Table 1 Description of study participants and characteristics of studies included in the systematic review and meta-analysis

Kheir, A.E.M., R. Ali, and S.M.H. Abdelmonim, 2016 [31]

Sudan

Facility based

Cross-sectional

Pregnant Mothers

Interview and Observation

1600

200

1.25

Neonatal: NICU admission (81.3%),LBW (60.4%), Prematurity (66%), APGAR <7 at 5th min (37.4%), Early neonatal mortality (19.6%)

Bekabil, T.T., et al; 2015 [32]

Ethiopia

Facility based

Prospective Cohort

Pregnant Mothers

Interview

3668

144

3.9

Neonatal: LBW (I5.7%), Prematurity (37.8%), Low APGAR (54%), NICU admission (75%), Neonatal death (4.7%), mal-presentation (37.4%), Congenital malformation 2(0.7%)

Maternal: medical complications:

HTN (25%); Hyperemesis (8.0%), Diabetes (0.7% )

Obstetric complications: PROM (15.3%), poor progress of labor (8.3%), cord prolapse (4.9%), and polyhydramnos (1.4%), PPH (3.2%), puerperal sepsis (3.1%), and maternal death (2.8%)

Marete, Irene, et al., 2014 [33]

Kenya

Facility based

cross-sectional

pregnant mothers

Chart review

8953

131

1.4

Neonatal: Stillbirths (78.1%), Early Neonatal mortality (11.3%)

Abdul, M.A., 2000 [34]

Comoros

Facility based

cross-sectional

pregnant mothers

Chart review

4370

109

2.5

Neonatal: LBW (50%), Perinatal mortality (5.5%)

Retained second twin (12%)

Maternal: Uterine atony (99%)

Ayza, A., 2018 [35]

Ethiopia

Facility based

Cross-sectional

Postnatal mother

Chart review

4328

124

2.9

Maternal: HDP (23.1%), PROM (13.5%), Preterm (7.1%), C/S (44.2%), Anemia (12.2%),

Neonatal: Cord prolapse (3.2%)

Elshibly EM and Schmalisch G, 2010, 2010 [36]

Sudan

Facility-based

Comparative cross sectional

Pregnant Mother

Interview and anthropometric measurement

1030

30

2.9

Neonatal: 66.7% of Twin A weigh greater than Twin B.

Musili, F. and J. Karagja, 2009 [37]

Sudan

Facility-based

Retrospective review

Postnatal mother

Chart review

15642

328

2.1

Neonatal: Prematurity 50(22.9%) Still birth 37(15.8),

Asphyxia 62(41.3%), Prematurity 57 (38%), 2 congenital malformation

Maternal: Anemia 12 (13%) APH 1(1.1%),

PROM 5 (5.4%) Polyhydraminious 1(1.1%)

Preeclampsia 65 (70.7%)

Gessessew,A.,2007 [38]

Ethiopia

Facility-based

Descriptive retrospective study

Postnatal mother

Chart review

7226

99

1.37

Neonatal: Malpresentation (14.1%)

Maternal: Preterm labor (39.4%), PROM (31.3%), APH (11.1%), PPH (9.1%), PE (9.1%), Maternal death (3%),

Habib,et al, 2008 [39]

Tanzania

Facility-based

Comparative cross-sectional

Postnatal mother

Chart review

15255

771

5.05

Maternal: cesarean section (40%)

Dafallah SE, Yousif EM,2004 [30]

Sudan

Facility-based

Cohort study

Pregnant mother

Observation and interview

44605

597

1.34

Neonatal: Perinatal mortality rate was 115/1000 for twin

Maternal : MMR=was 35.8/100.000

Pre-term labor, 35.5%; Cesarean section 53.1%

Abebaw et al., 2021 [40]

Ethiopia

Facility based

Cross-sectional

Newborn

Chart review

24561

748

3.05

Neonatal: LBW (9.1%), Stillbirth (42%), APGAR Score <7 (9.1%), Prematurity (66%), Prenatal death (23%),

Maternal: HDP (10.6%), PROM (8.8%)

Moller B. et al., 1989 [29]

Tanzania

Community based

Cross-sectional

Pregnant women

Interview

719

49

6.8

Neonatal: perinatal mortality (23%), Preterm (16%)

Chiwanga, E.S et al,. 2014 [41]

Tanzania

DHS

Cross-sectional

Pregnant Mother

Chart review

33997

822

2.1

Maternal: Preterm labor (9.4%) MMR (0.07%),

Preeclampsia (9.4%), APH (7.2%) Anemia (2.0%)

C/s (42.6%)

Gebremedhin, S. (2015) [42]

Burundi

DHS

cross-sectional

postnatal mothers

DHS chart review

4267

55

1.3

Neonatal mortality (5.5%)

Temesgen,T., 2015 [43]

Ethiopia

Facility-based

Case-control

Pregnant mother

Interview

3812

144

3.7

Not Applicable (N/A)

Gebremedhin, S. (2015) [42]

Comoros

DHS

cross-sectional

postnatal mothers

DHS chart review

3149

66

2.1

N/A

Gebremedhin, S. (2015) [42]

Ethiopia

DHS

cross-sectional

postnatal mothers

DHS chart review

11654

136

1.2

N/A

Gebremedhin, S. (2015) [42]

Kenya

DHS

Cross-sectional

postnatal mothers

DHS chart review

6079

81

1.3

N/A

Gebremedhin, S. (2015) [42]

Rwanda

DHS

Cross-section

postnatal mothers

DHS chart review

9002

134

1.5

N/A

Gebremedhin, S. (2015) [42]

Tanzania

DHS

Cross-section

postnatal mothers

DHS chart review

8648

146

1.7

N/A

Gebremedhin, S. (2015) [42]

Uganda

DHS

Cross-section

postnatal mothers

DHS chart review

7878

129

1.6

N/A

Sikosana, ML, 2006 [44]

Tanzania

Facility-based

Case- control

Postnatal mother

Delivery chart review

1922

57

2.9

N/A

MWITA S et al., 2022 [45]

Tanzania

Facility based

Retrospective cohort

Pregnant women

chart review

1012

210

19.6

N/A

Guo, G. and Grummer-Strawn, L.M., 1993 [46]

Burundi

DHS

Cross-sectional

Pregnant women

Interview

3811

66

1.7

N/A

Guo, G. and Grummer-Strawn, L.M., 1993 [46]

Kenya

DHS

Cross-sectional

Pregnant women

Interview

6985

196

2.8

N/A

Guo, G. and Grummer-Strawn, L.M., 1993 [46]

Uganda

DHS

Cross-sectional

Pregnant women

Interview

4959

162

3.3

N/A

Justesen, A. and Kunst, A., 2000 [47]

Tanzania

DHS

Cross-sectional

Newborns

secondary data analysis

8132

280

3.4

N/A

Bellizzi, S., et al, 2018 [48]

Burundi

DHS

Cross-sectional

Postnatal women

Chart review

7405

168

2.3

N/A

Bellizzi, S., et al, 2018 [48]

Comoros

DHS

Cross-sectional

Postnatal women

Chart review

3082

126

4.1

N/A

Bellizzi, S., et al, 2018 [48]

Ethiopia

DHS

Cross-sectional

Postnatal women

Chart review

11166

314

2.8

N/A

Bellizzi, S., et al, 2018 [48]

Kenya

DHS

Cross-sectional

Postnatal women

Chart review

5862

168

2.9

N/A

Bellizzi, S., et al, 2018 [48]

Rwanda

DHS

Cross-sectional

Postnatal women

Chart review

8678

246

2.8

N/A

Bellizzi, S., et al, 2018 [48]

Tanzania

DHS

Cross-sectional

Postnatal women

Chart review

7705

210

2.7

N/A

Bellizzi, S., et al, 2018 [48]

Uganda

DHS

Cross-sectional

Postnatal women

Chart review

7535

226

3

N/A