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Abstract
BackgroundSeveral studies have reported on factors influencing adolescent pregnancies and the associated outcomes, but evidence from a systematic review is limited, especially in sub-Saharan Africa where the greater burden lies. Establishment of accurate epidemiological data on the rates of adolescent pregnancy, its predictors, and adverse outcomes (maternal and neonatal) may have important implications towards attainment of the Sustainable Development Goals.MethodsThis will be a systematic review of studies reporting predictors of adolescent pregnancy and adverse outcomes in sub-Saharan Africa published between January 2000 and December 2017. The following databases will be searched: PubMed/MEDLINE, Excerpta Medica Database (EMBASE), SCOPUS, Popline, Africa Wide Information, African Index Medicus, Google scholar and the Cochrane library. Three authors will independently screen all potential articles for eligibility as guided by the selection criteria. The Stata statistical software will be used in analysing the data. Appropriate meta-analytic techniques will be used to pool prevalence estimates from studies with similar features, overall and by major subgroups as warranted. Heterogeneity of studies will be evaluated by the χ2 test on Cochrane’s Q statistic. Publication bias will be sorted for using funnel plot analysis and Egger’s test. Qualitative synthesis will be used where data are insufficient to produce a quantitative synthesis. This protocol is reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines.DiscussionThis systematic review and meta-analysis is expected to serve as a template for designing adolescent-friendly preventive and control programmes to help curb the ever-growing burden of adolescent pregnancies, and as a guide for future research.Systematic review registrationPROSPERO CRD42017070773
Highlights
Several studies have reported on factors influencing adolescent pregnancies and the associated outcomes, but evidence from a systematic review is limited, especially in sub-Saharan Africa where the greater burden lies
In developed and developing nations alike, adolescent pregnancy is of growing public health importance with approximately 11% of global births occurring in girls aged 15 to 19 years, and about 95% of these births occur in low and middle countries (LMICs) [2]
General objective The overall aim of the study will be to estimate the prevalence of pregnancy, its predictors and outcomes among adolescent girls in sub-Saharan Africa via a systematic review and meta-analysis. Review questions This 17-year review is expected to answer the following questions: 1. What is the prevalence of adolescent pregnancy in sub-Saharan Africa?
Summary
This review protocol is registered in the PROSPERO International Prospective Register of systematic reviews (Registration Number: CRD42017070773) and is written and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 Guidelines [22]. Interventional studies Studies lacking prevalence rates, predictors and/or outcomes of adolescent pregnancy with absence of data to compute the relevant effect sizes will be excluded from quantitative analysis if the necessary. Data from the different studies to be included in the final analysis will be extracted by two independent investigators (CBS and SNN), and any inconsistency will be reconciled through. The following items will be extracted from the selected studies: authors, year of study, year of publication and journal, country where study was conducted, geographical region, language of publication, study design and setting, duration of study, sample size, objectives, mean/ median age, age range, gravidity, parity, gestational age, antenatal records and proportion of adolescent pregnancy, as well as its measures of association (χ2, ORs, RR, CIs and p values) when available. Was some form of random selection used to select the sample, OR, was a census undertaken?
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