Prevalence of Common Gynecological Conditions in the Middle East: Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of prevalence studies.
PubMed 36304010 · doi:10.3389/frph.2021.661360
What was done
Authors searched five databases (MEDLINE, EMBASE, PsycINFO, Global Health, and Google Scholar) from inception to February 14, 2021, for peer-reviewed English or Arabic articles reporting the prevalence of polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, and adenomyosis in Middle Eastern populations. Pooled prevalence was estimated using Freeman-Tukey arcsine transformation, heterogeneity was evaluated with the I-squared statistic, and evidence quality was appraised using GRADE criteria across 47 included studies (26 on PCOS, 12 on endometriosis, 8 on uterine fibroids, and 7 on adenomyosis).
What was found
PCOS pooled prevalence was 8.9% by NIH criteria (95% CI: 6.5-11.7%; range: 4.0-27.6%), rising to 18.8% in Gulf Arab states (95% CI: 9.5-30.3%). Using Rotterdam criteria, PCOS pooled prevalence was 11.9% (95% CI: 7.1-17.7%; range: 3.4-19.9%), with data limited to Persian and Levant regions. Endometriosis was identified in 12.9% (95% CI: 4.2-25.4%; range: 4.2-21.0%) of women undergoing laparoscopy for any indication. Pooled prevalence was 30.6% (95% CI: 24.9-36.7%; range: 18.5-42.6%) for uterine fibroids and 30.8% (95% CI: 27.1-34.6%; range: 25.6-37.7%) for adenomyosis.
Why it matters
This review provides the first pooled regional baseline prevalence estimates for major gynecological conditions across Middle Eastern populations, highlighting a substantial burden of reproductive morbidity to inform public health resource allocation and future epidemiological research.
Limits
The quality of evidence was rated as low by GRADE criteria. Substantial statistical and methodological heterogeneity existed across studies, driven by differing diagnostic criteria, small sample sizes, and unrepresentative participant selection (such as restricting endometriosis assessment to surgical laparoscopy cohorts). Data for certain conditions and subregions were sparse.
Cited by
- partial PCOS affects 15% of women in the United States and over 20% in Middle Eastern countries.