Prevalence, indications, and complications of caesarean section in health facilities across Nigeria: a systematic review and meta-analysis

From the 3590 records obtained from the initial search, the titles and abstracts of 3245 articles were screened for inclusion after duplicates were removed, and results were truncated by dates. The 63 articles that passed the screening and eight articles obtained by hand search were then assessed for eligibility. In all, 45 articles [21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65] were deemed eligible and as such included in the review (Fig. 1).

Fig. 1figure 1

Flow diagram of literature search and results

Forty-four of these were included in the meta-analysis, having all reported on CS prevalence [21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63, 65]. However, only 31 articles [21,22,23,24, 27, 28, 30,31,32, 35, 37, 38, 41, 42, 44,45,46, 48,49,50, 55,56,57,58,59,60,61, 63, 64] reported the indications or complications of CS and, as such, were included in the narrative synthesis. These are presented in the PRISMA flow diagram (Fig. 1).

Study characteristics

Almost all included studies (41 [91.1%]) applied cross-sectional study design [21, 22, 24,25,26,27,28, 30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57, 65]. Of all the included studies, 27 (60.0%) were conducted in health facilities situated in the southern states [21, 23,24,25, 28, 29, 32, 34, 36, 38,39,

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