Résumé
Background: Since 1990, the maternal mortality significantly decreased at global scale as well as the North Africa and Middle East. However, estimates for mortality and morbidity by cause and age at national scale in this region are not available. Method(s): This study is part of the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. Here we report maternal mortality and morbidity by age and cause across 21 countries in the region from 1990 to 2019. Result(s): Between 1990 and 2019, maternal mortality ratio (MMR) dropped from 148.8 (129.6-171.2) to 94.3 (73.4-121.1) per 100 000 live births in North Africa and Middle East. In 1990, MMR ranged from 6.0 (5.3-6.8) in Kuwait to 502.9 (375.2-655.3) per 100 000 live births in Afghanistan. Respective figures for 2019 were 5.1 (4.0-6.4) in Kuwait to 269.9 (195.8-368.6) in Afghanistan. Percentages of deaths under 25 years was 26.0% in 1990 and 23.8% in 2019. Maternal hemorrhage, indirect maternal deaths, and other maternal disorders rank 1st to 3rd in the entire region. Ultimately, there was an evident decrease in MMR along with increase in socio-demographic index from 1990 to 2019 in all countries in the region and an evident convergence across nations. Conclusion(s): MMR has significantly declined in the region since 1990 and only five countries (Afghanistan, Sudan, Yemen, Morocco, and Algeria) out of 21 nations didn't achieve the Sustainable Development Goal (SDG) target of 70 deaths per 100 000 live births in 2019. Despite the convergence in trends, there are still disparities across countries.Copyright © 2022 Academy of Medical Sciences of I.R. Iran. All rights reserved.
Résumé
Due to the physiological changes of the pregnancy and considering the susceptibility of the fetus, pregnant women are among the vulnerable health groups. The current COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has multiplied the health burden on vulnerable and susceptible groups. With over 500,000 new cases daily, the vulnerable groups are in danger more than ever. Therefore, early diagnosis, effective treatment, and efficient prevention strategies are significant among these groups. Since the clinical knowledge about the diagnosis, management, prevention, and many other aspects of pregnancy and lactation during COVID-19 has significantly changed and improved from the pandemic's beginning, most of the previous knowledge has changed, and the previous publications might not be helpful anymore. This review aims to provide an updated and comprehensive review of the mutual impact of pregnancy and COVID-19 infection, discuss the current controversies based on the most recent findings, and highlight the existing knowledge gaps. Due to the increased susceptibility, undesired outcomes are more expected among pregnant women with COVID-19 infection. Still, prevention measures are the best way of managing COVID-19 in this population. Moreover, further clinical studies should address the long-term complications, outcomes, safety of vaccination, and the impact of the pandemic on mental health.
Résumé
Due to the physiological changes of the pregnancy and considering the susceptibility of the fetus, pregnant women are among the vulnerable health groups. The current COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has multiplied the health burden on vulnerable and susceptible groups. With over 500,000 new cases daily, the vulnerable groups are in danger more than ever. Therefore, early diagnosis, effective treatment, and efficient prevention strategies are significant among these groups. Since the clinical knowledge about the diagnosis, management, prevention, and many other aspects of pregnancy and lactation during COVID-19 has significantly changed and improved from the pandemic's beginning, most of the previous knowledge has changed, and the previous publications might not be helpful anymore. This review aims to provide an updated and comprehensive review of the mutual impact of pregnancy and COVID-19 infection, discuss the current controversies based on the most recent findings, and highlight the existing knowledge gaps. Due to the increased susceptibility, undesired outcomes are more expected among pregnant women with COVID-19 infection. Still, prevention measures are the best way of managing COVID-19 in this population. Moreover, further clinical studies should address the long-term complications, outcomes, safety of vaccination, and the impact of the pandemic on mental health.