Common causes of maternal mortality based on ICD-MM: A systematic review and meta- analysis

Abstract

Background Maternal mortality is a universal public health challenge. The present study was conducted to estimate the global prevalence of maternal death causes through a systematic review and meta-analysis. Methods A systematic literature search was conducted using various databases, including Web of Science, PubMed, Scopus, ScienceDirect, Cochrane Library, as well as Persian databases such as MagIran and SID. The search encompassed articles published until August 21, 2022. Thirty-four eligible articles were included in the final analysis. Analysis was performed using a meta-analysis approach. The exact Clopper-Pearson confidence intervals, heterogeneity assessment, and random effects models with Mantel-Haenszel methods were employed using the STATA software version 14.2. Results The most prevalent causes of maternal deaths, listed in descending order from highest to lowest prevalence, were non-obstetric complications (48.32%), obstetric hemorrhage (17.63%), hypertensive disorders of pregnancy, childbirth, and the puerperium (14.01%), other obstetric complications (7.11%), pregnancy with abortive outcome (5.41%), pregnancy-related infection (5.26%), unanticipated complications of management (2.25%), unknown/undetermined causes (2.01%), and coincidental causes (1.59%), respectively. Conclusion Accurate and timely diagnosis and treatment of conditions complicating pregnancy, childbirth, and the puerperium continue to pose a significant gap in high-quality care for pregnant women worldwide, particularly in developing countries where the incidence is higher. To reduce the burden of maternal mortality causes, it is crucial to implement effective screening mechanisms for high-risk mothers during pregnancy, childbirth, and the puerperium. Additionally, increasing awareness and promoting self-care management among women of reproductive age can play a significant role. Our findings offer comprehensive and standardized information on the prevalence of maternal mortality causes using the ICD-MM classification. This information can be utilized by policymakers and managers at various levels to facilitate necessary planning aimed at reducing the burden of maternal mortality causes.