ArticleReproductive health2020
Maternal mortality in six low and lower-middle income countries from 2010 to 2018: risk factors and trends.
Article in Reproductive health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01073475 (Global Network for Women's and Children's Health Research Maternal Newborn Health Registry), which is not on this map. Cited by 67 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Global Network for Women's and Children's Health Research Maternal Newborn Health Registry
Who cites it
67 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Preferences of women for maternal healthcare services in low-income and middle-income countries: a systematic review of discrete choice experiments.BMJ global health · 2025Pooled it
- The impact of health insurance on maternal and reproductive health service utilization and financial protection in low- and lower middle-income countries: a systematic review of the evidence.BMC health services research · 2024Pooled it
- Effectiveness of mobile technology and utilization of maternal and neonatal healthcare in low and middle-income countries (LMICs): a systematic review.BMC women's health · 2023Pooled it
- Understanding stillbirths and maternal deaths in Pakistan: evidence from a national household survey.Journal of global health · 2026Article
- Global, regional, and national burden of maternal hemorrhage from 1990 to 2021, with projections to 2050: Insights from the Global Burden of Disease Study 2021.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- The FemTech revolution: Unlocking the potential of new technology for optimizing pregnancy outcomes in low- and middle-income countries and remote areas.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Maternal mortality due to hypertensive disorders of pregnancy: an ecological time-series study in Brazil, 2000-2024.BMC pregnancy and childbirth · 2026Article
- Association between antenatal care utilization, preeclampsia, and neonatal Apgar scores among postnatal women in Eswatini: an analytical cross-sectional study.BMC pregnancy and childbirth · 2026Article
- Risk Factors and Awareness of Preeclampsia Among Pregnant Women Attending Antenatal Care in Nasarawa State.Public health challenges · 2026Article
- Time to Act; Let Us Unite to Eliminate Malaria Among Pregnant Women in War Zone From Eastern Democratic Republic of the Congo: A Review.Health science reports · 2026Article
- Prevalence, sociodemographic determinants and regional disparities in health facility delivery in Somalia.Research in health services & regions · 2026Article
- Adverse Pregnancy Outcomes: A Cross-sectional Study of Prevalence and Associated Factors among Women Who Delivered at a Regional Hospital in Afghanistan.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2026Article
- Nexus between sociocultural practices and maternal mortality in Pakistan: a geospatial analysis using Spatial Durbin model and multiscale geographically weighted regression.BMC public health · 2026Article
- Facilitators and barriers to implementation of obstetric ultrasound scanning intervention by midwives within maternal and child health departments of the selected healthcare facilities in four districts of Zambia: experiences of healthcare workers.BMC pregnancy and childbirth · 2026Article
- Spatial variation and hierarchical analysis of institutional delivery dropout after antenatal care contacts in Nigeria: findings from 3-survey rounds.Scientific reports · 2026Article
- Co-designed interventions package for enhancing women's resilience in reproductive and child health through income-generating associations: a human-centered design study in Tanzania.Frontiers in health services · 2026Article
- Fifty years of maternal mortality research in sub-Saharan Africa: a bibliometric analysis of trends, gaps, and opportunities for health equity.Frontiers in global women's health · 2026Review
- Time to maternal death and its predictors among obstetric ICU patients in a resource-limited setting: A 10-year survival analysis.PloS one · 2026Article
- Effective coverage of skilled birth attendance in Ethiopia: a population-based cross-sectional study.BMC pregnancy and childbirth · 2025Article
- Impact of conditional cash transfers under the Janani Suraksha Yojana on neonatal outcomes in India's EAG states.Scientific reports · 2025Article
7 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
26 authors.
Funding
Abstract
backgroundMaternal mortality is a public health problem that disproportionately affects low and lower-middle income countries (LMICs). Appropriate data sources are lacking to effectively track maternal mortality and monitor changes in this health indicator over time.
methodsWe analyzed data from women enrolled in the NICHD Global Network for Women's and Children's Health Research Maternal Newborn Health Registry (MNHR) from 2010 through 2018. Women delivering within research sites in the Democratic Republic of Congo, Guatemala, India (Nagpur and Belagavi), Kenya, Pakistan, and Zambia are included. We evaluated maternal and delivery characteristics using log-binomial models and multivariable models to obtain relative risk estimates for mortality. We used running averages to track maternal mortality ratio (MMR, maternal deaths per 100,000 live births) over time.
resultsWe evaluated 571,321 pregnancies and 842 maternal deaths. We observed an MMR of 157 / 100,000 live births (95% CI 147, 167) across all sites, with a range of MMRs from 97 (76, 118) in the Guatemala site to 327 (293, 361) in the Pakistan site. When adjusted for maternal risk factors, risks of maternal mortality were higher with maternal age > 35 (RR 1.43 (1.06, 1.92)), no maternal education (RR 3.40 (2.08, 5.55)), lower education (RR 2.46 (1.54, 3.94)), nulliparity (RR 1.24 (1.01, 1.52)) and parity > 2 (RR 1.48 (1.15, 1.89)). Increased risk of maternal mortality was also associated with occurrence of obstructed labor (RR 1.58 (1.14, 2.19)), severe antepartum hemorrhage (RR 2.59 (1.83, 3.66)) and hypertensive disorders (RR 6.87 (5.05, 9.34)). Before and after adjusting for other characteristics, physician attendance at delivery, delivery in hospital and Caesarean delivery were associated with increased risk. We observed variable changes over time in the MMR within sites.
conclusionsThe MNHR is a useful tool for tracking MMRs in these LMICs. We identified maternal and delivery characteristics associated with increased risk of death, some might be confounded by indication. Despite declines in MMR in some sites, all sites had an MMR higher than the Sustainable Development Goals target of below 70 per 100,000 live births by 2030.
trial registrationThe MNHR is registered at NCT01073475 .
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.