Maternal Deaths from COVID-19 in Brazil: Increase during the Second Wave of the Pandemic

Abstract

Objective To compare death rates by COVID-19 between pregnant or postpartum and nonpregnant women during the first and second waves of the Brazilian pandemic. Methods In the present population-based evaluation data from the Sistema de Informação da Vigilância Epidemiológica da Gripe (SIVEP-Gripe, in the Portuguese acronym), we included women with c (ARDS) by COVID-19: 47,768 in 2020 (4,853 obstetric versus 42,915 nonobstetric) and 66,689 in 2021 (5,208 obstetric versus 61,481 nonobstetric) and estimated the frequency of in-hospital death. Results We identified 377 maternal deaths in 2020 (first wave) and 804 in 2021 (second wave). The death rate increased 2.0-fold for the obstetric (7.7 to 15.4%) and 1.6-fold for the nonobstetric groups (13.9 to 22.9%) from 2020 to 2021 (odds ratio [OR]: 0.52; 95% confidence interval [CI]: 0.47–0.58 in 2020 and OR: 0.61; 95%CI: 0.56–0.66 in 2021; p < 0.05). In women with comorbidities, the death rate increased 1.7-fold (13.3 to 23.3%) and 1.4-fold (22.8 to 31.4%) in the obstetric and nonobstetric groups, respectively (OR: 0.52; 95%CI: 0.44–0.61 in 2020 to OR: 0.66; 95%CI: 0.59–0.73 in 2021; p < 0.05). In women without comorbidities, the mortality rate was higher for nonobstetric (2.4 times; 6.6 to 15.7%) than for obstetric women (1.8 times; 5.5 to 10.1%; OR: 0.81; 95%CI: 0.69–0.95 in 2020 and OR: 0.60; 95%CI: 0.58–0.68 in 2021; p < 0.05). Conclusion There was an increase in maternal deaths from COVID-19 in 2021 compared with 2020, especially in patients with comorbidities. Death rates were even higher in nonpregnant women, with or without comorbidities.

Genomic Surveillance of SARS-CoV-2 in Healthcare Workers: A Critical Sentinel Group for Monitoring the SARS-CoV-2 Variant Shift

“…In Brazil, Scheler et al (2022) compared the deaths of pregnant and non-pregnant women during the first and second waves of the pandemic [24]. The authors demonstrated that maternal deaths from COVID-19 increased in the second wave compared with the first wave, and this increase was greater in patients with comorbidities.…”

Evolução e desfechos da COVID-19 no ciclo gravídico puerperal: revisão integrativa da literatura

“…Houve um aumento expressivo da COVID-19 em 2021 em quase todos os estados brasileiros, no entanto, esse aumento foi mais acentuado no Norte do Brasil, epicentro da primeira onda de infecções. 25 Um estudo retrospectivo aponta que gestantes tiveram uma maior frequência de admissão na UTI, mortalidade, pré-eclâmpsia/eclâmpsia, hipertensão gestacional, hemorragia pós-parto, sofrimento fetal e cesariana de emergência. 29 Um estudo multicêntrico revelou um total de mulheres com hipertensão grave (94%) (6.315/6.706), enquanto 349 casos apresentaram disfunção ou falência orgânica.…”

Impact of COVID-19 pandemic in the Brazilian maternal mortality ratio: A comparative analysis of Neural Networks Autoregression, Holt-Winters exponential smoothing, and Autoregressive Integrated Moving Average models

“…In the obstetric group, the rate increased from 7.7% to 15.4%, while in the non-obstetric group, it increased from 13.9% to 22.9% from 2020 to 2021. Among women with comorbidities, the mortality rate increased by 1.7 times (from 13.3% to 23.3%) and by 1.4 times (from 22.8% to 31.4%) [ 18 ]. A retrospective time series study using the Holt-Winters exponential smoothing additive model revealed devastating consequences for maternal mortality during the COVID-19 pandemic in the state of Bahia, Brazil [ 19 ].…”