Peer-reviewed article
Preconception health risks among women of reproductive age in Sub-Saharan Africa: a systematic review of implications for preconception care.
Gebretsadik GG, Biratu AK, Gessessew A, Lassi ZS, Kahsay AB et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review examined preconception health risks among women of reproductive age across Sub-Saharan Africa by analyzing 83 studies. The review found that women in the region face multiple health challenges before pregnancy, including underweight and overweight conditions, anemia, unintended pregnancy, substance use, chronic diseases, and intimate partner violence. These preconception risks are linked to poor maternal and newborn outcomes, yet integrated preconception care services are limited in the region. The authors call for governments to adopt policies integrating preconception care into existing healthcare systems.
Key points
- Anemia prevalence among women ranges from 36.7% to 58.1% across Sub-Saharan Africa
- Intimate partner violence affects 6.7% to 43.7% of women of reproductive age
- Unintended pregnancy rates vary widely from 4.2% to 94.3% depending on setting
- Psychosocial distress is reported in 13.9% to 60% of women in the region
- High heterogeneity in study methods prevented meta-analysis, suggesting fragmented risk assessment approaches
Limitations
The review could not perform meta-analysis due to inconsistent outcome measurements and high heterogeneity across studies, which may mean the true burden of preconception health risks is underestimated. The wide ranges of prevalence estimates suggest substantial variation by country, setting, and population, limiting the ability to draw region-wide conclusions.
Abstract
Introduction Although preconception health risks are strongly linked to adverse pregnancy outcomes and offer opportunities to improve women's health, consolidated evidence remains limited in Sub-Saharan Africa (SSA). This review aims to synthesize evidence on preconception health risks in SSA, a region with the highest global rates of maternal and neonatal mortality and morbidity. Methods We searched PubMed/MEDLINE, African Index Medicus, ScienceDirect, and Google Scholar for studies published up to June 30, 2023. Two reviewers independently assessed study quality using Joanna Briggs Institute tools. Studies with at least one modifiable preconception risk were included. Due to inconsistencies in outcome measurements, participant variability, and high heterogeneity, a meta-analysis was not reported. Findings were summarized in text, figures, and tables. Results In the review, researchers selected 83 articles from a total of 3,425 retrieved articles. Overall, this review revealed a high proportion of preconception health risks among the participants which includes underweight (0.64% to 36.2%), overweight (8.3% to 76.7%), anemia (36.7% to 58.1%), unintended pregnancy (4.2% to 94.3%), alcohol intake (5.3% to 68.7%), smoking (1.1% to 20.3%), chewing khat (9.9% to 27.6%), history of chronic medical conditions (2% to 16.6%), a history of adverse pregnancy outcomes (11% to 51.9%), sexually transmitted infections (1.3% to 29.2%), psychosocial distress (13.9% to 60%), and intimate partner violence (6.7% to 43.7%). Conclusion The systematic review found that numerous women in SSA encounter various preconception health risks factors. Therefore, the governments of respective countries need to give emphasis and adopt policies to integrate preconception care services in to the existing healthcare system so that both financial and human resources need to be mobilized. There is gaps in research, as the true burden of preconception health risks may be underestimated due to fragmented risk assessment methods. Review registration (PROSPERO: CRD42023446801).