Prevalence and Associated Factors of Birth Injuries Among Neonates in Ethiopia: A Systematic Review and Meta-Analysis.

Introduction and Aims: Birth injuries contribute to neonatal morbidity and mortality. The incidence rates of birth injuries vary from 1.9 to 53 per 1000 live births. This systematic review and meta-analysis aimed to estimate the pooled prevalence of birth injuries in Ethiopian neonates and to identify key associated risk factors. The study addresses inconsistencies in previous prevalence estimates and fills knowledge gaps regarding important contributing factors that were insufficiently explored in earlier reviews. Methods: The study explored various databases to access articles about the prevalence and associated factors of birth injuries among newborns, which are pertinent only to Ethiopia. The Joanna Briggs Institute quality assessment tool was utilized to evaluate the quality of each study. Data analysis was conducted using Microsoft Excel and STATA 17.0 statistical software. A random effects model was employed to estimate the pooled prevalence of birth injuries. Additionally, the Cochrane Q-test statistics and the I² test were applied. Publication bias was assessed using funnel plots and Egger's statistical tests. Sensitivity analysis was also performed to detect the effects of smaller studies. Result: Six studies involving a total population of 3781 participants were included in the analysis. The pooled prevalence of birth injuries among newborns in Ethiopia was found to be 16.24% (95% CI: 13.34-19.14; I² = 82.67%; p < 0.001). Birth weight greater than 4 kg (adjusted odds ratio [AOR] = 8.88; 95% CI: 1.79-15.98), prolonged labor (AOR = 4.70; 95% CI: 1.90-7.49), vacuum-assisted birth (AOR = 14.92; 95% CI: 6.26 to 36.10), and forceps-assisted birth (AOR = 7.83; 95% CI: 4.71-10.95) were significant predictors. Conclusion and Recommendation: The prevalence of birth injuries is notably high. The identified predictors were preventable. Implementation of routine labor and delivery practice audits and enhancing the skills of healthcare providers are recommended to reduce the risk of birth injuries.