Predictors of severe maternal outcomes in Ethiopia: a systematic review and meta-analysis

Background/Aims Severe maternal outcomes refer to life-threatening obstetric complications that are near-fatal or result in maternal mortality. This systematic review and meta-analysis aimed to estimate the pooled magnitude of severe maternal outcomes and their predictors in Ethiopia. Methods A comprehensive search of PubMed, CINAHL, Global Health, Global Index Medicine, Hinari and Google Scholar was conducted. Cross-sectional, case control and cohort studies carried out between 2000 and 2022 that explored severe maternal outcomes in Ethiopia were screened for inclusion. Selected studies were subject to quality appraisal and analysis. Heterogeneity was assessed via the I 2 test. Funnel plots and Egger's test were used to assess publication bias between studies. Significant predictors of severe maternal outcomes were assessed using odds ratios. Results Of the 222 articles identified, 13 were included in the review and meta-analysis. The pooled magnitude of severe maternal outcomes was 24%. The identified predictors for severe maternal outcomes were living in rural residences, experiencing a delay in receiving care and lack of attendance at antenatal care services. Conclusions The pooled magnitude of severe maternal outcomes in Ethiopia was high, indicating a pressing need to address this rate. Healthcare professionals should consider the identified predictors of severe maternal outcomes when implementing interventions to reduce obstetric complications among women in Ethiopia. Implications for practice Policymakers should prioritise addressing severe maternal outcomes as part of current national public health agendas. The Ethiopian Federal Ministry of Health and other stakeholders should work toward reducing adverse maternal and perinatal outcomes to achieve sustainable development goals.