Revisitar As Causas Subjacentes Ao Desfecho Materno Nos Países Em Desenvolvimento: De 2016 A 2023- Uma Revisão Sistemática

Abstract

Background: Every two minutes, a woman dies from complications of pregnancy and childbirth. This fact requests critical attention. The main causes of maternal mortality are direct obstetric conditions, led by hemorrhage and followed by hypertensive disorders, sepsis, and abortion. In 2020, the vast majority of maternal deaths, 95%, occurred in low and low and middle-income countries (LMIC). Our study aims to outline which were the focus of investigation regarding maternal outcomes related factors, from 2016 to 2023, as to better understand researchers concerns in these settings, having in mind the 2016-30 United Nations agenda regarding maternal wellbeing. Methods: A revision of the literature was undertaken at the PubMed, Scopus, and Web of Science databases. The used query was "(Pregnancy Outcome OR Maternal Outcome) AND ((LMIC) OR (Low- and Middle-Income Countries) And (Randomized Controlled Trials) AND (Clinical Trials))". Filters were free access publications from 1st January 2016 to 31st December 2023, written in English, Portuguese, or Spanish. Publications focused on pregnant women or maternal outcomes in LMICs, as classified by the World Bank, were selected. Studies were organized into 8 categories based on maternal conditions or interventions, in which impact on pregnancy or maternal outcomes was analyzed. Results: The search obtained 353 articles and 21 (5.9%) were selected. Research was conducted in 16 LMICs, located in Asia and Africa, accounting for 21.62% of these countries. The majority, 14 out of 21 (66.66%), of maternal conditions or interventions under study aiming to evaluate their impact on maternal or pregnancy outcomes were categorized as "Antepartum Care", "Infectious Diseases", and "Others (maternal healthcare accessibility constrains depending on cultural or economic factors, or resource shortages)". Conclusions: This review highlights scarcity of research related to maternal outcomes in LMIC, since the beginning of the Sustainable Development Goals (UN 2016-2030 agenda). Most researchers' have focused the impact of infectious diseases and interventions on prenatal care and mothers' accessibility to healthcare, on maternal outcomes. Regarding maternal outcomes, there is a need for further investigation in these settings to attain healthcare equity between LMIC and higher developed countries. Keywords: Maternal mortality; Pregnancy complications; Pregnancy outcomes; Low- and middle-income countries (LMICs).