Preconception health risks among women of reproductive age in Sub-Saharan Africa: a systematic review of implications for preconception care

Abstract Introduction Although preconception health risks are strongly linked to adverse pregnancy outcomes and offer opportunities to improve women’s health, consolidated evidence remains limited in Sub-Saharan Africa (SSA). This review aims to synthesize evidence on preconception health risks in S...

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Main Authors: Gebremedhin Gebreegziabher Gebretsadik, Andargachew Kassa Biratu, Amanuel Gessessew, Zohra S. Lassi, Alemayehu Bayray Kahsay, Afework Mulugeta
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Journal of Health, Population and Nutrition
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Online Access:https://doi.org/10.1186/s41043-025-00888-1
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author Gebremedhin Gebreegziabher Gebretsadik
Andargachew Kassa Biratu
Amanuel Gessessew
Zohra S. Lassi
Alemayehu Bayray Kahsay
Afework Mulugeta
author_facet Gebremedhin Gebreegziabher Gebretsadik
Andargachew Kassa Biratu
Amanuel Gessessew
Zohra S. Lassi
Alemayehu Bayray Kahsay
Afework Mulugeta
author_sort Gebremedhin Gebreegziabher Gebretsadik
collection DOAJ
description Abstract Introduction Although preconception health risks are strongly linked to adverse pregnancy outcomes and offer opportunities to improve women’s health, consolidated evidence remains limited in Sub-Saharan Africa (SSA). This review aims to synthesize evidence on preconception health risks in SSA, a region with the highest global rates of maternal and neonatal mortality and morbidity. Methods We searched PubMed/MEDLINE, African Index Medicus, ScienceDirect, and Google Scholar for studies published up to June 30, 2023. Two reviewers independently assessed study quality using Joanna Briggs Institute tools. Studies with at least one modifiable preconception risk were included. Due to inconsistencies in outcome measurements, participant variability, and high heterogeneity, a meta-analysis was not reported. Findings were summarized in text, figures, and tables. Results In the review, researchers selected 83 articles from a total of 3,425 retrieved articles. Overall, this review revealed a high proportion of preconception health risks among the participants which includes underweight (0.64% to 36.2%), overweight (8.3% to 76.7%), anemia (36.7% to 58.1%), unintended pregnancy (4.2% to 94.3%), alcohol intake (5.3% to 68.7%), smoking (1.1% to 20.3%), chewing khat (9.9% to 27.6%), history of chronic medical conditions (2% to 16.6%), a history of adverse pregnancy outcomes (11% to 51.9%), sexually transmitted infections (1.3% to 29.2%), psychosocial distress (13.9% to 60%), and intimate partner violence (6.7% to 43.7%). Conclusion The systematic review found that numerous women in  SSA encounter various preconception health risks factors. Therefore, the governments of respective countries need to give emphasis and adopt policies to integrate preconception care services in to the existing healthcare system so that both financial and human resources need to be mobilized. There is gaps in research, as the true burden of preconception health risks may be underestimated due to fragmented risk assessment methods. Review registration: (PROSPERO: CRD42023446801)
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spelling doaj-art-2aaef4c9482f4ae79afaea69da250f322025-08-20T02:29:51ZengBMCJournal of Health, Population and Nutrition2072-13152025-05-0144112410.1186/s41043-025-00888-1Preconception health risks among women of reproductive age in Sub-Saharan Africa: a systematic review of implications for preconception careGebremedhin Gebreegziabher Gebretsadik0Andargachew Kassa Biratu1Amanuel Gessessew2Zohra S. Lassi3Alemayehu Bayray Kahsay4Afework Mulugeta5Department of Midwifery, College of Medicine and Health Sciences, Adigrat UniversitySchool of Public Health, College of Medicine and Health Sciences, Hawassa UniversitySchool of Medicine, College of Health Sciences, Mekelle UniversitySchool of Public Health, Faculty of Health and Medical Sciences, University of AdelaideSchool of Public Health, College of Health Sciences, Mekelle UniversitySchool of Public Health, College of Health Sciences, Mekelle UniversityAbstract Introduction Although preconception health risks are strongly linked to adverse pregnancy outcomes and offer opportunities to improve women’s health, consolidated evidence remains limited in Sub-Saharan Africa (SSA). This review aims to synthesize evidence on preconception health risks in SSA, a region with the highest global rates of maternal and neonatal mortality and morbidity. Methods We searched PubMed/MEDLINE, African Index Medicus, ScienceDirect, and Google Scholar for studies published up to June 30, 2023. Two reviewers independently assessed study quality using Joanna Briggs Institute tools. Studies with at least one modifiable preconception risk were included. Due to inconsistencies in outcome measurements, participant variability, and high heterogeneity, a meta-analysis was not reported. Findings were summarized in text, figures, and tables. Results In the review, researchers selected 83 articles from a total of 3,425 retrieved articles. Overall, this review revealed a high proportion of preconception health risks among the participants which includes underweight (0.64% to 36.2%), overweight (8.3% to 76.7%), anemia (36.7% to 58.1%), unintended pregnancy (4.2% to 94.3%), alcohol intake (5.3% to 68.7%), smoking (1.1% to 20.3%), chewing khat (9.9% to 27.6%), history of chronic medical conditions (2% to 16.6%), a history of adverse pregnancy outcomes (11% to 51.9%), sexually transmitted infections (1.3% to 29.2%), psychosocial distress (13.9% to 60%), and intimate partner violence (6.7% to 43.7%). Conclusion The systematic review found that numerous women in  SSA encounter various preconception health risks factors. Therefore, the governments of respective countries need to give emphasis and adopt policies to integrate preconception care services in to the existing healthcare system so that both financial and human resources need to be mobilized. There is gaps in research, as the true burden of preconception health risks may be underestimated due to fragmented risk assessment methods. Review registration: (PROSPERO: CRD42023446801)https://doi.org/10.1186/s41043-025-00888-1Preconception health risksSystematic reviewSub-Saharan AfricaPreconception care
spellingShingle Gebremedhin Gebreegziabher Gebretsadik
Andargachew Kassa Biratu
Amanuel Gessessew
Zohra S. Lassi
Alemayehu Bayray Kahsay
Afework Mulugeta
Preconception health risks among women of reproductive age in Sub-Saharan Africa: a systematic review of implications for preconception care
Journal of Health, Population and Nutrition
Preconception health risks
Systematic review
Sub-Saharan Africa
Preconception care
title Preconception health risks among women of reproductive age in Sub-Saharan Africa: a systematic review of implications for preconception care
title_full Preconception health risks among women of reproductive age in Sub-Saharan Africa: a systematic review of implications for preconception care
title_fullStr Preconception health risks among women of reproductive age in Sub-Saharan Africa: a systematic review of implications for preconception care
title_full_unstemmed Preconception health risks among women of reproductive age in Sub-Saharan Africa: a systematic review of implications for preconception care
title_short Preconception health risks among women of reproductive age in Sub-Saharan Africa: a systematic review of implications for preconception care
title_sort preconception health risks among women of reproductive age in sub saharan africa a systematic review of implications for preconception care
topic Preconception health risks
Systematic review
Sub-Saharan Africa
Preconception care
url https://doi.org/10.1186/s41043-025-00888-1
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