Epidemiology of perinatal asphyxia among newborns in Ethiopia: a systematic review and meta-analysis of incidence and risk factors
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.006 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".