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COVID-19 Observatory highlights high rates of maternal mortality


09/06/2021

Regina Castro (CCS/Fiocruz)

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The Bulletin of the Fiocruz COVID-19 Observatory, released last Friday (June 4th), concluded there is a rising trend for Severe Acute Respiratory Syndrome (SARS) in 12 states, in addition to the Federal District, in epidemiological week 21, between May 23rd and 29th. All regions have worrying figures, mainly those in the South and in the Central-West Brazilian regions. About 96% of SARS cases are caused by the new coronavirus.

The relation between COVID-19 and maternal deaths is another highlight of this release. Pregnant women and women who have recently given birth are increasingly becoming a group of great concern, due to the evolution of maternal death to extremely high levels. Brazil has the highest number of maternal deaths and a frightening lethality of 7.2%, that is, more than double the country’s yearly lethality rate for this group, which is 2.8%.

A study on the pandemic in the Americas, published in mid-May 2021 by the Pan-American Health Organization (PAHO), showed that between January and April this year there has been a significant increase in cases among pregnant women and women who have just given birth, and in cases of maternal deaths by COVID-19 in 12 countries.

Specialists also warn that pregnant women may evolve into severe forms of COVID-19, with respiratory distress. In particular, those who are around 32-33 weeks pregnant. In many cases, the birth must be brought forward and the baby born before its due date.

This all increases preoccupation regarding the availability of adult ICU beds for these women and of neonatal ICU beds for their newborns, as they can often be premature. Researchers warn that both mothers and newborns require specialized and immediate care. In mid-2020, papers began being published on the death of pregnant women and women who have recently given birth caused by COVID-19 in Brazil, warning of the need to prepare and organize the entire healthcare network in the country.

According to the Brazilian COVID-19 Observatory of Obstetrics (OOBr Covid-19), maternal deaths in 2021 have already overtaken the number reported in 2020. In 2020 there were 554 reported deaths of pregnant women and women who had recently given birth caused by COVID-19 in the country, with a weekly average of 12.1 deaths. It must be taken into account that the pandemic lasted 45 epidemiological weeks that year. Up to 26 May 2021, after 20 epidemiological weeks, 911 deaths had been reported, for a weekly average of 47.9 deaths — a very concerning increase.

Incidence and mortality rates due to COVID-19

The Fiocruz COVID-19 Observatory draws attention to the fact that, as winter is coming closer, the current scenario of the pandemic may become worse, with the appearance of more severe cases of COVID-19 and more cases of other respiratory diseases that also require hospital beds.

In the past two epidemiological weeks, stability has been seen in the incidence and mortality rates of cases and deaths by COVID-19, confirming the formation of a plateau with a high daily average of cases and deaths. Most states show similar trends, which may have as a consequence an increase of thousands of severe cases which will require intensive care.

Researchers of the Fiocruz COVID-19 Observatory have confirmed a change in the demographic profile of the pandemic, which has been recording a significant increase in cases, hospitalizations and deaths among younger people.

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