Abstract

Background

The COVID-19 pandemic is having significant direct and associated effects on many health outcomes, including maternal mortality. As a useful marker of healthcare system functionality, trends in maternal mortality provide a lens to gauge impact and inform mitigation strategies.

Objective

To report the findings of a rapid systematic review of studies on levels of maternal mortality before and during the COVID-19 pandemic.

Methods

We systematically searched for studies on the 1st March 2021 in MEDLINE and Embase, with additional studies identified through MedRxiv and searches of key websites. We included studies that reported levels of mortality in pregnant and postpartum women in time-periods pre- and during the COVID-19 pandemic. The maternal mortality ratio was calculated for each study as well as the excess mortality.

Results

The search yielded 3411 references, of which five studies were included in the review alongside two studies identified from grey literature searches. Five studies used data from national health information systems or death registries (Mexico, Peru, Uganda, South Africa, and Kenya), and two studies from India were record reviews from health facilities. There were increased levels of maternal mortality documented in all studies; however, there was only statistical evidence for a difference in maternal mortality in the COVID-19 era for four of these. Excess maternal mortality ranged from 8.5% in Kenya to 61.5% in Uganda.

Conclusions

Measuring maternal mortality in pandemics presents many challenges, but also essential opportunities to understand and ameliorate adverse impact both for women and their newborns. Our systematic review shows a dearth of studies giving reliable information on levels of maternal mortality, and we call for increased and more systematic reporting of this largely preventable outcome. The findings help to highlight four measurement-related issues which are priorities for continuing research and development.

Details

Title
Maternal mortality in the covid-19 pandemic: findings from a rapid systematic review
Author
Calvert, Clara 1   VIAFID ORCID Logo  ; Jeeva, John 2 ; Nzvere, Farirai P 2   VIAFID ORCID Logo  ; Cresswell, Jenny A 3   VIAFID ORCID Logo  ; Fawcus, Sue 4   VIAFID ORCID Logo  ; Fottrell, Edward 5   VIAFID ORCID Logo  ; Say, Lale 3   VIAFID ORCID Logo  ; Graham, Wendy J 6 

1  Centre for Global Health, Usher Institute, University of Edinburgh, UK; Department of Population Health, London School of Hygiene and Tropical Medicine, UK 
2  Centre for Global Health, Usher Institute, University of Edinburgh, UK 
3  UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland 
4  Department of Obstetrics and Gynaecology, University of Cape Town, Rondebosch, South Africa 
5  UCL Institute for Global Health, Faculty of Population Health Sciences, University College London, London, UK 
6  Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, UK 
Publication year
2021
Publication date
Oct 2021
Publisher
Taylor & Francis Ltd.
e-ISSN
16549880
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1080/16549716.2021.1974677
ProQuest document ID
2646963336
Copyright
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.