Sleep disturbance and its associated factors among pregnant women in Ethiopia: systematic review and meta-analysis.

ABSTRACT

INTRODUCTION: Globally, sleep disturbance is the foremost public health issue among pregnant women which might have undesirable birth outcome including neurocognitive impairment, preterm birth, low birth weight, and neonatal morbidity and mortality. In Ethiopia, inconsistent findings have been reported on the prevalence of sleep disturbance among pregnant women. Therefore, this review aims to estimate the pooled prevalence sleep disturbance and its associated factors among pregnant women in Ethiopia. METHODS: This systematic review and meta-analysis of observational studies was designed according to the PRISMA guideline. A systematic search of literature was conducted in PubMed, Scopus, Web of science, and Google Scholar using relevant searching key terms. The Newcastle-Ottawa scale was used to evaluate the quality of all selected articles. Data were analyzed using STATA Version 14 software. Publication bias was checked using Egger's test and funnel plot. Cochran's chi-squared test and I2 values were used to assess heterogeneity. A fixed-effects model was applied during meta-analysis. RESULTS: In this review, six studies were included after reviewing 17,100 articles. The pooled prevalence of sleep disturbance among pregnant women in Ethiopia was 50.43% (95%CI 39.34-61.52). Third trimester pregnancy AOR = 4.03; 95% CI 2.84,5.71), multigravidity (AOR = 1.99; 95% CI 1.54, 2.59), unplanned pregnancy (AOR = 2.56; 95% CI 1.52,4.31), depression (AOR = 3.57; 95% CI 2.04, 6.27), stress (AOR = 2.77; 95% CI 1.57, 4.88), anxiety (AOR = 3.69; 95% CI 1.42, 9.59) and poor sleep hygiene (AOR = 2.49; 95% CI 1.56, 3.99) and were statistically associated with sleep disturbance among pregnant women. CONCLUSION: This review revealed that the magnitude of sleep disturbance among pregnant woman in Ethiopia was relatively high and multiple factors determined the likelihood of having a disturbed sleep-awake pattern. Thus, the implementation of interventions for sleep disturbance after screening pregnant women is needed. Moreover, public health interventions targeted on the prevention of unintended pregnancy and depression during pregnancy should be implemented.