COVID-19 and Maternal Death in Brazil: An Invisible Tragedy

Nakamura‐Pereira, Marcos; Amorim, Melânia Maria Ramos; Pacagnella, Rodolfo C.; Takemoto, Maíra Libertad Soligo; Penso, Fatima Cristina Cunha; Filho, Jorge Fonte de Rezende; Leal, María do Carmo

doi:10.1055/s-0040-1715138

Cited by 38 publications

(36 citation statements)

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“…Maternal deaths seem, in fact, more frequent in low and middle income countries and would result from serious health system failures allied to the social determinants of the health-disease process. This has also been seen in other Latin American countries, [10][11][12][13][14][15] especially Mexico, which maintains an efficient reporting system. 20 The studies of a group also show a higher frequency of death in the puerperal period 11,12 and suggest that the higher mortality in pregnant women in Brazil is due to chronic problems of women's health care in the country, such as insufficient resources, low prenatal quality, available beds less than the real necessity, difficulty to access the services, racial disparities and obstetric violence.…”

Section: Introductionmentioning

confidence: 68%

“…9 The Brazilian Group of Studies on COVID-19 and Pregnancy has been publishing since April several articles in the national literature alerting the risk of maternal death by COVID-19. [10][11][12][13][14][15] In a widely disseminated study analyzing data from the spreadsheet of the Sistema de Informações de Vigilância Epidemiológica da Gripe (SIVEP Gripe) (Influenza Epidemiological Surveillance Information System), available from the Ministry of Health found that 978 pregnant women and puerperal were diagnosed with Severe Acute Respiratory Syndrome (SARS) by COVID-19 and of these 124 died (lethality rate of 12.7%). Although an association of death with co-morbidities such as obesity, diabetes and cardiovascular diseases had been found, what attracted more attention in this study were the serious failures of care: 15% of the women had not received any type of ventilatory assistance, 28% did not have access to an intensive care unit (ICU) bed and 36% were not intubated or received mechanical ventilation.…”

Section: Introductionmentioning

confidence: 99%

“…12 Another study of this same group, at the same time, analyzed all deaths published by COVID-19 in the world and found 160 deaths recorded in the international literature, so that of every 10 deaths by COVID-19 in the world, eight occurred in Brazil. 15 Also, it is worth mentioning that this article evaluated the disproportionate impact of structural racism S255 Maternal mortality by COVID-19 in Brazil on maternal deaths by COVID-19. This study found that black women were hospitalized in worse conditions, such as higher prevalence of dyspnea and lower oxygen saturation, in addition to a higher rate of intensive care unit (ICU) admission and assisted mechanical ventilation, and a risk of death almost twice as high in black women when compared to white women.…”

Section: Introductionmentioning

confidence: 99%

“…The policy of the Ministry of Health has also been criticized, which so far has not implemented universal testing for admission to maternity hospitals using molecular tests (RT-PCR). [10][11][12][13][14][15] It is also important to highlight the speed of transmission in the world and the consequent increase in the maternal death rate in Brazil. By September 27, 2020 there were 32,925.668 million people infected and 995,352 deaths worldwide by COVID-19, nine months after the first reported case.…”

Section: Introductionmentioning

confidence: 99%

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Maternal mortality by COVID-19 in Brazil

Souza

Amorim

2021

Rev. Bras. Saude Mater. Infant.

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SARS-CoV-2, the new coronavirus of severe acute respiratory syndrome, which causes a predominantly respiratory disease called COVID-19, quickly caused a pandemic, due to its high transmissibility, leaving a trail of deaths around the world. Initially, the pregnancy puerperal cycle was not associated with complications and mortality, only later was recognized as a risk group. As the disease progressed, the maternal mortality rate by COVID-19 increased, Brazil is responsible for an important portion. This rate may be even higher due to underreporting, difficulties in performing laboratorial tests and possible false negative results and depends on the health policies adopted by each region or country. It is important to carry out studies on maternal mortality so that the prognostic factors can be recognized and so avoid them.

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Section: Introductionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maternal mortality by COVID-19 in Brazil

Souza

Amorim

2021

Rev. Bras. Saude Mater. Infant.

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“…A ocorrência de óbitos em gestantes e puérperas acometidas pela Covid-19 logo começou a chamar a atenção dos profissionais, gestores e pesquisadores no país, inclusive com a publicação de vários artigos científicos. Em seguida, foram publicados relatórios pela Suécia, Irã, México, Reino Unido e EUA apontando casos graves e mortes em gestantes e puérperas (Nakamura-Pereira et al, 2020). No meio do mês de abril, o Ministério da Saúde (MS) passou a considerar esse grupo como de risco.…”

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O Brasil seis meses após a declaração da Covid-19 como pandemia global

Freitas¹,

Barcellos²,

Villela³

et al. 2020

Diplomacia Da Saúde E Covid-19: Reflexões a Meio Caminho

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All the contents of this work, except where otherwise noted, is licensed under a Creative Commons Attribution 4.0 International license.Todo o conteúdo deste trabalho, exceto quando houver ressalva, é publicado sob a licença Creative Commons Atribição 4.0.Todo el contenido de esta obra, excepto donde se indique lo contrario, está bajo licencia de la licencia Creative Commons Reconocimento 4.0.

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Association of Conditional Cash Transfers With Maternal Mortality Using the 100 Million Brazilian Cohort

et al. 2023

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ImportanceConditional cash transfers (CCTs) have been consistently associated with improvements to the determinants of maternal health, but there have been insufficient investigations regarding their effects on maternal mortality.ObjectiveTo evaluate the association between being a Bolsa Família program (BFP) beneficiary and maternal mortality and to examine how this association differs by duration of BFP receipt, maternal race, living in rural or urban areas, the Municipal Human Development Index (MHDI), and municipal primary health care coverage.Design, Setting, and ParticipantsThis cross-sectional analysis was nested within the 100 Million Brazilian Cohort. Girls and women aged 10 to 49 years (hereinafter referred to as women) who had at least 1 live birth were included, using data from Brazilian national health databases linked to the 100 Million Brazilian Cohort (January 1, 2004, to December 31, 2015). Propensity score kernel weighting was applied to control for sociodemographic and economic confounders in the association between BFP receipt and maternal mortality, overall and stratified by different subgroups (race, urban or rural area, and MHDI), and duration of BFP receipt. Data were analyzed from July 12, 2019, to December 31, 2022.Main Outcome(s) and MeasuresMaternal death.ResultsA total of 6 677 273 women aged 10 to 49 years were included in the analysis, 4056 of whom had died from pregnancy-related causes. The risk of maternal death was 18% lower in women who received BFP (weighted odds ratio [OR], 0.82 [95% CI, 0.71-0.93]). A longer duration receiving BFP was associated with an increased reduction in maternal mortality (OR for 1-4 years, 0.85 [95% CI, 0.75-0.97]; OR for 5-8 years, 0.70 [95% CI, 0.60-0.82]; OR for ≥9 years, 0.69 [95% CI, 0.53-0.88]). Receiving BFP was also associated with substantial increases in the number of prenatal appointments and interbirth intervals. The reduction was more pronounced in the most vulnerable groups.Conclusions and RelevanceThis cross-sectional analysis nested within the 100 Million Brazilian Cohort found an association between BFP receipt and maternal mortality. This association was of greater magnitude in women with longer exposure to BFP and in the most vulnerable groups. These findings reinforce evidence that programs such as BFP, which have already proven effective in poverty reduction, have great potential to improve maternal survival.

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COVID-19 and Maternal Death in Brazil: An Invisible Tragedy

Cited by 38 publications

References 22 publications

Maternal mortality by COVID-19 in Brazil

Maternal mortality by COVID-19 in Brazil

O Brasil seis meses após a declaração da Covid-19 como pandemia global

Association of Conditional Cash Transfers With Maternal Mortality Using the 100 Million Brazilian Cohort

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