García-Tizón Larroca, SantiagoAmor Valera, FranciscoAyuso Herrera, EstherCueto Hernández, IgnacioCuñarro López, YolandaLeón Luis, Juan Antonio2025-01-212025-01-212020-04-16García-Tizón Larroca S, Arévalo-Serrano J, Ruiz Minaya M, Paya Martinez P, Perez Fernandez Pacheco R, Lizarraga Bonelli S, et al. Maternal mortality trends in Spain during the 2000-2018 period: the role of maternal origin. BMC public health. 2022;22(1):337.1471-239310.1186/s12884-020-02901-3https://hdl.handle.net/20.500.14352/115269Background The reduction in maternal mortality worldwide has increased the interest in studying more frequent severe events such as maternal near miss. The Human Development Index is a sociodemographic country-specific variable that includes key human development indicators such as living a long and healthy life, acquiring knowledge, and enjoying a decent standard of living, allowing differentiation between countries. In a globalised environment, it is necessary to study whether the Human Development Index of each patient's country of origin can be associated with the maternal near-miss rate and thus classify the risk of maternal morbidity and mortality. Methods A systematic review of the literature published between 2008 and 2019 was conducted, including all articles that reported data about maternal near miss in their sample of pregnant women, in addition to describing the study countries of their sample population. The Human Development Index of the study country, the maternal near-miss rate, the maternal mortality rate, and other maternal-perinatal variables related to morbidity and mortality were used. Results After the systematic review, eighty two articles from over thirty countries were included, for a total of 3,699,697 live births, 37,191 near miss cases, and 4029 mortality cases. A statistically significant (p <0.05) inversely proportional relationship was observed between the Human Development Index of the study country and the maternal near-miss and mortality rates. The most common cause of maternal near miss was haemorrhage, with an overall rate of 38.5%, followed by hypertensive disorders of pregnancy (34.2%), sepsis (7.5%), and other undefined causes (20.9%). Conclusions The Human Development Index of the maternal country of origin is a sociodemographic variable allowing differentiation and classification of the risk of maternal mortality and near miss in pregnant women. The most common cause of maternal near miss published in the literature was haemorrhage. Trial registration PROSPERO ID: CRD 42019133464engAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/journal articlehttps://doi.org/10.1186/s12884-020-02901-3https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-02901-3open access61Maternal near missMaternal mortalityHuman Development IndexImmigrantsCiencias Biomédicas32 Ciencias Médicas