PT  - JOURNAL ARTICLE
AU  - Tesfa Dejenie Habtewold
AU  - Nigussie Tadesse Sharew
AU  - Sisay Mulugeta Alemu
TI  - What is the impact of gender of new-born, antenatal care and postnatal care on breastfeeding practices in Ethiopia? A systematic review and meta-analysis
AID  - 10.1101/405605
DP  - 2018 Jan 01
TA  - bioRxiv
PG  - 405605
4099  - http://biorxiv.org/content/early/2018/09/05/405605.1.short
4100  - http://biorxiv.org/content/early/2018/09/05/405605.1.full
AB  - Objective The aim of this systematic review and meta-analysis was to investigate the association of gender of new-born, antenatal care (ANC) and postnatal care (PNC) with TIBF and EBF.Design Systematic review and meta-analysisMethods PubMed, EMBASE, CINAHL, WHO Global Health Library, Web of Science and SCOPUS databases systematically searched for all available literature, complemented by manual searches. Newcastle-Ottawa Scale (NOS) was used for quality check; Egger’s regression test for publication bias at p-value threshold ≤ 0.01; and Cochran’s Q X2 test and I2 statistics for heterogeneity. A meta-analysis using a weighted inverse variance random-effects model was performed.Results Of 523 articles retrieved, 16 studies on TIBF and 23 on EBF fulfilled the eligibility criteria. Antenatal care (Odds ratio (OR) = 1.61, 95% CI 1.01 - 2.57) was significantly associated with TIBF but not gender of new-born (OR = 1.03, 95% CI 0.84 - 1.26). In addition, antenatal (OR = 2.25, 95% CI 1.63 - 3.10) and postnatal care (OR = 1.86, 95% CI 1.41 - 2.47) significantly associated with exclusive breastfeeding (EBF) but not gender of new-born (OR = 1.08, 95% CI 0.86 - 1.36).Conclusions Optimal care during pregnancy and after birth is important to ensure adequate breastfeeding. In addition, there was no difference in breastfeeding between male and female new-born. This meta-analysis study provided evidence on breastfeeding practice and its associated factors in an Ethiopian context, which can be useful for cross-country and cross-cultural comparison and for breastfeeding improvement initiative in Ethiopia.Protocol registration and publication CRD42017056768 and 10.1136/BMJOPEN-2017-017437Strengths and limitations of this studyThis systematic review and meta-analysis was conducted based on the registered and published protocol, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for literature reviews.Since it is the first study of its kind in Ethiopia, the information could be helpful for future researchers and public health practitioners.Almost all included studies were observational which may hinder causality inference.Based on the conventional methods of heterogeneity test, a few analyses suffer from high between-study variation.