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

BackgroundDuring 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.MethodsThis 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.ResultsElectronic 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.ConclusionsThe 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.