Systematic review and meta-analysis reveals significant global disparities in maternal mortality from SARS-CoV-2, highlighting disproportionate risks in low-income countries.
Key Points
Assess variations in maternal mortality rates and specific causes of death among pregnant and recently pregnant women infected with SARS-CoV-2 across geographical regions and country income groups.
Searched Medline, LILACS, BIREME, and Embase from December 2019 to January 2023, identifying studies that reported deaths among at least 10 consecutive pregnant or recently pregnant women with confirmed SARS-CoV-2 infection.
Extracted data from 169 studies encompassing 319,172 infected women and calculated pooled proportions of all-cause maternal death using a multilevel random-effects logistic regression model.
Categorized primary causes of death using the International Statistical Classification of Diseases and Related Health Problems-Maternal Mortality criteria.
The overall pooled maternal mortality rate was 0.87% (95% CI 0.64% to 1.16%), accounting for 4,253 total maternal deaths across all included studies.
Mortality varied significantly across regions, peaking in Sub-Saharan Africa (3.48%, 95% CI 0.66% to 16.42%), Latin America and the Caribbean (3.16%, 95% CI 1.53% to 6.43%), and low-income countries (4.66%, 95% CI 0.75% to 24.07%).
Among women with a documented cause of death, 98.6% (2,390/2,423) of fatalities were directly attributable to COVID-19.