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Factors Causing Maternal Death due to COVID-19 in Several Countries: A Literature Review

*Vina Firmanty Mustofa orcid  -  Faculty of Public Health, Universitas Airlangga, Indonesia
Budi Prasetyo  -  Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Indonesia
Diah Indriani  -  Department of Epidemiology, Biostatistics, Population Studies and Health Promotion, Faculty of Public Health, Universitas Airlangga, Indonesia
Nur Anisah Rahmawati  -  Faculty of Public Health, Universitas Airlangga, Indonesia
Open Access Copyright (c) 2023 Jurnal Promosi Kesehatan Indonesia

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Background: Since 2019, the world has been faced with a global crisis. The spread of SARS-CoV-2 has an impact on all populations, including pregnant women, who are among the most vulnerable and at-risk population groups. The worldwide spread of the virus is called the COVID-19 pandemic. This study aims to explore the factors that cause maternal death during pregnancy and postpartum due to COVID-19 in several countries.

Method: A literature review was conducted to explore broadly the causes of maternal deaths due to COVID in several countries. Article search on three databases, namely PubMed, Google Scholar, and ScienceDirect. A total of 7 articles were analyzed. The data studied are cases of death and their causes.

Results: The study was conducted in the period 2018 to 2021 with the type of research using retrospective data. When compared to before the pandemic, there was a significant increase in the number of maternal deaths. Factors that increase the risk of maternal death come from direct and indirect factors. Indirect factors such as age, health facility access, inadequate tools, and health services, access to knowledge, cultural practice, and poverty. Direct factors are comorbidities such as obesity, diabetes, cardiovascular disease, hypertension, and immune impairment. Pregnant women who do not have comorbidities can have a poor prognosis with undetected causes of death. Health facilities need to conduct early screening so that direct and indirect factors can be minimized to prevent maternal mortality.

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Keywords: maternal death;pregnancy;postpartum period;COVID-19;SARS-CoV-2

Article Metrics:

  1. Chen Y, Bai J. Maternal and infant outcomes of full-term pregnancy combined with COVID-2019 in Wuhan, China: retrospective case series. Vol. 302, Archives of Gynecology and Obstetrics. Springer; 2020. p. 545–51
  2. Souza ASR, Amorim MMR. Maternal mortality by COVID-19 in Brazil. Revista Brasileira de Saude Materno Infantil. 2021;21:S257–61
  3. Fatmaningrum DA, Anis W, Laksana MAC. The Impact of The COVID-19 Pandemic on Maternal Mortality Attributes. Jurnal Administrasi Kesehatan Indonesia [Internet]. 2022 Jun 30;10(1):70–8. Available from:
  4. Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Vol. 99, Acta Obstetricia et Gynecologica Scandinavica. Wiley-Blackwell; 2020. p. 823–9
  5. Cartaxo ANS, Barbosa FIC, de Souza Bermejo PH, Moreira MF, Prata DN. The exposure risk to COVID-19 in most affected countries: A vulnerability assessment model. PLoS One. 2021 Mar 1;16(3 March)
  6. Rofiqa R. Gambaran Kesiapan Ibu Hamil Menghadapi Persalinan Pada Masa Pandemi COVID-19 DI RSUD LA Temmamala Kabupaten Soppeng. [Makassar]: UNIVERSITAS HASANUDDIN; 2021
  7. Toro F, Gjoka M, di Lorenzo G, de Santo D, de Seta F, Maso G, et al. Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Vol. 27, Clinical Microbiology and Infection. Elsevier B.V.; 2021. p. 36–46
  8. Karimi L, Makvandi S, Vahedian-Azimi A, Sathyapalan T, Sahebkar A. Effect of COVID-19 on Mortality of Pregnant and Postpartum Women: A Systematic Review and Meta-Analysis. Vol. 2021, Journal of Pregnancy. Hindawi Limited; 2021
  9. Nakamura-Pereira M, Knobel R, Menezes MO, Andreucci CB, Takemoto MLS. The impact of the COVID-19 pandemic on maternal mortality in Brazil: 523 maternal deaths by acute respiratory distress syndrome potentially associated with SARS-CoV-2. International Journal of Gynecology and Obstetrics. 2021 May 1;153(2):360–2
  10. Rawat SK, Saad T, Jindal A, Vyas AK. Coronavirus disease 2019 in pregnancy: Case report on maternal death in Sagar City of Central India. Journal of Obstetrics and Gynaecology Research. 2021 Apr 1;47(4):1579–82
  11. Mendez-Dominguez N, Santos-Zaldívar K, Gomez-Carro S, Datta-Banik S, Carrillo G. Maternal mortality during the COVID-19 pandemic in Mexico: a preliminary analysis during the first year. BMC Public Health. 2021 Dec 1;21(1)
  12. Thoma ME, Declercq ER. All-Cause Maternal Mortality in the US Before vs During the COVID-19 Pandemic. JAMA Netw Open [Internet]. 2022 Jun 1;5(6):e2219133. Available from:
  13. Basu JK, Chauke L, Magoro T. Maternal mortality from COVID 19 among South African pregnant women. Journal of Maternal-Fetal and Neonatal Medicine. 2021;
  14. Liu D, Li L, Wu X, Zheng D, Wang J, Yang L, et al. Pregnancy and perinatal outcomes of women with coronavirus disease (COVID-19) Pneumonia: A preliminary analysis. American Journal of Roentgenology. 2020 Jul 1;215(1):127–32
  15. Heck JL, Jones EJ, Bohn D, Mccage S, Parker JG, Parker M, et al. Maternal Mortality among American Indian/Alaska Native Women: A Scoping Review. Vol. 30, Journal of Women’s Health. Mary Ann Liebert Inc.; 2021. p. 220–9
  16. Storm F, Agampodi S, Eddleston M, Sorensen JB, Konradsen F, Rheinlander T. Indirect causes of maternal death. The Lancet. 2014 Oct;2:566
  17. Nair M, Nelson-Piercy C, Knight M. Indirect maternal deaths: UK and global perspectives. Obstet Med. 2017;10(1):10–5
  18. Topriceanu CC, Wong A, Moon JC, Hughes AD, Bann D, Chaturvedi N, et al. Evaluating access to health and care services during lockdown by the COVID-19 survey in five UK national longitudinal studies. BMJ Open. 2021 Mar 18;11(3)
  19. Tuczyńska M, Matthews-Kozanecka M, Baum E. Accessibility to Non-COVID Health Services in the World During the COVID-19 Pandemic: Review. Vol. 9, Frontiers in Public Health. Frontiers Media S.A.; 2021
  20. Nshimyiryo A, Barnhart DA, Cubaka VK, Dusengimana JMV, Dusabeyezu S, Ndagijimana D, et al. Barriers and coping mechanisms to accessing healthcare during the COVID-19 lockdown: a cross-sectional survey among patients with chronic diseases in rural Rwanda. BMC Public Health. 2021 Dec 1;21(1)
  21. Abdisa DK, Jaleta DD, Feyisa JW, Kitila KM, Berhanu RD. Access to maternal health services during COVID-19 pandemic, re-examining the three delays among pregnant women in Ilubabor zone, southwest Ethiopia: A cross-sectional study. PLoS One. 2022 May 1;17(5 May)
  22. Meaney S, Leitao S, Olander EK, Pope J, Matvienko-Sikar K. The impact of COVID-19 on pregnant womens’ experiences and perceptions of antenatal maternity care, social support, and stress-reduction strategies. Women and Birth. 2022 May 1;35(3):307–16
  23. Bankar S, Ghosh D. Accessing Antenatal Care (ANC) services during the COVID-19 first wave: insights into decision-making in rural India. Reprod Health [Internet]. 2022 Jul 8;19(1):158. Available from:
  24. Bozkaya VÖ, Kaplan ZAO, Özgü E, Engin-Üstün Y. Screening and evaluation of newly diagnosed cardiovascular diseases in first-trimester asymptomatic pregnant women in a tertiary antenatal care center in Turkey. Anatol J Cardiol. 2020;23(2):99–104
  25. Ralston ER, Smith P, Chilcot J, Silverio SA, Bramham K. Perceptions of risk in pregnancy with chronic disease: A systematic review and thematic synthesis. Vol. 16, PLoS ONE. Public Library of Science; 2021
  26. Jølving LR, Nielsen J, Kesmodel US, Nielsen RG, Beck-Nielsen SS, Nørgård BM. Prevalence of maternal chronic diseases during pregnancy – a nationwide population based study from 1989 to 2013. Acta Obstet Gynecol Scand. 2016 Nov 1;95(11):1295–304

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