Prevalence and risk factors of maternal near miss in India: A systematic review and meta-analysis

Background and objectives Maternal near miss (MNM) is a marker of severe maternal complications and reflects the quality of obstetric care systems. The present systematic review and meta-analysis aimed to estimate the prevalence of MNM and identify common risk factors among pregnant women in India. Methods In accordance with PRISMA 2020 guidelines, “MEDLINE, Scopus, Embase, and Web of Science” database search was carried out until November 21, 2024. Observational studies from India that detailed the risk factors and prevalence of MNM were included. The Newcastle Ottawa Scale (NOS) and the JBI checklist were used to evaluate quality. Prevalence and heterogeneity were determined through meta-analysis using a random-effects model. Results There were 6,606 MNM cases in 39 studies with 242,015 pregnant women. The pooled prevalence of MNM was 3.9% (95% CI: 1.6%–7.2%) with substantial heterogeneity (I 2 =99.4%). The prevalence of MNM varied between the states, with Rajasthan reporting as low as <1% to West Bengal reporting 38%. Anemia, sepsis, haemorrhage, and hypertensive disorders were the most frequently mentioned risk factors. Interpretation and conclusions The prevalence of MNM varies greatly throughout India. The study emphasizes the necessity of integrating MNM surveillance into national health systems.