Background
Postpartum hemorrhage (PPH) is a major public health problem and remains one of the leading causes of maternal morbidity and mortality, with sub-Saharan Africa carrying the highest burden. This study aimed to determine the prevalence and risk factors of postpartum hemorrhage in Africa.
Methods
A systematic review and meta-analysis of observational studies estimating PPH was undertaken through literature searches in biomedical databases. The protocol has been registered at PROSPERO and is available at https://www.crd.york.ac.uk/, under the registration number (CRD42020206087). All statistical analyses were conducted using STATA-Version 13 software. To assess heterogeneity, the I2 test was used across the studies. A random-effect model was used to estimate the pooled prevalence of PPH. Odds ratios (OR) with 95% confidence intervals (CI) were also used to determine the association of variables with PPH.
Result
Twenty-nine articles were included in this meta-analysis with a total sample size of 179,730 from countries in Africa. The pooled prevalence of PPH in Africa from 2003 to 2023 was 4.2% (95% CI; 3–4). The regional distribution was 1% (95% CI: 1–1) in Eastern Africa, 3% (95% CI: 3–4) in Southern Africa, 4% (95% CI: 3–5) in Northern Africa, 5% (95% CI: 4–5) in Western Africa, and 5% (95% CI: 4–5) in Central Africa. Macrosomia and cesarean section were shown to be risk factors for PPH.
Conclusion
This analysis demonstrated that the prevalence of PPH was low. This result will inform risk factor-based prevention, cause-based treatment, and the planning and implementation of applicable public health strategies.
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