A systematic review and meta-analysis protocol on the association of malaria in pregnancy and adverse birth outcomes

IntroductionMalaria in pregnancy contributes to significant adverse birth outcomes. This study is aimed to quantify the relationship between malaria in pregnancy and occurrence of adverse birth outcomes, including preterm delivery, low birth weight, small for gestational age, miscarriages, and stillbirth. Methods and analysisObservational studies and Randomised controlled trials reporting data on selected birth outcomes separately for pregnancies, with or without malaria will be included. We will search for studies over various information sources and data extraction will be done from included studies. Pooled odds ratio (OR) will be calculated for each birth outcomes using fixed effect model or random effects models, based on the level of heterogeneity. Forest plot will be prepared with effect size (with 95 percent confidence interval) of each study and pooled effect size. The methodological quality will be assessed for included observational studies using the Newcastle-Ottawa scale (NOS). Cochrane Risk of Bias tool will be used to evaluate bias in randomised controlled trials. For publication bias, funnel plot will be prepared and assessed for asymmetry, along with Eggers test. DiscussionThis study will provide an estimate of the risk of adverse birth outcomes in pregnancies with malaria. Results of this study will contribute towards planning effective service delivery in areas with a higher risk of malaria transmission. Ethics and disseminationThe current study is a review of published literature, and it does not require ethical committee approval. Results of this review will be published in a peer-reviewed journal. PROSPERO registration numberCRD42020153009 Article summaryO_ST_ABSStrengths and limitations of this studyC_ST_ABSO_LITo the best of reviewers knowledge, this will be a first-ever comprehensive review on the relationship between malaria in pregnancy and occurrence of most frequent adverse birth outcomes, i.e. preterm delivery, low birth weight, small for gestational age and miscarriages. C_LIO_LIThe finding of this review will be very crucial for the governments of malaria-endemic countries. C_LIO_LIAll the leading information sources will be included in this study to perform searches. C_LIO_LIThe protocol is prepared in adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines (PRISMA-P). C_LIO_LIA limitation of this study will be, various definition criteria used to define adverse birth outcomes among the included studies. Due to which, it will be challenging to interpret and extrapolate the findings of this study. C_LI