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Induction of Labor and Factors Associated with its Outcome in Ethiopia A Systemic Review and Meta-Analysis

Eden Asmare Kassahun, Fikadu Waltengus Sendeku, Tigist Wubet Gezahegn and Bezawit Abeje Alemayehu

Background: Induction of labor is one of the most common procedures to prevent adverse birth out comes of mother and the newborn yet if not performed under clear indication; it may result in devastating effects. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of Induction of labor and factors associated with its outcome among pregnant women in Ethiopia.

Methods: The data bases used were: PUBMED, Google Scholar, HINARI, EMBASE, African Online Journals and on line repositories. This meta- analysis used twelve observational studies (cross-sectional and case control) which included 7401 participants. Different searching terms were applied based on the adapted PICO principles to achieve and access all the essential articles. Subgroup and sensitivity analysis were conducted with the evidence of heterogeneity. Egger test with funnel plot were used to investigate publication bias. The data were entered and analyzed using Microsoft Excel and Stata11 software respectively.

Results: Twelve studies were included in this systematic review and meta-analysis. The overall pooled prevalence of IOL was 16.43% (95% CI; 9.2, 23.67) in Ethiopia. Gestational age < 42 weeks (AOR: 4.3) and Bishop score > 5 (AOR:5) were associated with successful induction of labor while Nulliparity (AOR:2.9), Gestational age > 42 weeks (AOR:4.5) and Unfavorable Bishop score (AOR 5.2) showed significant association with failed induction.

Conclusion: Gestational age < 42 weeks and Bishop Score > 5 was associated with success of induction of labor while Nulliparity, Gestational age > 42 weeks and Unfavorable Bishop score showed significant association with failed induction. This finding is important to design strategic policies and to prevent emergency neonatal and women complications during the childbirth and postpartum periods.