Predictors of birth asphyxia in Ethiopia: an updated systematic review with meta-analysis
Bibliographic record
Abstract
BACKGROUND: Birth asphyxia is one of the leading causes of most neonatal deaths. Hence, strengthening and investing in care is crucial, particularly around birth and the first week of life. As a result, several studies, including an umbrella review, were conducted even though significant variations were observed among those investigations. Thus, this is an updated systematic review and meta-analysis aimed to determine predictors of birth asphyxia in Ethiopia. METHODS: Online databases such as CINAHL, PubMed, Embase, Web of Science, and Cochrane Library were searched. Online searches turned up pertinent grey literature, and repositories of several universities were also searched. Observational studies carried out in Ethiopia were included. The authors conducted an independent search, quality check, and data extraction. The Newcastle Ottawa Scale checklist was used to evaluate the quality of articles. STATA version 17 was used for both data entry and statistical analysis. Since there were variations among studies, a random-effect model was employed for analysis. Egger's regression test and funnel plot were utilized to assess publication bias, and the I-squared test was performed to verify the studies' heterogeneity. RESULTS: This analysis comprised 38 studies with 13,593 sample sizes. The pooled prevalence of birth asphyxia was 23.07% (95% CI: 19.96, 26.18). An intrapartum (i.e., prolonged labor, blood- or meconium-stained amniotic fluid, tight nuchal cord, cord prolapse, intrapartum fetal distress, malposition/malpresentation, and premature rupture of membrane) and obstetric procedure (i.e., labor induction, emergency cesarean sections, instrumental deliveries, and night time deliveries) factors were significantly associated with birth asphyxia. Moreover; neonatal (i.e., low birth weight, premature birth, and the male sex of the neonate), and maternal (i.e., place of residence, primigravida, mother's age, chronic hypertension, pregnancy-induced hypertension, anemia throughout pregnancy, antepartum hemorrhage, absence of antenatal care follow-up) were also significantly associated with birth asphyxia. CONCLUSIONS: This meta-analysis indicates nearly one in four newborns suffered from birth asphyxia in Ethiopia. It implicates tailored interventions for an intrapartum, maternal, neonatal, and an obstetrics procedure-related associated factors are needed to reduce birth asphyxia, thereby enhancing achievement of the sustainable development goal that aimed to reduce neonatal mortality to less than 12 per 1000 live births. Therefore, advocacy for public health initiatives aimed at increasing awareness of birth asphyxia and promoting early detection and intervention strategies, multidisciplinary approaches, and interventional studies are crucial.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.031 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.016 | 0.032 |
| Bibliometrics | 0.012 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".