Worldwide prevalence of maternal methicillin-resistant Staphylococcus aureus colonization: A systematic review and meta-analysis.
Malihe Nourollahpour Shiadeh, Mahdi Sepidarkish, Abolfazl Mollalo, Nayereh As'adi, Soghra Khani, Zohreh Shahhosseini, Mahmonir Danesh, Sahar Esfandyari, Ali H Mokdad, Ali Rostami
Author Information
Malihe Nourollahpour Shiadeh: Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran. Electronic address: malihe.nurollahpur@gmail.com.
Mahdi Sepidarkish: Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran.
Abolfazl Mollalo: Department of Public Health and Prevention Science, School of Health Sciences, Baldwin Wallace University, Berea, OH, USA.
Nayereh As'adi: Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Soghra Khani: Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Zohreh Shahhosseini: Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Mahmonir Danesh: Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Sahar Esfandyari: Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Ali H Mokdad: Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Ali Rostami: Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Methicillin-resistant Staphylococcus aureus (MRSA) infection during pregnancy can adversely influence the well-being of pregnant women, fetuses, and neonates. To our knowledge, there is no global data on the maternal prevalence of MRSA colonization. We conducted a systematic review and meta-analysis to estimate the global and regional prevalence rates of MRSA colonization among pregnant women. We searched international databases (i.e., MEDLINE/PubMed, EMBASE, Scopus, Web of Science collection, and SciELO) for studies published from inception to March 10, 2022. Observational population-based studies reporting MRSA colonization among pregnant women were eligible to be included. We utilized the random-effects meta-analyses to compute the pooled prevalence estimates of maternal colonization across studies at 95% confidence intervals (CIs). The heterogeneity was assessed by I statistic and the Cochran's Q test. Subgroup and meta-regression analyses were used to adjust for potential sources of heterogeneity. The data source regarding maternal MRSA colonization included 55 studies from 24 countries and 110,654 pregnant women. The worldwide pooled prevalence for maternal MRSA colonization was 3.23% (95% CI, 2.40-4.17%), with the highest and lowest colonization rates for Africa (9.13%, 4.36-15.34%) and Europe (0.79%, 0.28-1.51%), respectively. We estimated that nearly 4.5 million pregnant women are colonized with MRSA worldwide. MRSA colonization rates were higher among black ethnicity, multiparous women, pregnant women with prior MRSA infection, women with lower personal hygiene, and those living in lower-income and human development indices countries or regions. MRSA colonizes substantial numbers of pregnant women worldwide, with varying prevalence rates in different regions; however, further investigations are needed to recognize regional differences. Our findings emphasized the need for prevention efforts against MRSA to reduce the health risks among women and newborns.
