Global prevalence of maternal mortality ratio in pregnant women infected with coronavirus: A comprehensive review and meta–meta-analysis

ABSTRACT

Background

During the various waves of the COVID-19 pandemic, extensive and hasty systematic reviews were carried out. Information on the increase or decrease in maternal mortality in pregnant women infected with COVID-19 is not sufficient. This study aimed to evaluate the maternal mortality ratio (MMR) in pregnant women diagnosed with COVID-19 according to published previous systematic reviews.

Methods

This meta-meta-analysis study was reported according to the PRISMA checklist for systematic reviews and meta-analysis. We searched the electronic databases PubMed and Web of Science to assess the prevalence of MMR. Random effects meta-analysis was used to pool the available prevalence. Study quality was also evaluated.

Results

Electronic search retrieved 810 potentially relevant papers. After removing duplicates, reviewing titles and abstracts, and screening full texts, 46 studies were finally selected. The weighted pooled worldwide prevalence of MMR was 2096.5/100,000 [95% CI: 1258.13- 2934.87]. Heterogeneity was explored using subgroup analyses based on the pandemic years and the number of articles combined in previous systematic reviews.

Conclusions

The prevalence of MMR in pregnant women diagnosed with COVID-19 is considerable. Countries must increase the quality of care in maternity facilities and to improve women's health, reduce the risk of MMR.

KEYWORDS:

• Maternal mortality
• maternal health
• prevalence
• systematic review
• meta-meta-analysis
• COVID-19

Acknowledgments

The authors would like to extend their deepest thanks to all librarians who helped them to access information resources at Mashhad University of Medical Sciences.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research received a grant from Mashhad University of Medical Sciences [grant number 4011162].

Notes on contributors

Sedigheh Abdollahpour

Dr. Sedigheh Abdollahpour received her Ph.D. degree from the Mashhad University of Medical Sciences. She is currently an assistant professor in Sexual and Reproductive health at the Nursing and Midwifery Care Research Center, Mashhad, Iran. Her research interest includes maternal mortality, maternal health, maternal morbidities, and pregnancy.

Mahla shafeei

Mrs. Mahla shafeei received her Bachelor's degree from the Mashhad University of Medical Sciences. She is Student Research Committee in Midwifery.

Talat Khadivzadeh

Talat Khadivzadeh received her Ph.D. degree from the Mashhad University of Medical Sciences. She is currently an associate professor in Sexual and Reproductive health at the Faculty of Nursing and Midwifery. Professor in Reproductive Health, Nursing and Midwifery. Her research interest includes maternal mortality and childbearing.

Mahdieh Arian

Mahdieh Arian received her Ph.D. degree from the Semnan University of Medical Sciences. She is currently an assistant professor in Nursing at the Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Iran. Her research interest includes quality of care, meta-analysis and machine learning.

Hamid Heidarian miri

Dr. Hamid Heidarian Miri received his Ph.D. degree from the Shiraz University of Medical Sciences, Iran. He is currently an associate professor at Mashhad University of Medical Sciences. His research interest includes Epidemiology in women's health.