tetano
Editor, Senior Moderator
BMJ Glob Health
. 2025 Apr 21;10(4):e015815.
doi: 10.1136/bmjgh-2024-015815. Global maternal mortality associated with SARS-CoV-2 infection: a systematic review and meta-analysis
Kathryn Barry[SUP] 1 [/SUP], Silvia Fernández-García[SUP] 2 [/SUP], Alya Khashaba[SUP] 1 [/SUP], Gabriel Ruiz-Calvo[SUP] 3 [/SUP], Miriam Roncal Redin[SUP] 4 [/SUP], Ghadir Mahmoud[SUP] 1 [/SUP], Magnus Yap[SUP] 1 [/SUP], Yasmin King[SUP] 5 [/SUP], Dengyi Zhou[SUP] 1 [/SUP], Massa Mamey[SUP] 1 [/SUP], Isabella Shepherd-Evans[SUP] 1 [/SUP], Jameela Sheikh[SUP] 1 [/SUP], Heidi Lawson[SUP] 1 [/SUP], Tania Kew[SUP] 1 [/SUP], Kehkashan Ansari[SUP] 1 [/SUP], Shruti Attarde[SUP] 1 [/SUP], Adeolu Banjoko[SUP] 1 [/SUP], Helen Fraser[SUP] 1 [/SUP], Megan Littmoden[SUP] 1 [/SUP], Tanisha Rajah[SUP] 1 [/SUP], Kate Walker[SUP] 5 [/SUP], Keelin O'Donoghue[SUP] 6 [/SUP], Madelon van Wely[SUP] 7 [/SUP], Elizabeth van Leeuwen[SUP] 8 [/SUP], Elena Kostova[SUP] 7 [/SUP], Heinke Kunst[SUP] 9 10 [/SUP], Asma Khalil[SUP] 11 [/SUP], Vanessa Brizuela[SUP] 12 [/SUP], Edna Kara[SUP] 12 [/SUP], Caron Rahn Kim[SUP] 12 [/SUP], Anna Thorson[SUP] 12 [/SUP], Olufemi T Oladapo[SUP] 12 [/SUP], Lynne Mofenson[SUP] 13 [/SUP], Mercedes Bonet[SUP] 12 [/SUP], Javier Zamora[SUP] 3 14 [/SUP], John Allotey[SUP] 15 16 [/SUP], Shakila Thangaratinam[SUP] 17 18 19 [/SUP]; PregCOV-19 Living Systematic Review Consortium
Collaborators, Affiliations
Background: Pregnant and recently pregnant women infected with SARS-CoV-2 are at increased risk of death and serious complications than those without the infection. The extent of variation in mortality rates in pregnant women with SARS-CoV-2 infection across regions, and the causes of death are not known. We systematically reviewed all available evidence on the variation in mortality rates in pregnant women with SARS-CoV-2 infection across geographical and country income groups, and the reported cause of death.
Methods: We searched major databases (December 2019-January 2023) including Medline, LILACS, BIREME and Embase. We included studies that reported deaths in at least 10 consecutive pregnant or recently pregnant women with confirmed SARS-CoV-2 infection and assessed the studies' risk of bias. We calculated the summary estimates of any cause of death as proportions with 95% CIs using a multilevel random-effects logistic regression model. Subgroup analyses were performed by geographical region and country income groups. We used International Statistical Classification of Diseases and Related Health Problems-Maternal Mortality to categorise the reported cause of death.
Findings: From 1 326 315 citations, we included 169 studies (319 172 women with confirmed SARS-CoV-2 infection; 4253 women died). The overall rate of unspecified maternal death was 0.87% (95% CI 0.64% to 1.16%). There were significant differences between geographical regions in rates of maternal mortality, with the highest rates in Sub-Saharan Africa (3.48%; 95% CI 0.66% to 16.42%) and Latin America and the Caribbean (3.16%, 95% CI 1.53% to 6.43%). Rates of maternal mortality varied by country income groups, with the highest rates in low-income countries (4.66%, 95% CI 0.75% to 24.07%). Among women with reported cause of death, 98.6% (2,390/2,423) of deaths were attributable to COVID-19.
Interpretation: Rates of deaths in pregnant and recently pregnant women with SARS-CoV-2 infection vary significantly across regions and by country income groups, with the highest burden in Sub-Saharan Africa and low-income countries. COVID-19 is the main reported cause of death.
Prospero registration number: CRD42020224120.
Keywords: Maternal health; SARS.
. 2025 Apr 21;10(4):e015815.
doi: 10.1136/bmjgh-2024-015815. Global maternal mortality associated with SARS-CoV-2 infection: a systematic review and meta-analysis
Kathryn Barry[SUP] 1 [/SUP], Silvia Fernández-García[SUP] 2 [/SUP], Alya Khashaba[SUP] 1 [/SUP], Gabriel Ruiz-Calvo[SUP] 3 [/SUP], Miriam Roncal Redin[SUP] 4 [/SUP], Ghadir Mahmoud[SUP] 1 [/SUP], Magnus Yap[SUP] 1 [/SUP], Yasmin King[SUP] 5 [/SUP], Dengyi Zhou[SUP] 1 [/SUP], Massa Mamey[SUP] 1 [/SUP], Isabella Shepherd-Evans[SUP] 1 [/SUP], Jameela Sheikh[SUP] 1 [/SUP], Heidi Lawson[SUP] 1 [/SUP], Tania Kew[SUP] 1 [/SUP], Kehkashan Ansari[SUP] 1 [/SUP], Shruti Attarde[SUP] 1 [/SUP], Adeolu Banjoko[SUP] 1 [/SUP], Helen Fraser[SUP] 1 [/SUP], Megan Littmoden[SUP] 1 [/SUP], Tanisha Rajah[SUP] 1 [/SUP], Kate Walker[SUP] 5 [/SUP], Keelin O'Donoghue[SUP] 6 [/SUP], Madelon van Wely[SUP] 7 [/SUP], Elizabeth van Leeuwen[SUP] 8 [/SUP], Elena Kostova[SUP] 7 [/SUP], Heinke Kunst[SUP] 9 10 [/SUP], Asma Khalil[SUP] 11 [/SUP], Vanessa Brizuela[SUP] 12 [/SUP], Edna Kara[SUP] 12 [/SUP], Caron Rahn Kim[SUP] 12 [/SUP], Anna Thorson[SUP] 12 [/SUP], Olufemi T Oladapo[SUP] 12 [/SUP], Lynne Mofenson[SUP] 13 [/SUP], Mercedes Bonet[SUP] 12 [/SUP], Javier Zamora[SUP] 3 14 [/SUP], John Allotey[SUP] 15 16 [/SUP], Shakila Thangaratinam[SUP] 17 18 19 [/SUP]; PregCOV-19 Living Systematic Review Consortium
Collaborators, Affiliations
- PMID: 40258634
- DOI: 10.1136/bmjgh-2024-015815
Background: Pregnant and recently pregnant women infected with SARS-CoV-2 are at increased risk of death and serious complications than those without the infection. The extent of variation in mortality rates in pregnant women with SARS-CoV-2 infection across regions, and the causes of death are not known. We systematically reviewed all available evidence on the variation in mortality rates in pregnant women with SARS-CoV-2 infection across geographical and country income groups, and the reported cause of death.
Methods: We searched major databases (December 2019-January 2023) including Medline, LILACS, BIREME and Embase. We included studies that reported deaths in at least 10 consecutive pregnant or recently pregnant women with confirmed SARS-CoV-2 infection and assessed the studies' risk of bias. We calculated the summary estimates of any cause of death as proportions with 95% CIs using a multilevel random-effects logistic regression model. Subgroup analyses were performed by geographical region and country income groups. We used International Statistical Classification of Diseases and Related Health Problems-Maternal Mortality to categorise the reported cause of death.
Findings: From 1 326 315 citations, we included 169 studies (319 172 women with confirmed SARS-CoV-2 infection; 4253 women died). The overall rate of unspecified maternal death was 0.87% (95% CI 0.64% to 1.16%). There were significant differences between geographical regions in rates of maternal mortality, with the highest rates in Sub-Saharan Africa (3.48%; 95% CI 0.66% to 16.42%) and Latin America and the Caribbean (3.16%, 95% CI 1.53% to 6.43%). Rates of maternal mortality varied by country income groups, with the highest rates in low-income countries (4.66%, 95% CI 0.75% to 24.07%). Among women with reported cause of death, 98.6% (2,390/2,423) of deaths were attributable to COVID-19.
Interpretation: Rates of deaths in pregnant and recently pregnant women with SARS-CoV-2 infection vary significantly across regions and by country income groups, with the highest burden in Sub-Saharan Africa and low-income countries. COVID-19 is the main reported cause of death.
Prospero registration number: CRD42020224120.
Keywords: Maternal health; SARS.