The effect of antenatal care on low birth weight and neonatal mortality: protocol for umbrella review of meta-analysis.

Abstract

Background: The World Health Organization defines low birth weight as a birth weight of less than 2500 g, regardless of the gestational age. It is regarded as the most significant predictor of infant mortality overall, particularly for deaths that occur in the first few months of life. Among all the months of a person's existence, the neonatal period, the first month of life, has one of the highest death rates. The necessity for an umbrella review is highlighted by the lack of a comprehensive synthesis of collective meta-analytic evidence connecting antenatal care as a factor of low birth weight and newborn death. Thus, this umbrella review's main goal is to thoroughly synthesize the existing meta-analytic evidence, with a focus on assessing the relationship between antenatal care with low birth weight and neonatal mortality.

Methods: All English-language meta-analyses of cohort, case-control, and cross-sectional studies that looked at the relationship between antenatal care with low birth weight and neonatal mortality will be included, regardless of the time and location of publication. To find pertinent literature for review, major medical electronic databases including Embase, CINAHL, Cochrane database, and PubMed will be used. Two reviewers will screen the eligible articles, extract data, and evaluate their quality independently. The reviewers will work together to reach a consensus on any disagreements. If there are still issues, a third reviewer will be consulted in order to fix them. The meta-umbrella R package will be used for all statistical analysis. The random-effects model and 95% prediction interval for the summary estimate will be used for both outcomes. Q and I² test statistics will be calculated to determine the degree of heterogeneity. We will use Egger's regression asymmetry test to assess publication bias, the Ioannidis test for excess significance bias, and Hedges' g value for each risk factor.

Discussion: This is the first comprehensive analysis of the effect of antenatal care on low birth weight and neonatal mortality that we are aware of. For clinicians and researchers seeking to lower low birth weight and neonatal mortality, summarizing this evidence is helpful.

Trial registration: PROSPERO-CRD42024567150.