The impact of sociodemographic, macroeconomic, and health status and resources determinants on infant mortality rates in the Gulf Cooperation Council (GCC) countries: A systematic review and meta-analysis

Infant mortality rate (IMR) is a reliable indicator of the health of children and their mothers. Although IMR has declined in the Gulf Cooperation Council (GCC) countries since the 20th century, it remains a public health concern. This review aimed to examine the determinants of IMR in the GCC countries. All articles published up to July 2022 were included in this review. They were extracted from 12 databases and subjected to PRISMA guidelines. In total, 27 out of 10,297 papers met all criteria, and 3 main determinants were identified. In sociodemographics: the risk of IMR may be increased by parents who are less educated and unemployed, consanguineous marriages, and female infants. Health status: low birth weight and premature infants, the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score <7, multiple pregnancies, no antenatal care, mode of delivery, and infants who experience a breech presentation may raise the risk of IMR. In macroeconomics: the reduction in Gross Domestic Product (GDP) had a detrimental impact on IMR. Some of the findings were consistent with international findings, whereas others contradicted the prevailing narrative. Most of the publications included in this review were not designed to assess the direct and indirect effects of sociodemographic, macroeconomic, and health status on IMR simultaneously, thus highlighting the need to develop a model to understand the phenomenon is important.