Author:

Bayih Wubet Alebachew12ORCID,Ayalew Metadel Yibeltal34,Tadege Melaku15ORCID,Mekie Maru16,Kiros Teklehaimanot17,Alemu Eshetie Molla16,Alemnew Efrem Fenta18,Getacher Lemma910ORCID,Belay Demeke Mesfin111,Birhane Binyam Minuye12,Alemu Dr Kassaw Demilie112,Yitbarek Getachew Yideg113,Kefale Belayneh114

Affiliation:

1. Debre Tabor University, Debre Tabor, Ethiopia

2. Master of Science degree in Maternity and Neonatal Health Nursing

3. Bahir Dar University, Bahir Dar, Ethiopia

4. Bachelor of Science degree in Comprehensive Nursing

5. Assistant Professor of Human Nutrition

6. Master of Public Health degree in Reproductive Health

7. Master of Science degree in Medical Micro-Biology

8. Master of Science degree in Advanced Clinical Anesthesia

9. Debre Berhan University, Debre Berhan, Ethiopia

10. Master of Public Health degree in Human Nutrition

11. Master of Science degree in Pediatrics and Child Health Nursing

12. Assistant Professor of General Human Surgery

13. Master of Science degree in Medical Physiology

14. Master of Science degree in Clinical Pharmacy

Abstract

Background. Substances mainly khat, alcohol and cigarette are used during pregnancy in Ethiopia. However, to this date, there is no pooled evidence about the burden of adverse neonatal outcomes among the substance users during pregnancy in the country. Methods. Eligible primary studies were accessed from 4 international data bases (Google Scholar, Science Direct, Scopus, and PubMed). The required data were extracted from these studies and then exported to stata version 14 for analysis. Subgroup analyses were conducted for evidence of heterogeneity. Results. A total of 2298 neonates were included from 7 studies. Among these neonates, 530(23.06%) were those whose mothers used substance during pregnancy (exposed group) whereas 1768 neonates were those whose mothers didn’t use substance during pregnancy (controls group). The pooled prevalence of adverse neonatal outcome among the exposed mothers was 38.32% (95% CI: 29.48%, 47.16%; I2 = 76.3%) whereas it was 16.29% (95% CI: 9.45%, 23.13%) among the controls. Adverse neonatal outcome was most burdensome among cigarette smokers 45.20% (95% CI: 37.68%, 52.73%; I2 = .00%) when compared with khat chewers 34.00% (95% CI: 20.87%, 47.13%) and alcohol drinkers 38.47% (95% CI: 17.96%, 58.98%). Low birth weight 42.00% (95% CI: 18.01%, 65.99%; I2 = 91.8%) was the most common adverse birth outcome. Conclusion. It was found that adverse neonatal outcomes were much more burdensome among antenatal substance users than the controls. Therefore, mothers should be enabled to quit using substance before pregnancy. Besides, strict comprehensive screening of every pregnant mother should be made at antenatal care clinics for early identification and management of antenatal substance use.

Publisher

SAGE Publications

Subject

Pediatrics,Pediatrics, Perinatology, and Child Health

Reference52 articles.

1. World Health Organization. WHO Guidelines for the identification and management of substance use and substance use disorders in pregnancy. WHO, 2014.

2. Substance use during pregnancy

3. Smoking during pregnancy and harm reduction in birth weight: a cross-sectional study

4. The effects of maternal smoking exposure during pregnancy on postnatal outcomes: A cross sectional study

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