Pre-Eclampsia Among Pregnant Women in Ghana: A Systematic Review & Meta-Analysis of the Current Prevalence, Risk Factors, and Perinatal Outcomes.

BACKGROUND AND AIMS: Pre-eclampsia (PE) is a major hypertensive disorder during pregnancy, contributing significantly to maternal and perinatal mortality, especially in low- and middle-income countries. While primary studies on PE have been conducted in Ghana and meta-analyses exist for sub-Saharan Africa broadly, no review has synthesized Ghana-specific evidence to produce a pooled prevalence estimate. This study aimed to provide a comprehensive summary of the prevalence, risk factors, and outcomes associated with PE among pregnant women in Ghana.

METHODS

Following the PRISMA guidelines, we searched four databases. Studies published between January 2015 and July 2025 were eligible for inclusion. Fourteen studies were included in the final meta-analysis. Pooled prevalence was calculated using random-effects meta-analysis in R Studio, with heterogeneity evaluated via the I 2 statistic and publication bias assessed through funnel plots and Egger's regression test.

RESULTS

The pooled prevalence of PE was 14.52% (95% CI: 7.88-22.74). Regional prevalence was highest in the Greater Accra (18.32%, 95% CI: 4.10-39.39), followed by Ashanti (17.41%, 95% CI: 6.38-32.32) and Northern (16.43%, 95% CI: 0.65-46.48) regions. Commonly reported risk factors included advanced maternal age, primigravidity, previous cesarean section, placental malaria, and vitamin D deficiency. Notable outcomes were lower Apgar scores, cesarean deliveries, stillbirths, and postpartum depression.

CONCLUSION

PE affects a significant proportion of pregnant women in Ghana, with a pooled prevalence of 14.52%, which varies across regions and clinical settings. This estimate is derived from highly heterogeneous studies and should be interpreted as an approximate indicator of burden rather than a precise national figure. The identified risk factors and outcomes highlight the urgent need for enhanced prenatal screening and tailored interventions to reduce the burden of PE in Ghana.