Preference of mode of delivery and associated factors among mothers in East Africa: systematic review and meta-analysis

IntroductionPreference of mode of delivery refers to the expectant mother's personal choice or preference for the method by which she would like to have her baby delivered. Although there are many fragmented primary studies on the preference of mode of delivery among women in East Africa, the pooled preference rate is unknown. In addition, those studies disagreed on reporting the associated factors. Therefore, this study was intended to determine the pooled preference for mode of delivery and its associated factors among women in East Africa.MethodWe searched studies using PubMed, Scopus, Embase, Science Direct, and Google Scholar that were published between March 01/2014 and March 31/2024. This study used the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The quality of studies was evaluated using the modified Newcastle-Ottawa quality assessment tool. The data were extracted by two authors independently using Microsoft Excel and analyzed by Stata version 17. A random effects model was applied to calculate the pooled preference for mode of delivery and its associated factors. The PROSPERO registration number for the review was CRD42024541921.ResultsA total of 14 studies comprising 47,561 participants were involved in this meta-analysis. The pooled preference of vaginal delivery and cesarean delivery were 75% ((95% C.I = 67 - 83%) and 25% (95% C.I = 17 - 34%), \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\:{I}<^>{2}=99.7\:)$$\end{document}respectively. This study showed that ANC-follow (OR= 1.11; 95% CI=0.67-1.82), previous intrapartum satisfaction (OR= 2.69; 95% CI = 0.53-13.64), place of residence (OR= 1.10; 95% CI = 0.86-1.42), occupation (P=0.000; OR= 0.97; 95% CI=0.67-1.42), planned pregnancy (OR= 1.89; 95% CI=1.26-2.82), previous history of spontaneous abortion (OR= 2.30; 95% CI=0.71-7.44), current pregnancy related problem (OR= 3.86; 95% CI=1.37-10.84), discussion with a partner (OR= 0.67; 95% CI=0.35-1.27), types of the hospital (OR= 1.13; 95% CI = 0.65-1.94) were significant factors associated with preference of mode of delivery.ConclusionThe preference for vaginal delivery was higher than for cesarean delivery. Factors such as antenatal care follow-up, previous intrapartum satisfaction, place of residence, occupation, planned pregnancy, prior history of spontaneous abortion, maternal education, current pregnancy-related problems, discussion with partner, and types of hospital were significantly associated. The findings of this study imply a multifaceted approach is required.