ABSTRACT:
Maternal death (MD) and morbidity are critical indicators of a nation's health and the development of its healthcare system (1-3). Few studies have utilized national surveillance data to explore maternal health in Georgia. This study investigates MD, maternal morbidity, and associated risk factors using data from the Georgian Birth Registry (GBR) and other national digital health surveillance systems from 2014 to 2022. The study analyzed MDs to identify direct and indirect causes of MD in Georgia. Furthermore, women registered in the GBR were assessed to determine the odds of MD, post-delivery intensive care unit (ICU) admission, and caesarean section (CS) related to SARS-CoV-2 infection during pregnancy. Finally, pregnancies were evaluated to investigate the prevalence of maternal anemia and its association with post-delivery ICU admission and preterm delivery. MD is rare in Georgia, yet the maternal mortality ratio is higher than in high-income countries. Direct causes of MD (62%) were more prevalent than indirect causes (38%), with hemorrhage and infections being the primary direct and indirect causes, respectively (4). SARS-CoV-2 infection within 30 days before or during delivery was strongly linked to MD, post-delivery ICU admission, and CS (5). Anemia affected 40.6% of pregnant women, though severe anemia was rare. Anemia was not significantly associated with post-delivery ICU admission or increased odds of preterm delivery (6). The findings highlight the need to enhance acute obstetric care in Georgia, as direct causes of death and hemorrhage are primarily linked to pregnancy complications and delivery. The COVID-19 pandemic adversely affected maternal health, with infected pregnant women having higher odds of MD and post-delivery ICU admission. These results underscore the necessity to improve antenatal care quality and ensure effective management during delivery and postpartum. Attention should be given to the high prevalence of anemia among pregnant women as well.