Prevalence, Mortality Rate and Risk Factors of Obstetrics-Related Venous Thromboembolism in Africa: A Systematic Review.

Abstract

BACKGROUND: Obstetric-related venous thromboembolism (VTE) is common in Africa. However, management has remained suboptimal. Evaluating its epidemiology will aid policy decisions. AIM: To evaluate the prevalence, mortality rate and risk factors of obstetrics-related venous thromboembolism in Africa. SEARCH STRATEGY: We searched four databases namely MEDLINE, PubMed, CINAHL, and Academic Search Complete. DATA COLLECTION AND SELECTION: We undertook independent screening to identify relevant articles. Only peer-reviewed articles written and published in English were included. DATA ANALYSIS: We fitted a random-effect model to estimate the pooled prevalence and mortality rates, with I2 computed to estimate the degree of heterogeneity. RESULT: Prevalence of obstetrics-related VTE varied between 2 (per 100,000 deliveries) in 2000 and 248 (per 100,000 births) in 2020. The pooled prevalence was 17 per 100,000 births (95% CI 6-480/100,000 births). Two most important risk factors were immobilization/prolonged travel (OR=2.5 [95% CI 1.4 - 4.5] to 18 (95% CI 2.3-137) and oral contraceptive (OR=15.9, [95% CI 1.9-133.1]). VTE-related maternal mortality ranged from 33 to 286 per 100,000 live births. CONCLUSION: Moving from 2000 to 2020, there is an increasing trend in the prevalence of obstetrics-related VTE and associated maternal mortality in Africa. The strength of risk factors of obstetrics-related VTE in Africa may not follow a global risk stratification pattern.