Prevalence and associated factors of post dural puncture headache among parturients who underwent cesarean section with spinal anesthesia: A systemic review and meta-analysis, 2021

Introduction: PDPH is a headache that develops after dural puncture which worsens in an upright position, and improves with lying down. It could affect maternal satisfaction and health care quality. The prevalence and factors of PDPH vary based on different literature and there is no previous meta-analysis done. Methods: This study was done by searching studies from databases PubMed/MEDLINE, Google scholar, and google. Data were extracted by three reviewers independently by using Microsoft Excel and then exported to STATA (TM) 16 version statistical software for analysis. Heterogeneity assessed using the I-2 statistic. With a random model meta-analysis, the pooled prevalence of post-dural puncture headache and its associated factors (POR) with a 95% confidence interval was estimated. Result: Eight studies with a total of 175, 652 study participants were included to estimate the pooled prevalence of PDPH following cesarean section under spinal anesthesia. The pooled prevalence of PDPH in this meta-analysis was found to be 23.47% with 95% CI (10.53, 36.42). Having normal BMI, multiple attempts of spinal injection and spinal injection with a needle size of less than or equal to 22 gauge were positively associated with the PDPH with AOR and 95% CI of 1.22 (1.09, 1.35), 3.50 (1.55, 5.44) and 7.36 (4.93, 9.80) respectively. Conclusion: The pooled prevalence of PDPH among parturients who gave birth with the cesarean section under spinal anesthesia is estimated to be 23.47%. Having normal BMI, multiple attempts of spinal injection, and spinal injection with a needle size of less than or equal to 22 gauge were positively associated with the PDPH.