Maternal Mortality in Brazil, 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019

Leal, Lisiane Freitas; Malta, Déborah Carvalho; Marinho, Fátima; Vasconcelos, Ana Maria Nogales; Teixeira, Renato Azeredo; Veloso, Guilherme Augusto; Lansky, Sônia; Ribeiro, Antônio Luiz Pinho; França, Giovanny Vinícius Araújo de; Naghavi, Mohsen

doi:10.1590/0037-8682-0279-2021

Cited by 11 publications

(5 citation statements)

References 28 publications

(26 reference statements)

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“…Our study evidenced an over-mortality from COVID-19 of 37% in relation to the maternal mortality from other causes. The MMR in Brazil, which was already high -62.1/100,000 LB in 2019 [35], reached a value close to 1 per 1,000 live births after adding COVID-19 maternal deaths.…”

Section: Resultsmentioning

confidence: 92%

COVID-19 Mortality in Brazil, 2020-21: Consequences of the pandemic inadequate management

Szwarcwald

Boccolini

Almeida

et al. 2022

Preprint

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Background The COVID-19 pandemic brought countless challenges to public health and highlighted the Brazilian health system vulnerabilities to face the emergency situation. In this article, we analyze data on COVID-19-related deaths in Brazil in 2020-21 to show the tragic consequences of the pandemic on the Brazilian population. Methods The Mortality Information System and the Live Birth Information System were the main information sources. We used the population estimates in 2020-21 to calculate COVID-19 specific mortality rates by age and sex and educational level. Considering the total number of deaths in 2020-21, the COVID-19 proportional mortality (%) was estimated for each age group and sex. A graph of the daily deaths from January 2020 to December 2021 by sex was elaborated to show the temporal evolution of COVID-19 deaths in Brazil. In addition, four indicators related to COVID-19 mortality were estimated: infant mortality rate; maternal mortality ratio (MMR); number of orphans due to mother's death; average number of years lost. Results The overall COVID-19 mortality rate was 14.8 (/10,000). The mortality rates increase with age and show a decreasing gradient with higher schooling. Among illiterate people, the rate was 38.8/10,000, three times higher than those with college education. Male mortality was 31% higher than female mortality. COVID-19 deaths represented 19.1% of all deaths, with the highest proportions in the median age groups. The average number of years lost due to COVID-19 was 19 years. The MMR due to COVID-19 was 35.7 per 100,000 LB, representing 37.4% of the overall MMR. Regarding the number of orphans due to COVID-19, we estimated that 40,830 children under 18 years old lost their mothers during the pandemic, with an orphans' rate of 7.5/10,000 children aged 0–17 years. The pandemic peak occurred in March 2021, reaching almost 4,000 deaths per day, higher than the average number of deaths per day from all causes in 2019. Conclusions The COVID-19 lethality rate in Brazil was 2.2%, twice the global lethality rate. The delay in adopting public health measures necessary to control the epidemic has exacerbated the spread of the disease, resulting in several avoidable deaths.

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Section: Resultsmentioning

confidence: 92%

COVID-19 Mortality in Brazil, 2020-21: Consequences of the pandemic inadequate management

Szwarcwald

Boccolini

Almeida

et al. 2022

Preprint

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“…Say et al reported in 2014 that globally, MMOH represented 27.1% of all early maternal deaths, 36 which contrasts with 16.6% for Colombia between 2018 and 2021, 18.8% for Canada between 2002 and 2010, 37 14.3% for Brazil during 2019, 38 and 10.7% for the USA in 2017 39 . In Sub‐Saharan Africa, Bates et al estimated that 16%–72% of all MMOH could be prevented through rapid access to safe blood transfusion 40 .…”

Section: Discussionmentioning

confidence: 99%

“…The OR was 1.06 with a 95% CI of 0.63-1.79, suggesting that MMOH were associated with hospitalisation with a similar probability before and during the pandemic. and 2010, 37 14.3% for Brazil during 2019, 38 and 10.7% for the USA in 2017. 39 In Sub-Saharan Africa, Bates et al estimated that 16%-72% of all MMOH could be prevented through rapid access to safe blood transfusion.…”

Section: Correlation Between Total Blood Collection and Oneg Donation...mentioning

confidence: 97%

Role of disruptions in O RhD negative donations in Colombia on increasing maternal mortality ratio from haemorrhage

Bermúdez‐Forero,

Delgado‐López,

Anzola‐Samudio

et al. 2023

Transfusion Medicine

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ObjectiveThe aim of this work was to evaluate the relationship of the maternal mortality ratio due to obstetric haemorrhage (MMROH) with the national blood donations, particularly O RhD negative (Oneg) before and during COVID‐19 pandemic.BackgroundThe maternal mortality ratio is increasing in Colombia, yet little is known regarding the relationship between blood donations and maternal mortality due to obstetric haemorrhage.Materials and MethodsA retrospective cross‐sectional study between January 1, 2018, and December 31, 2021, was performed, to assess MMROH compared to the blood donations notified to the Colombian National Haemovigilance System, through non‐parametric methods. Because a relationship between blood donations and MMROH was identified, the analysis was expanded from 2009 to 2017.ResultsIn 2020, Colombia increased the MMROH by 32% compared to 2019 which coincided with the lockdown period to contain COVID‐19. An inversed relationship (SumD2 = 631.0; rs = −0.7335; p 0.01) between blood donations, particularly Oneg (SumD2 = 652.0; rs = −0.7912; p 0.002) and MMROH was identified. For the years 2015–2019 and 2021, the annual mean MMROH was 8.5 ± 0.5 per 100 000 live births when the annual mean blood donations was 18.2 ± 0.4 donations per 1000 people and the Oneg was 1.0 ± 0.0 donations per 1000 people. In contrast, the years 2009–2014 and 2020 displayed an annual MMROH of 12.6 ± 0.8, when the annual collection of blood was 16.4 ± 0.8 donations and the Oneg was 0.9 ± 0.0, p < 0.001.ConclusionThere was an inverse relationship between blood donation, mainly Oneg, and maternal mortality from obstetric haemorrhage. However, we recognise these deaths could be related to other reasons, especially when they occurred in rural areas with limited access to medical services.

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“…Our study evidenced an over-mortality from COVID-19 of 37% on maternal mortality from other causes. The MMR in Brazil, which was already high – 62.1/100,000 LB in 2019 [ 41 ], reached a value close to 1 per 1000 live births after adding COVID-19 maternal deaths. It is necessary to mention that the number of miscarriages in pregnant women with COVID-19 has not been analyzed and would significantly increase the burden of COVID-19 on births and maternal health.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 mortality in Brazil, 2020-21: consequences of the pandemic inadequate management

et al. 2022

Self Cite

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Background The COVID-19 pandemic brought countless challenges to public health and highlighted the Brazilian health system vulnerabilities in facing the emergency. In this article, we analyze data on COVID-19-related deaths in 2020-21 to show the epidemic consequences in Brazil. Methods The Mortality Information System and the Live Birth Information System were the primary information sources. We used population estimates in 2020-21 to calculate COVID-19 specific mortality rates by age, sex, and educational level. Considering the total number of COVID-19 deaths in 2020-21, the COVID-19 proportional mortality (%) was estimated for each age group and sex. A graph of the daily number of deaths from January 2020 to December 2021 by sex was elaborated to show the temporal evolution of COVID-19 deaths in Brazil. In addition, four indicators related to COVID-19 mortality were estimated: infant mortality rate (IMR); maternal mortality ratio (MMR); number and rate of orphans due to mother’s COVID-19 death; the average number of years lost. Results The overall COVID-19 mortality rate was 14.8 (/10,000). The mortality rates increase with age and show a decreasing gradient with higher schooling. The rate among illiterate people was 38.8/10,000, three times higher than a college education. Male mortality was 31% higher than female mortality. COVID-19 deaths represented 19.1% of all deaths, with the highest proportions in the age group of 40-59 years. The average number of years lost due to COVID-19 was 19 years. The MMR due to COVID-19 was 35.7 per 100,000 live births (LB), representing 37.4% of the overall MMR. Regarding the number of orphans due to COVID-19, we estimated that 40,830 children under 18 lost their mothers during the epidemic, with an orphans’ rate of 7.5/10,000 children aged 0-17 years. The IMR was 11.7 per 1000 LB, with 0.2 caused by COVID-19. The peak of COVID-19 deaths occurred in March 2021, reaching almost 4000 COVID-19 deaths per day, higher than the average number of deaths per day from all causes in 2019. Conclusions The delay in adopting public health measures necessary to control the epidemic has exacerbated the spread of the disease, resulting in several avoidable deaths.

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Maternal Mortality in Brazil, 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019

Cited by 11 publications

References 28 publications

COVID-19 Mortality in Brazil, 2020-21: Consequences of the pandemic inadequate management

COVID-19 Mortality in Brazil, 2020-21: Consequences of the pandemic inadequate management

Role of disruptions in O RhD negative donations in Colombia on increasing maternal mortality ratio from haemorrhage

COVID-19 mortality in Brazil, 2020-21: consequences of the pandemic inadequate management

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