Pregnancy and neonatal outcomes in Eastern Democratic Republic of the Congo: a systematic review

Kambale Kasonia; Hannah Brindle; Daniela Manno; Tansy Edwards; Soazic Gardais; Grace Mambula; Zephirin Mossoko; Edward M Choi; Nicholas E Connor; Pierre Mukadi; Rebecca F Grais; Babajide Keshinro; Chrissy H Roberts; Hugo Kavunga-Membo; Daniel G Bausch; Jean-Jacques Muyembe; Deborah Watson-Jones

doi:10.3389/fgwh.2024.1412403

Pregnancy and neonatal outcomes in Eastern Democratic Republic of the Congo: a systematic review

Front Glob Womens Health. 2024 Dec 5:5:1412403. doi: 10.3389/fgwh.2024.1412403. eCollection 2024.

Authors

Kambale Kasonia^#¹, Hannah Brindle^#¹, Daniela Manno¹, Tansy Edwards^{2

3}, Soazic Gardais⁴, Grace Mambula⁴, Zephirin Mossoko⁵, Edward M Choi¹, Nicholas E Connor¹, Pierre Mukadi⁵, Rebecca F Grais⁴, Babajide Keshinro⁶, Chrissy H Roberts¹, Hugo Kavunga-Membo⁵, Daniel G Bausch^{7

8}, Jean-Jacques Muyembe⁵, Deborah Watson-Jones^#^{1

9}

Affiliations

¹ Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
² MRC International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
³ School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
⁴ Research Department, Epicentre, Paris, France.
⁵ Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
⁶ Janssen Vaccines and Prevention B.V., Leiden, Netherlands.
⁷ Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
⁸ FIND, Geneva, Switzerland.
⁹ Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.

^# Contributed equally.

Abstract

Background: Conflict is known to impact maternal and neonatal health in Eastern Democratic Republic of the Congo (DRC), an area of longstanding insecurity. We conducted a systematic review on pregnancy and neonatal outcomes in this region to provide a comprehensive overview of maternal and neonatal outcomes over a 20-year period.

Methods: We systematically searched databases, such as Medline, EMBASE, Global Health, ClinicalTrials.gov and the Cochrane Library, along with grey literature, for articles published between 2001 and 2021. These articles provided quantitative data on selected pregnancy and neonatal outcomes in the provinces of Ituri, Maniema and North and South Kivu, Eastern DRC. We conducted a descriptive analysis, combining results from different data sources and comparing incidence of outcomes in North Kivu with those in other provinces in Eastern DRC.

Results: A total of 1,065 abstracts from peer-reviewed publications and 196 articles from the grey literature were screened, resulting in the inclusion of 14 scientific articles in the review. The most frequently reported pregnancy complications were caesarean sections (11.6%-48.3% of deliveries) and miscarriage (1.2%-30.0% of deliveries). The most common neonatal outcomes were low birth weight (3.8%-21.9% of live births), preterm birth (0.9%-74.0%) and neonatal death (0.2%-43.3%).

Conclusion: Our review provides data on pregnancy and neonatal outcomes in Eastern DRC, which will be valuable for future studies. Despite the area's ongoing armed conflict, the percentages of complications we noted in Eastern DRC are comparable with those observed in other countries in the region.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=262553, PROSPERO (CRD42021262553).

Keywords: DRC; conflict; eastern; neonatal; outcomes; pregnancy.

Publication types

Systematic Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This review was supported through funds from the Coalition for Epidemic Preparedness Innovations (CEPI) [FELS1903] and the Paul G. Allen Family Foundation. This review was also supported by the Department for International Development (DFID) and Wellcome [220506/Z/20/Z] and by the European Union’s Horizon 2020 research and innovation programme under grant agreement No 857935. This publication reflects only the authors’ view, and the European Commission is not responsible for any use that may be made of the information it contains. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. HB and ChR were funded by the Department of Health and Social Care using UK Aid Funding as part of the UK Vaccine Network and is managed by the National Institute for Health and Care Research. The views expressed in this publication are those of the author(s) and not necessarily those of the Department of Health and Social Care.