Prevalence of sexually transmitted infections among pregnant migrant and refugee women: Protocol for a systematic review and meta-analysis

: Sexually transmitted infections during pregnancy are associated with important maternal, fetal, and neonatal complications, including vertical transmission, congenital infection, stillbirth, preterm birth, and increased maternal morbidity. Pregnant migrant and refugee women may face additional risks because displacement, legal precarity, socioeconomic vulnerability, and limited access to antenatal care can delay screening and treatment. However, the burden of sexually transmitted infections in this population remains poorly characterized, and available estimates are fragmented across geographic regions, migration categories, diagnostic methods, and healthcare settings. Objective: This systematic review and meta-analysis aims to estimate infection-specific prevalence of sexually transmitted infections among pregnant migrant, refugee, asylum-seeking, undocumented, internally displaced, or otherwise displaced women worldwide and to characterize variation by geographic region, migration status, and other clinically relevant factors. Methods: This protocol is registered in PROSPERO (CRD420251085346). We will include peer-reviewed primary cross-sectional studies and cohort studies with a defined prevalence denominator, while excluding case reports, case series, case-control studies, grey literature and reports without a valid denominator. MEDLINE via Ovid, Embase.com, Scopus, Web of Science, the Virtual Health Library, and the WHO Global Index Medicus will be searched without language, date, or geographic restrictions and citation searches. Two reviewers will independently screen records and extract data using a prespecified form that will be pilot-tested before formal extraction. Risk of bias will be assessed with the Joanna Briggs Institute prevalence checklist. When at least three comparable independent estimates are available, random-effects meta-analysis will be conducted separately for each infection. A participant-level composite of any STI will be analyzed only when explicitly reported using unique individuals and will not be derived by summing infection-specific cases. Certainty will be evaluated using a GRADE-informed approach adapted for prevalence estimates.