Factors Affecting the Maternal Mortality in different Areas of Iran: A Systematic Review

Introduction: Lowering the amount of maternal death is an important goal of many health organizations world-wide. We aimed to investigate the factors affecting the maternal mortality in different area of Iran.Materials and Methods: In this systematic review, a systemic search of online databases (Medline, EMBASE, Scopus, Web of Science, Cochrane Library, CIVILICA, SID, Magiran, and Google Scholar search engine) was conducted for related studies with no time limit up to Jul ۲۰۲۲, using the related Mesh keywords. Two reviewers evaluated the quality of eligible studies and carried out the selection procedure.Results: Finally ۲۱ related studies were included. The total MMR for this period was between ۱۵.۸ (Tehran city), and ۳۸۴ (Sistan and Baluchestan province) per ۱۰۰.۰۰۰ live births. According to the WHO, the maternal mortality rate in Iran has decreased from ۱۲۳ to ۲۵ deaths per ۱۰۰,۰۰۰ live births between ۱۹۹۰ and ۲۰۱۸. The most common causes of deaths were bleeding (۴۳.۷%), preeclampsia/eclampsia (۲۴.۵%), hypertensive disorders (۲۴%), and embolus (۲۲.۸%), respectively. There was a significant relationship between maternal deaths and cares before pregnancy, suffering from different diseases during pregnancy, type of delivery, maternal education level, maternal age, requiring to special care, delivery agent, locations of birth, maternal socio-economic status, and distance between two pregnancy times (p<۰.۰۵).Conclusion: Based on the results, MMR was between ۱۵.۸ and ۳۸۴ per ۱۰۰,۰۰۰ live births. Although Iran has had a successful track in reducing its maternal mortality rate at current, there is still a recognizable disparity in MMR between and among provinces, which should be addressed. The most common causes of maternal death were hemorrhage, preeclampsia/eclampsia, hypertensive disorders, and embolus, respectively.

Keywords:

MMR , Pregnant women , Iran , Causes , Death