Thrombocytopenia among pregnant women in Africa: a systematic review and meta-analysis

Introduction: thrombocytopenia is a common hematological disorder during pregnancy next to anemia. Pregnant women with thrombocytopenia have complications of excessive bleeding during or after childbirth, cesarean section incision site oozing, stillbirth and neonatal thrombocytopenia. Findings on the magnitude of thrombocytopenia among pregnant women were inconsistent. Therefore, this review aimed to estimate the pooled prevalence of thrombocytopenia among pregnant women in Africa. Methods: this systematic review and meta-analysis were performed based on PRISMA guidelines. The databases (PubMed, PubMed Central, Hinari, Science Direct, Pop line, Google Scholar, and African Journals Online) were searched to identify relevant studies. Data were analyzed using STATA 11 statistical software. A random-effect model was fitted to estimate the pooled prevalence of thrombocytopenia. I-2 test statistics were done to test the heterogeneity of included studies. Funnel plots analysis and Egger weighted regression tests were done to detect publication bias. Results: of the total 1,517 articles retrieved, 15 articles which involved 8,380 pregnant women were eligible for meta-analysis. The overall pooled prevalence of thrombocytopenia among pregnant women in Africa was 10.23% (95% confidence interval (CI): 7.44, 13.02%). Its level of severity showed that, 77.95% (I-2=43.1%), 15.62% (I-2=53.4%), and 5.60 (I-2=0.0%) of pregnant women had mild, moderate and severe thrombocytopenia, respectively. The highest prevalence of thrombocytopenia was occurred in the third trimester of pregnancy (54.05% (95% CI: 29.48, 78.61)). Conclusion: this systematic review and meta-analysis showed that the pooled prevalence of thrombocytopenia among pregnant women in Africa was found to be relatively higher compared with the globe. Therefore, routine screening and follow-up programs are needed to identify pregnant women with thrombocytopenia and provide them with the necessary interventions.