Epidemiology of hepatitis B virus infection among pregnant women in Ethiopia: a systematic review and meta-analysis of data published between 2021 and 2025

Hepatitis B virus infection among pregnant women is a significant public health problem in Ethiopia. Although primary studies on HBV infection among pregnant women have been conducted across different regions in Ethiopia, a synthesized pooled estimate and associated factors remain fragmented. Therefore, this systematic review was aimed at summarising the available information and making an accurate estimate of hepatitis B virus infection among pregnant women in Ethiopia. A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Different databases (Google Scholar, PubMed, Embase, Web of Science, Scopus, Cochrane Library, and African Journal Online) were searched to identify relevant studies published between January 1, 2021, and December 25, 2025 in Ethiopia. The Joanna Briggs Institute tool was used to assess the methodological qualities of the included studies. The random effect DerSimonian-Liard model was used to estimate the pooled prevalence of Hepatitis B virus infection. I 2 assessed the amount of heterogeneity. Publication bias was assessed using Egger’s test and a funnel plot. We included 25 studies conducted in Ethiopia. The pooled prevalence of hepatitis B infection among pregnant women in Ethiopia was 7.3% (95% CI: 6.3–8.4%), with significant heterogeneity between studies (I 2 = 76.25%, p < 0.001). History of abortion(AOR = 3.81, 95%CI: 1.69–8.57), Body tattooing(AOR = 3.54, 95%CI: 1.65–7.58), Contact history with HBV patients(AOR = 8.38, 95%CI: 3.89,-18.06), HIV positivity(AOR = 10.04, 95%CI: 3.91–25.75), dental procedure(AOR = 3.64, 95%CI: 1.92, 6.92), Family history of HBV(AOR = 6.37, 95%CI: 3.83–10.6), History of blood transfusion(AOR = 6.32, 95%CI: 4.11–9.74), History of hospitalization(AOR = 3.99, 95%CI: 2.47–6.45), Multiple sexual partner(AOR = 7.91, 95%CI: 5.31–11.8) and Traditional tonsillectomy(AOR = 3.81, 95%CI: 1.92–7.57) were associated factors for hepatitis B infection among pregnant women. A higher intermediate level of hepatitis B virus infection (2–7.99%) was observed among pregnant women in Ethiopia. Therefore, early detection of pregnant women, awareness creation on the mode of transmission of HBV, and early implementation of evidence-based control measures are recommended.