Stillbirth and its association with early rupture of membranes in
Sub-Saharan Africa: Systematic review and meta-analysis
Abstract
Background: The stillbirth rate is an important indicator of access to
quality antenatal and delivery care services. Many previous pocket
studies were conducted to assess the magnitude of stillbirth. Method:
Electronic databases were used for searching original articles. The
heterogeneity of the studies was checked. The random-effects method was
applied to estimate the pooled prevalence of stillbirth and the effect
size of the early rupture of membranes in sub-Saharan Africa. Subgroup
analysis was performed. A funnel plot and Egger’s regression test were
used to see publication bias. Result: Pooled prevalence of stillbirth in
sub-Saharan Africa was 6.4 % (95% CI: 5.5 - 7.3). In sub-group
analysis, Southern African regions had a higher stillbirth prevalence
and the western African regions had a lower than East and Southern
Africa. The prevalence of stillbirth in the region is increased from
4.1% (95% CI: 2.2 – 6.0) before 2015 to 7.1% (95% CI: 5.8 - 8.3)
after 2015. The pooled odds ratio results from seven studies showed the
non-significant effect of early rupture of membrane on stillbirth
(pooled OR = 1.54, 95% CI: 0.26 - 2.82). According to the regression
test (Egger test), there were no small study effects or publication bias
(P = 0.108). Conclusions: Pooled prevalence of stillbirth in sub-Saharan
Africa was relativity high. The analysis establishes the minimal effects
of early rupture of membrane on stillbirth. Therefore, we recommend that
strengthening the testing intervention is crucial to reduce the still
relatively high stillbirth. Keywords: Stillbirth, Early Rupture of
Membranes, sub-Saharan Africa