背景:新生儿和婴儿的连续护理,例如基本的新生儿护理,早期开始和纯母乳喂养,强烈建议进行免疫接种,以提高婴儿的生活质量和存活率。然而,撒哈拉以南非洲国家的新生儿和婴儿死亡率仍然很高。虽然意外怀孕与不良的新生儿和婴儿健康结局有关,关于妊娠意向是否影响新生儿和婴儿连续完成护理的证据尚无定论。因此,本综述旨在汇集文献中报道的关于撒哈拉以南非洲地区连续护理中妊娠意向与新生儿和婴儿保健之间关系的研究结果.
方法:我们搜索了MEDLINEComplete,EMBASE,CINAHL完成,和全球卫生数据库,用于可能符合本系统评价和荟萃分析的研究。两名研究人员通过摘要和标题独立筛选了已确定的文章,然后使用Covidence全文。我们使用纽卡斯尔-渥太华量表来评估纳入研究的质量。进行CochranQ检验和I2检验以检测和量化研究中统计异质性的存在。当一项以上的原始研究报告相关数据时,对每个结果进行荟萃分析,使用Stata统计软件第18版。
结果:共纳入了通过检索确定的235篇文章中的11项研究。完成基本新生儿护理的几率(汇总优势比:3.04,95%CI:1.56,5.90),早期开始母乳喂养(汇总比值比:1.30,95%CI:1.13,1.52),纯母乳喂养(汇总比值比:2.21,95%CI:1.68,2.89),与意外怀孕的女性相比,计划怀孕的女性所生婴儿的完全免疫(合并比值比:2.73,95%CI:1.16,6.40)较高.
结论:预期妊娠与基本新生儿护理完成呈正相关,早期开始和纯母乳喂养,和SSA国家的婴儿全面免疫接种。因此,决策者和利益攸关方应加强提供优质计划生育服务,以防止意外怀孕。此外,需要对意外怀孕妇女采取后续行动,以增加妇女获得基本新生儿保健服务的机会,从而进一步降低新生儿和婴儿发病率和死亡率的风险。
背景:PROSPERO注册号CRD42023409148。
BACKGROUND: The newborn and infant continuum of care such as essential newborn care, early initiation and exclusive breastfeeding, and immunisation are highly recommended for improving the quality of life and survival of infants. However, newborn and infant mortality remains high across Sub-Saharan African countries. While unintended pregnancies are associated with adverse newborn and infant health outcomes, there is inconclusive evidence on whether pregnancy intention influences newborn and infant continuum of care completion. Therefore, this review aimed to pool findings reported in the literature on the association between pregnancy intention and newborn and infant health care across the continuum of care in Sub-Saharan Africa.
METHODS: We searched MEDLINE Complete, EMBASE, CINAHL Complete, and Global Health databases for studies potentially eligible for this systematic review and meta-analysis. Two researchers independently screened the identified articles by abstract and title, and then full-text using Covidence. We used the Newcastle-Ottawa Scale to assess the quality of the included studies. The Cochran\'s Q test and I2 were executed to detect and quantify the presence of statistical heterogeneity in the studies. Meta-analysis was done for each outcome when more than one original study reported relevant data, using Stata statistical software version 18.
RESULTS: Eleven studies were included from a total of 235 articles identified by the search. The odds of completing essential newborn care (pooled odds ratio: 3.04, 95% CI: 1.56, 5.90), early initiation of breastfeeding (pooled odds ratio: 1.30, 95% CI: 1.13, 1.52), exclusive breastfeeding (pooled odds ratio: 2.21, 95% CI: 1.68, 2.89), and being fully immunised (pooled odds ratio: 2.73, 95% CI: 1.16, 6.40) were higher among infants born to women with intended pregnancies as compared to women with unintended pregnancies.
CONCLUSIONS: Intended pregnancy was positively associated with essential newborn care completion, early initiation and exclusive breastfeeding, and full immunisation of infants in SSA countries. Thus, policy-makers and stakeholders should strengthen the provision of quality family planning services to prevent unintended pregnancy. Furthermore, follow-up of women with unintended pregnancies is needed to increase women\'s opportunity to access essential newborn health care services that further reduce the risk of newborn and infant morbidity and mortality.
BACKGROUND: PROSPERO registration number CRD42023409148.