The impact of Antenatal care on maternal near-miss events in Ethiopia: A Systematic review and meta-analysis

Abstract Background Antenatal care (ANC) is one of the renowned reproductive health care, and adequate antenatal care utilization averts adverse feto-maternal outcomes. Many fragmented studies were conducted on the effect of ANC on maternal near-miss events in Ethiopia but no single evidence was present. Hence, the aim of this study was a need to systematically pool existing data to determine the effect of ANC on Maternal Near Miss (MNM) events. Methods We systematically reviewed and meta-analyzed studies reporting the associations between ANC and maternal near-miss events in Ethiopia through an electronic search from databases including Medline, PubMed, and Web of Science. A random-effects model was used to calculate the pooled estimate with a 95% confidence interval (CI) in STATA 14.1 version. Heterogeneity and publication bias of the included studies were assessed using Cochran's Q, I2, and meta-bias statistics. Results A total of nine studies with 5990 of participants were included. The pooled estimate by the random-effects model was 0.28 (95% CI: 0.19, 0.40) for mothers who received at least one antenatal care visit by a skilled provider as compared to mothers who did not receive any visits. Conclusion This systematic review and meta-analysis found a statistically significant effect of ANC on maternal near-miss events in Ethiopia. About three fourth of maternal near-miss events will be averted by at least one ANC visit. Hence, in order to accelerate progress towards the reduction of maternal deaths and achieve the sustainable development goals, all pregnant women should receive antenatal care during pregnancy.