Commonest causes of maternal mortality in Nigeria: a situational report requiring an urgent action.

Abstract

Abstract: Maternal mortality remains a critical public health challenge in Nigeria, with rates far exceeding global targets. This narrative review correlates findings from peer-reviewed studies published between 2015 and 2025 to assess the burden, causes, and contributing factors of maternal mortality across Nigeria's six geopolitical zones. PubMed and Google Scholar were searched using predefined keywords, and studies reporting maternal mortality ratios (MMRs), causes of death, or contributing factors from Nigerian health facilities or population-based surveys were included. Hypertensive disorders of pregnancy (HDP) and obstetric hemorrhage were consistently identified as the leading direct causes of maternal death, while complications of unsafe abortion and sepsis were also prominent. Most of the non-medical contributing factors identified in this review study were poor utilization of prenatal care (PNC) services, limited access to healthcare facilities, financial constraints, and low educational attainment. Significant regional variation was observed, with facility-based MMRs ranging from 383 to 7,364 per 100,000 live births. This study emphasizes the urgent need for strengthened PNC delivery, improved emergency obstetric services, health workforce development, and targeted community health education to reduce maternal mortality in Nigeria.

Lay summary: Deaths from pregnancy-related causes remain a major public health concern, especially in less developed countries. Nigeria is one of the countries with high pregnancy-related deaths. A substantial number of women who become pregnant in Nigeria never make it through the pregnancy. Our study investigated pregnancy-related deaths and their responsible factors across Nigeria. We found out that most of these deaths are caused by pregnancy-related bleeding, high blood pressure, and their complications. Pregnant women who do not attend prenatal care and those with low socioeconomic status are affected the most. Understanding the causes and contributing factors behind pregnancy-related deaths can help create ways to reduce this serious public health problem.