{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:34:42Z","timestamp":1777944882292,"version":"3.51.4"},"reference-count":124,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Severe maternal outcomes (SMOs), including maternal deaths and life-threatening complications during pregnancy, childbirth, or within 42\u2009days postpartum, reflect the quality of maternal healthcare services and highlight gaps in timely and effective interventions. Monitoring SMOs is crucial for improving maternal health systems, as it helps identify preventable factors, strengthen clinical practices, and inform policy decisions to reduce maternal morbidity and mortality. This study synthesizes existing evidence on the pooled incidence proportion of SMOs in Ethiopia and examines their underlying causes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To estimate the pooled incidence proportion of SMOs and their underlying causes in Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources and methods:<\/jats:title>\n                    <jats:p>\n                      The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. A comprehensive search was conducted in PubMed, Cochrane Library, Google Scholar, Scopus, and Hinari using the CoCoPop strategy. Study quality was assessed using the Newcastle\u2013Ottawa Scale. Heterogeneity was evaluated with the\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistic, and publication bias was assessed using funnel plots and Egger\u2019s test. A random-effects model was applied to calculate the pooled incidence proportion with 95% confidence intervals (CIs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Thirteen studies, including 2451 SMO cases among 67,954 live births, were analyzed. The pooled incidence of SMOs was 41.74 per 1000 live births (95% CI: 29.58\u201353.89). The maternal mortality index was 10.53% (95% CI: 7.71\u201313.36). The leading causes of SMO were pregnancy-induced hypertension (PIH; 40.8%), obstetric hemorrhage (24.94%), uterine rupture (19.61%), severe systemic infection (11.65%), and early pregnancy complications (7.74%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The incidence of SMOs in Ethiopia is higher than in many other countries. PIH, obstetric hemorrhage, uterine rupture, severe systemic infection, and early pregnancy complications are the main contributing causes. Targeted, context-specific interventions that emphasize early detection, effective management, and prevention of these conditions could significantly reduce maternal morbidity and mortality. Strengthening healthcare infrastructure, improving access to quality emergency obstetric care, and enhancing community awareness and timely health-seeking behaviors are essential. Policymakers and program planners should prioritize resource allocation and capacity-building efforts tailored to these high-burden conditions to accelerate progress toward national and global maternal health goals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number:<\/jats:title>\n                    <jats:p>CRD42024629544.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057251387475","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T07:05:24Z","timestamp":1762758324000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe maternal outcomes and their underlying causes in Ethiopia. Systematic review and meta-analysis"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9425-6273","authenticated-orcid":false,"given":"Tirusew Nigussie","family":"Kebede","sequence":"first","affiliation":[{"name":"Department of Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kidist Ayalew","family":"Abebe","sequence":"additional","affiliation":[{"name":"Department of Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Worku Taye","family":"Getahun","sequence":"additional","affiliation":[{"name":"Department of Midwifery, Debre Markos Comprehensive Specialized Hospital, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birhan Tsegaw","family":"Taye","sequence":"additional","affiliation":[{"name":"Department of Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Temesgen Dessie","family":"Mengistu","sequence":"additional","affiliation":[{"name":"Department of Midwifery, College of Medicine and Health Science, Debre Tabor University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bezawit Melak","family":"Fente","sequence":"additional","affiliation":[{"name":"Department of General Midwifery, School of Midwifery, College of Medicine and Health Science, University of Gondar, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3698-119X","authenticated-orcid":false,"given":"Moges Sisay","family":"Chekole","sequence":"additional","affiliation":[{"name":"Department of Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tebabere","family":"Moltot","sequence":"additional","affiliation":[{"name":"Department of Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,9]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"100217","article-title":"Severe maternal morbidity in the Asia Pacific: a systematic review and meta-analysis","volume":"14","author":"De Silva M","year":"2021","unstructured":"De Silva M, Panisi L, Lindquist A, et al. 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Maternal health https:\/\/en.wikipedia.org\/wiki\/Maternal_health?utm (2010 November 2025)."},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14686-5"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-021-01151-6"},{"key":"e_1_3_3_63_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-015-0493-4"},{"key":"e_1_3_3_64_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e18217"},{"key":"e_1_3_3_65_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-03312-0"},{"key":"e_1_3_3_66_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(97)10018-1"},{"key":"e_1_3_3_67_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-14-159"},{"key":"e_1_3_3_68_2","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2021.1953242"},{"key":"e_1_3_3_69_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00468-0"},{"key":"e_1_3_3_70_2","unstructured":"WHO. Maternal mortality https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/maternal-mortality?utm_source=chatgpt.com (2025 August 2025)."},{"issue":"5","key":"e_1_3_3_71_2","first-page":"48","article-title":"How to reduce maternal mortality","volume":"320","author":"McLemore MR","year":"2019","unstructured":"McLemore MR, D\u2019Efilippo V. How to reduce maternal mortality. Sci Am 2019; 320(5): 48\u201351.","journal-title":"Sci Am"},{"key":"e_1_3_3_72_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2024.102572"},{"key":"e_1_3_3_73_2","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2024.1289835"},{"key":"e_1_3_3_74_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1431159"},{"key":"e_1_3_3_75_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-023-06078-3"},{"key":"e_1_3_3_76_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15852"},{"issue":"9","key":"e_1_3_3_77_2","first-page":"375","article-title":"Maternal mortality and healthcare disparities: addressing systemic inequities in underserved communities","volume":"13","author":"Majebi NL","year":"2024","unstructured":"Majebi NL, Adelodun MO, Chinyere E. Maternal mortality and healthcare disparities: addressing systemic inequities in underserved communities. Int J Eng Invent 2024; 13(9): 375\u2013385.","journal-title":"Int J Eng Invent"},{"key":"e_1_3_3_78_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S160022"},{"key":"e_1_3_3_79_2","unstructured":"WorldData.info. Country comparison Ethiopia VS south Sudan https:\/\/www.worlddata.info\/country-comparison.php?country1=ETHcountry2=SSDutm (2015 accessed May 2022)."},{"key":"e_1_3_3_80_2","unstructured":"WHO. Strengthening primary health care in fragile settings: South Sudan https:\/\/www.who.int\/news-room\/feature-stories\/detail\/strengthening-primary-health-care-fragile-settings-south-sudan?utm_source=chatgpt.com (2022)."},{"key":"e_1_3_3_81_2","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.17484"},{"key":"e_1_3_3_82_2","unstructured":"Guardian T. Pregnancy is not a disease\u2019: why do so many women die giving birth in Nigeria? https:\/\/www.theguardian.com\/global-development\/2024\/apr\/16\/pregnancy-is-not-disease-why-do-so-many-women-die-giving-birth-in-nigeria-one-of-africas-richest-countries?utm_source=chatgpt.com (2024 accessed July 2025)."},{"key":"e_1_3_3_83_2","volume-title":"African governments falling short on healthcare funding. Slow progress 23 years after landmark Abuja declaration","author":"Mwangi M.","year":"2020","unstructured":"Mwangi M. African governments falling short on healthcare funding. Slow progress 23 years after landmark Abuja declaration. Human Rights Watch, 2020."},{"key":"e_1_3_3_84_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2024.01.026"},{"key":"e_1_3_3_85_2","unstructured":"CDC. Working together to reduce black maternal mortality. https:\/\/www.cdc.gov\/womens-health\/features\/maternal-mortality.html?utm_source=chatgpt.com (2024 accessed January 2025)."},{"key":"e_1_3_3_86_2","unstructured":"The World Facetbook. Maternal mortality ratio https:\/\/www.cia.gov\/the-world-factbook\/field\/maternal-mortality-ratio\/country-comparison\/?utm_source=chatgpt.com (2023 accessed March 2024)."},{"key":"e_1_3_3_87_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0303028"},{"key":"e_1_3_3_88_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2023-011911"},{"key":"e_1_3_3_89_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018459"},{"key":"e_1_3_3_90_2","unstructured":"NUMBEO. Health care comparison between Somalia and Ethiopia https:\/\/www.numbeo.com\/health-care\/compare_countries_result.jsp?country1=Somalia&country2=Ethiopia&utm_source=chatgpt.com (2023 accessed September 2025)."},{"key":"e_1_3_3_91_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-022-01995-5"},{"key":"e_1_3_3_92_2","unstructured":"Nigeria Health Watch. How Ethiopia improved the quality of maternal care through the strengthening of midwifery training https:\/\/articles.nigeriahealthwatch.com\/how-ethiopia-improved-the-quality-of-maternal-care-through-the-strengthening-of-midwifery-training\/?utm_source=chatgpt.com (2022 accessed August 2024)."},{"key":"e_1_3_3_93_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-09321-x"},{"key":"e_1_3_3_94_2","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-24-00145"},{"key":"e_1_3_3_95_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101411"},{"key":"e_1_3_3_96_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-024-09075-9"},{"key":"e_1_3_3_97_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-93"},{"key":"e_1_3_3_98_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2617-8"},{"key":"e_1_3_3_99_2","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2025.1555778"},{"key":"e_1_3_3_100_2","article-title":"Hypertensive disorders of pregnancy","volume":"381","author":"Wu P","year":"2023","unstructured":"Wu P, Green M, Myers JE. Hypertensive disorders of pregnancy. BMJ 2023; 381: e071653.","journal-title":"BMJ"},{"key":"e_1_3_3_101_2","first-page":"152","volume-title":"WHO recommendations on antenatal care for a positive pregnancy experience. WHO recommendations on antenatal care for a positive pregnancy experience","author":"WHO","year":"2016","unstructured":"WHO. WHO recommendations on antenatal care for a positive pregnancy experience. WHO recommendations on antenatal care for a positive pregnancy experience. WHO, 2016, p.152."},{"key":"e_1_3_3_102_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-025-01332-9"},{"key":"e_1_3_3_103_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-022-03438-x"},{"key":"e_1_3_3_104_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-08892-5"},{"key":"e_1_3_3_105_2","doi-asserted-by":"publisher","DOI":"10.5812\/jnms-143631"},{"key":"e_1_3_3_106_2","unstructured":"WHO. Standards for improving quality of maternal and newborn care in health facilities https:\/\/cdn.who.int\/media\/docs\/default-source\/mca-documents\/qoc\/quality-of-care\/standards-for-improving-quality-of-maternal-and-newborn-care-in-health-facilities_1a22426e-fdd0-42b4-95b2-4b5b9c590d76.pdf?sfvrsn=3b364d8_4&utm_source=chatgpt.com (2016 accessed May 2024)."},{"key":"e_1_3_3_107_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-3-6"},{"key":"e_1_3_3_108_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1721882"},{"issue":"4","key":"e_1_3_3_109_2","first-page":"322","article-title":"Saving women\u2019s lives: evidence-based recommendations for the prevention of postpartum haemorrhage","volume":"85","author":"Mathai M","year":"2007","unstructured":"Mathai M, G\u00fclmezoglu AM, Hill S. Saving women\u2019s lives: evidence-based recommendations for the prevention of postpartum haemorrhage. Bull World Health Organ 2007; 85(4): 322\u2013323.","journal-title":"Bull World Health Organ"},{"key":"e_1_3_3_110_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2024.01.012"},{"key":"e_1_3_3_111_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2024-015342"},{"key":"e_1_3_3_112_2","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0000000000000123"},{"key":"e_1_3_3_113_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0240675"},{"key":"e_1_3_3_114_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xagr.2022.100063"},{"key":"e_1_3_3_115_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0297734"},{"key":"e_1_3_3_116_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0020252"},{"key":"e_1_3_3_117_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0000889"},{"key":"e_1_3_3_118_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04951-1"},{"key":"e_1_3_3_119_2","volume-title":"WHO recommendations on antenatal care for a positive pregnancy experience: summary: highlights and key messages from the World Health Organization\u2019s 2016 global recommendations for routine antenatal care. WHO recommendations on antenatal care for a positive pregnancy experience: summary: highlights and key messages from the World Health Organization\u2019s 2016 global recommendations for routine antenatal care","author":"WHO","year":"2018","unstructured":"WHO. WHO recommendations on antenatal care for a positive pregnancy experience: summary: highlights and key messages from the World Health Organization\u2019s 2016 global recommendations for routine antenatal care. WHO recommendations on antenatal care for a positive pregnancy experience: summary: highlights and key messages from the World Health Organization\u2019s 2016 global recommendations for routine antenatal care. 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