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

Estela Blanco, Marcela Marin, Loreto Nuñez, Erika Retamal, Ximena Ossa, Katherine Woolley, Tosin Oludotun, Suzanne Bartington, Juana Maria Delgado Saborit, Roy Harrison, Pablo Ruiz-Rudolph, María Elisa Quinteros

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Abstract

Objective: To estimate the point prevalence and likely ranges of pregnancy-induced hypertension, preeclampsia, 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 prevalence 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 1 087 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 diabetes, 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 pregnancy 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.
Original languageEnglish
Article numbere21
Number of pages10
JournalPan American Journal of Public Health
Volume46
DOIs
Publication statusPublished - 2 May 2022

Keywords

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

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