Pooled prevalence and predictors of intraventricular hemorrhage (IVH) in preterm neonates (28–34 weeks) in Africa: a systematic review and meta-analysis

Abstract Objective To assess the pooled prevalence and predictors of intraventricular hemorrhage (IVH) among preterm neonates born between 28 and 34 weeks of gestational age in Africa. Method A weighted inverse-variance random-effects model estimated the pooled prevalence and predictors of germinal...

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Main Authors: Solomon Demis Kebede, Demewoz Kefale, Tigabu Munye Aytenew, Kindu Agmas
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Pediatrics
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Online Access:https://doi.org/10.1186/s12887-025-05462-6
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author Solomon Demis Kebede
Demewoz Kefale
Tigabu Munye Aytenew
Kindu Agmas
author_facet Solomon Demis Kebede
Demewoz Kefale
Tigabu Munye Aytenew
Kindu Agmas
author_sort Solomon Demis Kebede
collection DOAJ
description Abstract Objective To assess the pooled prevalence and predictors of intraventricular hemorrhage (IVH) among preterm neonates born between 28 and 34 weeks of gestational age in Africa. Method A weighted inverse-variance random-effects model estimated the pooled prevalence and predictors of germinal matrix hemorrhage. Heterogeneity was assessed using forest plots and I² statistics, focusing on studies conducted in African settings. Cross-sectional studies published in English between 2004 and 2022 were identified through online and manual searches conducted from September 18 to October 27, 2024. Outcome measure Intraventricular hemorrhage/Germinal matrix hemorrhage (Grades I-IV), defined as bleeding in a developing brain region that typically resolves by term gestational age. Result Ten primary studies involving 2,622 preterm neonates born at 28–34 weeks of gestation were included. The pooled prevalence of IVH was nearly three in ten cases, with substantial heterogeneity across studies (I² = 99%, P < 0.001). Extremely premature neonates had almost twice the risk of IVH compared to those born after 28 weeks (AOR = 1.98; 95% CI: 1.31–3.64). Antenatal corticosteroid (ANC) administration reduced IVH risk by 35% (AOR = 0.65; 95% CI: 0.08–0.78), while intubation status showed no significant effect (AOR = 1.04; 95% CI: -0.19–2.28). Conclusion The pooled prevalence of IVH in very preterm and very low birth weight (VLBW) neonates in Africa was considerable, affecting nearly three out of ten cases. Extremely premature neonates were almost twice as likely to develop IVH compared to those born after 28 weeks of gestation, while antenatal corticosteroid (ANC) administration significantly reduced the risk. Intubation status had no significant impact on IVH risk. These findings highlight the urgent need for healthcare professionals and policymakers to prioritize preterm care standards in Africa to improve neonatal outcomes. PROSPERO ID CRD42024499505.
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spelling doaj-art-9af4dae792834c02aef5bd072f32c3012025-08-20T02:12:59ZengBMCBMC Pediatrics1471-24312025-02-0125111310.1186/s12887-025-05462-6Pooled prevalence and predictors of intraventricular hemorrhage (IVH) in preterm neonates (28–34 weeks) in Africa: a systematic review and meta-analysisSolomon Demis Kebede0Demewoz Kefale1Tigabu Munye Aytenew2Kindu Agmas3Department of Pediatrics and Neonatal Nursing, Debre Tabor UniversityDepartment of Pediatrics and Neonatal Nursing, Debre Tabor UniversityDepartment of Comprehensive Nursing, Debre Tabor UniversityDepartment of Pediatrics and Child Health, Debre Tabor Comprehensive Specialized HospitalAbstract Objective To assess the pooled prevalence and predictors of intraventricular hemorrhage (IVH) among preterm neonates born between 28 and 34 weeks of gestational age in Africa. Method A weighted inverse-variance random-effects model estimated the pooled prevalence and predictors of germinal matrix hemorrhage. Heterogeneity was assessed using forest plots and I² statistics, focusing on studies conducted in African settings. Cross-sectional studies published in English between 2004 and 2022 were identified through online and manual searches conducted from September 18 to October 27, 2024. Outcome measure Intraventricular hemorrhage/Germinal matrix hemorrhage (Grades I-IV), defined as bleeding in a developing brain region that typically resolves by term gestational age. Result Ten primary studies involving 2,622 preterm neonates born at 28–34 weeks of gestation were included. The pooled prevalence of IVH was nearly three in ten cases, with substantial heterogeneity across studies (I² = 99%, P < 0.001). Extremely premature neonates had almost twice the risk of IVH compared to those born after 28 weeks (AOR = 1.98; 95% CI: 1.31–3.64). Antenatal corticosteroid (ANC) administration reduced IVH risk by 35% (AOR = 0.65; 95% CI: 0.08–0.78), while intubation status showed no significant effect (AOR = 1.04; 95% CI: -0.19–2.28). Conclusion The pooled prevalence of IVH in very preterm and very low birth weight (VLBW) neonates in Africa was considerable, affecting nearly three out of ten cases. Extremely premature neonates were almost twice as likely to develop IVH compared to those born after 28 weeks of gestation, while antenatal corticosteroid (ANC) administration significantly reduced the risk. Intubation status had no significant impact on IVH risk. These findings highlight the urgent need for healthcare professionals and policymakers to prioritize preterm care standards in Africa to improve neonatal outcomes. PROSPERO ID CRD42024499505.https://doi.org/10.1186/s12887-025-05462-6Transfontanelle ultrasoundIntraventricular hemorrhageIntracranial hemorrhage
spellingShingle Solomon Demis Kebede
Demewoz Kefale
Tigabu Munye Aytenew
Kindu Agmas
Pooled prevalence and predictors of intraventricular hemorrhage (IVH) in preterm neonates (28–34 weeks) in Africa: a systematic review and meta-analysis
BMC Pediatrics
Transfontanelle ultrasound
Intraventricular hemorrhage
Intracranial hemorrhage
title Pooled prevalence and predictors of intraventricular hemorrhage (IVH) in preterm neonates (28–34 weeks) in Africa: a systematic review and meta-analysis
title_full Pooled prevalence and predictors of intraventricular hemorrhage (IVH) in preterm neonates (28–34 weeks) in Africa: a systematic review and meta-analysis
title_fullStr Pooled prevalence and predictors of intraventricular hemorrhage (IVH) in preterm neonates (28–34 weeks) in Africa: a systematic review and meta-analysis
title_full_unstemmed Pooled prevalence and predictors of intraventricular hemorrhage (IVH) in preterm neonates (28–34 weeks) in Africa: a systematic review and meta-analysis
title_short Pooled prevalence and predictors of intraventricular hemorrhage (IVH) in preterm neonates (28–34 weeks) in Africa: a systematic review and meta-analysis
title_sort pooled prevalence and predictors of intraventricular hemorrhage ivh in preterm neonates 28 34 weeks in africa a systematic review and meta analysis
topic Transfontanelle ultrasound
Intraventricular hemorrhage
Intracranial hemorrhage
url https://doi.org/10.1186/s12887-025-05462-6
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