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Adverse pregnancy and perinatal outcomes in Latin America and the Caribbean: systematic review and meta-analysis

Publisher

PAN AMER HEALTH ORGANIZATION
DOI: 10.26633/RPSP.2022.21

Keywords

Hypertension; pregnancy-induced; pre-eclampsia; diabetes; gestational; infant; low birth weight; premature birth; Latin America; Caribbean Region

Funding

  1. CONICYT [DPI20140093]
  2. Research Councils, United Kingdom [DPI20140093]
  3. Generalitat Valenciana - Regional Ministry of Education, Research, Culture and Sport under the Talented Researcher Support Programme - Plan GenT [CIDE-GENT/2019/064]
  4. ANID Chile Beca Doctorado Nacional [21150801, 21201332]

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This study provides updated estimates of some of the most prevalent adverse pregnancy and perinatal outcomes in Latin America and the Caribbean. There is important heterogeneity in prevalence estimates, which may reflect the diversity of populations in the region.
Objective. To estimate the point prevalence and likely ranges of pregnancy-induced hypertension, pre-eclampsia, gestational diabetes, low birth weight and preterm delivery in Latin America and the Caribbean, and evaluate the heterogeneity of the estimates. Methods. We conducted a systematic review and meta-analysis of observational studies reporting the prev-alence of maternal and perinatal adverse outcomes in populations in Latin American and the Caribbean published between 2000 and 2019 in English, Spanish, or Portuguese. We searched PubMed, Embase, and LILACS. We estimated the point prevalence and evaluated overall heterogeneity and, in sub-group analyses, heterogeneity by study design and level of bias. Results. Of 1087 records retrieved, 50 articles were included in the review: two on hypertensive disorders of pregnancy, 14 on pre-eclampsia, six on gestational diabetes, nine on low birth weight and 19 on preterm birth. No meta-analysis for hypertensive disorders of pregnancy could be done because of the small number of studies. Point prevalence estimates and 95% confidence intervals (CIs) for pre-eclampsia, gestational diabe-tes, low birth weight, and preterm birth were: 6.6% (95% CI: 4.9%, 8.6%), 8.5% (95% CI: 3.9%, 14.7%), 8.5% (95% CI: 7.2%, 9.8%), and 10.0% (95% CI: 8.0%, 12.0%), respectively. We observed substantial heterogeneity overall and by study design. No major differences in estimates were observed by level of bias. Conclusions. The results of this study provide updated estimates of some of the most prevalent adverse preg-nancy and perinatal outcomes in Latin America and the Caribbean. They highlight that important heterogeneity exists in prevalence estimates, which may reflect the diversity of populations in the region.

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