Lidiane Nóbrega (Fiocruz News Agency)
Released this Thursday (01/19), a study by the COVID-19 Fiocruz Observatory points out that, in 2020, there was a 40% excess of maternal deaths, when compared to previous years. Even considering the expected increase in overall deaths as a result of the COVID-19 pandemic, there was still a 14% excess. The research, which estimated the excess of maternal deaths caused directly and indirectly by COVID-19 in Brazil in the year of 2020, was published (01/12) in the scientific journal BMC Pregnancy and Childbirth.
The article shows that pregnant and puerperal women were penalized more by the pandemic than the general population. The odds of being a black woman, residing in rural areas, and being hospitalized outside the municipality of residence among maternal deaths were 44, 61, and 28% higher than the control group. Throughout 2020, the country recorded 549 maternal deaths from COVID-19, mainly in pregnant women in the second and third trimester.
The clinical characteristics and clinical management of pregnant and puerperal women seen due to COVID-19 were also identified. The odds of hospitalization for pregnant women diagnosed with COVID-19 were 337% higher. For ICU admissions, the odds were 73% higher, and the use of invasive ventilatory support was 64% higher than general COVID-19 patients who died in 2020.
The study used data from the Influenza Epidemiologic Surveillance Information System (Sivep-Flu) for COVID-19 deaths in the years of 2020 and 2021, and compared them with data from the Mortality Information System in the year of 2020 (when there was already a pandemic) and in the 5 previous years to estimate the expected number of maternal deaths in the country.
According to researcher Raphael Guimarães, this scenario compromises the challenge of achieving the Sustainable Development Goals, established by the United Nations (UN), by 2030 on a global scale. "The service network seems to have been more protective of pregnant and puerperal women, ensuring more immediate admissions and referrals to intensive and invasive care. However, the delay in starting vaccination among pregnant women and women who have recently given birth may have been decisive in penalizing these women more. We also highlight that the excess of deaths had COVID-19 not only as a direct cause, but also inflated the number of deaths of women who do not have access to prenatal care and adequate conditions to deliver their babies in the country", says the main researcher of the study.
Guimarães reflects that it is important to recognize that COVID-19 did not reach all social and demographic groups evenly. This means that monitoring and intervention strategies must be guided by specific profiles and demands, ensuring the premise of equality in public policies, including health policies. The study showed that maternal death is marked by social inequalities, which are closely related to the supply of quality services.