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CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(08): 740-745
DOI: 10.1055/s-0042-1751059
Original Article
Obstetrics/Covid-19

Increment of Maternal Mortality Among Admissions for Childbirth in Low-risk Pregnant Women in Brazil: Effect of COVID-19 Pandemic?

Aumento da taxa de mortalidade materna entre as admissões para parto em gestantes de baixo risco gestacional no Brasil: Efeito da pandemia do COVID-19?
Bruna Depieri Michels 
1   Faculty of Medicine, Universidade do Sul de Santa Catarina, Tubarão, SC, Brazil
,
Daniela Ferreira D'Agostini Marin 
1   Faculty of Medicine, Universidade do Sul de Santa Catarina, Tubarão, SC, Brazil
,
Betine Pinto Moehlecke Iser 
1   Faculty of Medicine, Universidade do Sul de Santa Catarina, Tubarão, SC, Brazil
2   Post Graduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Tubarão, SC, Brazil
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Abstract

Objective To assess the possible impact of the COVID-19 pandemic on maternal mortality among admissions for childbirth in 2020 in relation of the last 10 years.

Methods An ecological study with pregnant women who underwent hospital births at the Brazilian unified public health service (SUS, in the Portuguese acronym) in Brazil from 2010 to 2020. The mortality among admissions for childbirth was obtained based on the number of admissions for childbirth with reported death as outcome divided by the total number of admissions. The underlying gestational risk and route of delivery were considered based on the national surveillance system. The average mortality for the period between 2010 and 2019 (baseline) was compared with the rate of deaths in 2020 (1st pandemic year); the rate ratio was interpreted as the risk of death in 2020 in relation to the average of the previous period (RR), with 95% confidence intervals (CIs).

Results In 2020, the 1st year of the COVID-19 pandemic, 1,821,775 pregnant women were hospitalized for childbirth and 651 deaths were reported, which represents 8.7% of the total hospitalizations and 11.3% of maternal deaths between 2010 and 2020. There was an increase in maternal mortality after births in 2020 compared with the average for the period between 2010 and 2019, specially in low-risk pregnancies, both in vaginal (RR = 1.60; 95%CI:1.39–1.85) and cesarean births (RR = 1.18; 95%CI:1.04–1.34).

Conclusion Maternal mortality among admissions for childbirth according to SUS data increased in 2020 compared with the average between 2010 and 2019, with an increment of 40% in low-risk pregnancies. The increase was of 18% after cesarean section and of 60% after vaginal delivery.

Resumo

Objetivo Avaliar os possíveis impactos da pandemia de COVID-19 na mortalidade materna nas admissões para o parto em 2020 em relação ao histórico dos últimos 10 anos.

Métodos Estudo ecológico com gestantes que realizaram parto hospitalar pelo Sistema Unificado de Saúde do Brasil (SUS) de 2010 a 2020. Para obter-se a taxa de mortalidade entre as admissões para o parto, foi utilizado o número de internações para parto que tiveram óbito como desfecho dividido pelo total de internações. O risco gestacional e o tipo de parto foram considerados a partir do sistema de vigilância nacional. A média de mortalidade no período de 2010 a 2019 (linha de base) foi comparada com a taxa de mortalidade pós-parto de 2020 (1° ano pandêmico); a razão das taxas foi interpretada como risco de óbito em 2020 em relação à média no período anterior (RR), com intervalo de confiança (IC) de 95%.

Resultados Em 2020, 1° ano da pandemia de COVID-19, 1.821.775 gestantes foram internadas para o parto e 651 óbitos foram registrados, o que representa 8,7% do total de internações e 11,3% das mortes maternas entre 2010 e 2020. Houve aumento na mortalidade materna após partos em 2020 em relação à média do período entre 2010 e 2019, especialmente em gestações de baixo risco, tanto em partos normais (RR = 1.60; IC95%: 1.39–185) quanto em cesáreas (RR = 1.18; IC95%: 1.04–1.34).

Conclusão A mortalidade entre as admissões para o parto pelo SUS aumentou em 2020 em relação à média de óbitos entre 2010 e 2019, com um incremento de 40% em mulheres de baixo risco gestacional. O aumento verificado foi de 18% após cesárea e de 60% após parto vaginal.

Keywords

mortality - maternal - COVID-19 - postpartum period - health impact assessment

Palavras-chave

mortalidade materna - COVID-19 - período pós-parto - avaliação do impacto na saúde

Contributions

Michels B. D., Iser B. P. M, and Marin D.F.D. were responsible for the conception and design of the present study. Michels B. D. was responsible for the literature review and for the first version of writing, collection, analysis, and interpretation of data. Iser B. P. M and Marin D.F.D. participated in data analysis and interpretation and performed a relevant critical review of the intellectual content. Michels B. D., Iser B. P. M, and Marin D.F.D. approved the final version presented here.




Publication History

Received: 15 September 2021

Accepted: 04 May 2022

Article published online:
07 July 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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