Mortalidade materna pela COVID-19 no Brasil
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Publicado
Aug 9, 2023
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Resumo
Objetivo: Revisar a produção científica relacionada à morte materna causada pela infecção da COVID-19 no Brasil, contextualizando dentro do cenário epidemiológico nacional e identificando os possíveis fatores contribuintes para esse desfecho. Revisão bibliográfica: O sistema de saúde teve que se reorganizar durante a pandemia, comprometendo a assistência à saúde da mulher, visto que a atenção e os recursos estavam voltados para o controle da doença, e o cenário foi agravado pelos serviços sobrecarregados. Barreiras de acesso aos atendimentos persistem em muitos hospitais e ambulatórios do país. Uma pequena quantidade de maternidades possui UTI, e a disponibilidade de vagas é desigual. Os municípios com elevado índice de vulnerabilidade e altas desigualdades sociais foram particularmente afetados. Acredita-se que a causa de tantas mortes possa também estar vinculada à maior agressividade da variante Gama do vírus SARS-CoV-2. Existem fortes evidências que a vacinação contra a COVID-19 tenha efeito protetor contra desfechos adversos. Considerações finais: No presente torna-se valioso ressaltar a importância da experiência da pandemia aos gestores acerca das condições dos serviços de saúde e a necessidade de investimentos em todo âmbito da saúde feminina, visando melhorar a eficiência dos atendimentos, e preparando o sistema para necessidades futuras, incluindo novas pandemias.
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Como Citar
BrunsR. F., CarvalhoN. S. de, & ProsdócimoK. U. (2023). Mortalidade materna pela COVID-19 no Brasil. Revista Eletrônica Acervo Saúde, 23(8), e13500. https://doi.org/10.25248/reas.e13500.2023
Seção
Revisão Bibliográfica
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Referências
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2. BRASIL, Ministério da Saúde. 2009. Guia de Vigilância Epidemiológica do Óbito Materno. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/guia_vigilancia_epidem_obito_materno.pdf. Acessado em: 23 de dezembro de 2022.
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5. BRENDOLIN M, et al. Severe maternal morbidity and mortality during the COVID-19 pandemic: a cohort study in Rio de Janeiro. IJID regions, 2023; 6: 1-6.
6. CHEN N, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet, 2020; 395(10223): 507–13.
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8. DE SOUZA SANTOS D, et al. Disproportionate Impact of Coronavirus Disease 2019 (COVID-19) Among Pregnant and Postpartum Black Women in Brazil Through Structural Racism Lens. Clin Infect Dis, 2021; 72(11): 2068–9.
9. DO CARMO LEAL M, et al. A cor da dor: iniquidades raciais na atenção pré-natal e ao parto no Brasil. Cad Saude Publica, 2017; 33.
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11. GONÇALVES BMM, et al. Maternal mortality associated with COVID-19 in Brazil in 2020 and 2021: Comparison with non-pregnant women and men. PLoS One, 2021; 16(12): e0261492.
12. KNIGHT M, et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. BMJ, 2020; 369.
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14. LEAL LF, et al. Characteristics and outcomes of pregnant women with SARS-CoV-2 infection and other severe acute respiratory infections (SARI) in Brazil from January to November 2020. Brazilian J Infect Dis, 2021; 25(5).
15. MICHELS BD, et al. Increment of Maternal Mortality Among Admissions for Childbirth in Low-risk Pregnant Women in Brazil: Effect of COVID-19 Pandemic? Revista Brasileira de Ginecologia e Obstetrícia, 2022; 44: 740-745.
16. MARTINS-FILHO PR, et al. Factors associated with mortality in patients with COVID-19. A quantitative evidence synthesis of clinical and laboratory data. Eur J Intern Med, 2020; 76: 97–9.
17. MENEZES MO, et al. Risk factors for adverse outcomes among pregnant and postpartum women with acute respiratory distress syndrome due to COVID-19 in Brazil. Int J Gynecol Obs, 2020; 151(3): 415–23.
18. NAKAMURA-PEREIRA M, et al. Worldwide maternal deaths due to COVID-19: A brief review. Int J Gynaecol Obstet, 2020; 151(1): 148–50.
19. NAKAMURA-PEREIRA M, et al. COVID-19 e a Morte Materna no Brasil: uma Tragédia Invisível. Rev Bras Ginecol Obstet, 2020; 42(8): 445–7.
20. NAVECA FG, et al. COVID-19 in Amazonas, Brazil, was driven by the persistence of endemic lineages and P.1 emergence. Nat Med, 2021; 27(7): 1230–8.
21. ORELLANA J, et al. Excess maternal mortality in Brazil: Regional inequalities and trajectories during the COVID-19 epidemic. Plos one, 2022; 17(10): e0275333.
22. PAGANOTI CDF, et al. COVID-19 Vaccines Confer Protection in Hospitalized Pregnant and Postpartum Women with Severe COVID-19: A Retrospective Cohort Study. Vaccines, 2022; 10(5): 749.
23. PAGANOTI CDF, et al. The Influenza Vaccine May Protect Pregnant and Postpartum Women against Severe COVID-19. Vaccines, 2022; 10(2).
24. ROBERTON T, et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Heal, 2020; 8(7): e901–8.
25. RODRIGUES A, et al. Brazilian Obstetric Observatory. 2021. Disponível em: http://arxiv.org/abs/2105.06534. Acessado em: 23 de dezembro de 2022.
26. SCHELER CA, et al. Mortality in pregnancy and the postpartum period in women with severe acute respiratory distress syndrome related to COVID-19 in Brazil, 2020. Int J Gynaecol Obstet, 2021; 155(3): 475–82.
27. SCHELER CA, et al. Maternal deaths from COVID-19 in Brazil: increase during the second wave of the pandemic. Revista Brasileira de Ginecologia e Obstetrícia/RBGO Gynecology and Obstetrics, 2022; 44(06): 567-572.
28. SERRA FE, et al. COVID-19 outcomes in hospitalized puerperal, pregnant, and neither pregnant nor puerperal women. PLoS One, 2021; 16(11).
29. SIQUEIRA TS, et al. Spatial clusters, social determinants of health and risk of maternal mortality by COVID-19 in Brazil: a national population-based ecological study. Lancet Reg Heal Am, 2021; 3: 100076.
30. SIQUEIRA TS, et al. Clinical characteristics and risk factors for maternal deaths due to COVID-19 in Brazil: A nationwide population-based cohort study. J Travel Med, 2022; 29(3): taab199.
31. SOUZA ASR e AMORIM MMR. Maternal mortality from COVID-19 in Brazil. Rev Bras Saúde Matern Infant, 2021; 21: 253–6.
32. TAKEMOTO MLS, et al. Clinical characteristics and risk factors for mortality in obstetric patients with severe COVID-19 in Brazil: a surveillance database analysis. BJOG, 2020; 127(13): 1618–26.
33. TAKEMOTO MLS, et al. The tragedy of COVID-19 in Brazil: 124 maternal deaths and counting. Int J Gynaecol Obstet, 2020; 151(1): 154–6.
34. TAKEMOTO, et al. Maternal mortality and COVID-19. The Journal of Maternal-Fetal & Neonatal Medicine, 2022; 35(12): 2355-2361.
35. VILLAR J. et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatr, 2021; 175(8): 817–26.
36. WESTGREN M, et al. Severe maternal morbidity and mortality associated with COVID-19: The risk should not be downplayed. Acta Obstet Gynecol Scand, 2020; 99(7): 815–6.
37. World Health Organization (WHO). WHO Coronavirus (COVID-19) Dashboard. Disponível em: https://covid19.who.int/. Acessado em: 23 de dezembro de 2022.
38. WHO, 2023. Maternal mortality. Public Health. Disponível em: https://www.who.int/en/news-room/fact-sheets/detail/maternal-mortality. Acessado em: 23 de dezembro de 2022.
39. ZAMBRANO LD, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep, 2020; 69(44): 1641–7.
40. ZANETTE E, et al. Maternal near miss and death among women with severe hypertensive disorders: a Brazilian multicenter surveillance study. Reprod Health, 2014; 11(1).
2. BRASIL, Ministério da Saúde. 2009. Guia de Vigilância Epidemiológica do Óbito Materno. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/guia_vigilancia_epidem_obito_materno.pdf. Acessado em: 23 de dezembro de 2022.
3. BRASIL, Ministério da Saúde. DATASUS. Painel Coronavírus Brasil. Disponível em: https://covid.saude.gov.br/. Acessado em: 23 de dezembro de 2022.
4. BRASIL, Ministério da Saúde. 2021. Assistência à Gestante e Puérpera Frente à Pandemia de COVID-19, 2o edição. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/manual_assistencia_gestante_puerpera_covid-19_2ed.pdf. Acessado em: 23 de dezembro de 2022.
5. BRENDOLIN M, et al. Severe maternal morbidity and mortality during the COVID-19 pandemic: a cohort study in Rio de Janeiro. IJID regions, 2023; 6: 1-6.
6. CHEN N, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet, 2020; 395(10223): 507–13.
7. DE SÁ MFS. Maternal Mortality and the Public Health Service in Brazil. Rev Bras Ginecol Obstet, 2021; 43(9): 645–7.
8. DE SOUZA SANTOS D, et al. Disproportionate Impact of Coronavirus Disease 2019 (COVID-19) Among Pregnant and Postpartum Black Women in Brazil Through Structural Racism Lens. Clin Infect Dis, 2021; 72(11): 2068–9.
9. DO CARMO LEAL M, et al. A cor da dor: iniquidades raciais na atenção pré-natal e ao parto no Brasil. Cad Saude Publica, 2017; 33.
10. FRANCISCO RPV, et al. Obstetric Observatory BRAZIL - COVID-19: 1031 maternal deaths because of COVID-19 and the unequal access to health care services. Clinics, 2021; 76.
11. GONÇALVES BMM, et al. Maternal mortality associated with COVID-19 in Brazil in 2020 and 2021: Comparison with non-pregnant women and men. PLoS One, 2021; 16(12): e0261492.
12. KNIGHT M, et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. BMJ, 2020; 369.
13. LEAL M DO C, et al. Prenatal care in the Brazilian public health services. Rev Saúde Pública, 2020; 54: 08.
14. LEAL LF, et al. Characteristics and outcomes of pregnant women with SARS-CoV-2 infection and other severe acute respiratory infections (SARI) in Brazil from January to November 2020. Brazilian J Infect Dis, 2021; 25(5).
15. MICHELS BD, et al. Increment of Maternal Mortality Among Admissions for Childbirth in Low-risk Pregnant Women in Brazil: Effect of COVID-19 Pandemic? Revista Brasileira de Ginecologia e Obstetrícia, 2022; 44: 740-745.
16. MARTINS-FILHO PR, et al. Factors associated with mortality in patients with COVID-19. A quantitative evidence synthesis of clinical and laboratory data. Eur J Intern Med, 2020; 76: 97–9.
17. MENEZES MO, et al. Risk factors for adverse outcomes among pregnant and postpartum women with acute respiratory distress syndrome due to COVID-19 in Brazil. Int J Gynecol Obs, 2020; 151(3): 415–23.
18. NAKAMURA-PEREIRA M, et al. Worldwide maternal deaths due to COVID-19: A brief review. Int J Gynaecol Obstet, 2020; 151(1): 148–50.
19. NAKAMURA-PEREIRA M, et al. COVID-19 e a Morte Materna no Brasil: uma Tragédia Invisível. Rev Bras Ginecol Obstet, 2020; 42(8): 445–7.
20. NAVECA FG, et al. COVID-19 in Amazonas, Brazil, was driven by the persistence of endemic lineages and P.1 emergence. Nat Med, 2021; 27(7): 1230–8.
21. ORELLANA J, et al. Excess maternal mortality in Brazil: Regional inequalities and trajectories during the COVID-19 epidemic. Plos one, 2022; 17(10): e0275333.
22. PAGANOTI CDF, et al. COVID-19 Vaccines Confer Protection in Hospitalized Pregnant and Postpartum Women with Severe COVID-19: A Retrospective Cohort Study. Vaccines, 2022; 10(5): 749.
23. PAGANOTI CDF, et al. The Influenza Vaccine May Protect Pregnant and Postpartum Women against Severe COVID-19. Vaccines, 2022; 10(2).
24. ROBERTON T, et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Heal, 2020; 8(7): e901–8.
25. RODRIGUES A, et al. Brazilian Obstetric Observatory. 2021. Disponível em: http://arxiv.org/abs/2105.06534. Acessado em: 23 de dezembro de 2022.
26. SCHELER CA, et al. Mortality in pregnancy and the postpartum period in women with severe acute respiratory distress syndrome related to COVID-19 in Brazil, 2020. Int J Gynaecol Obstet, 2021; 155(3): 475–82.
27. SCHELER CA, et al. Maternal deaths from COVID-19 in Brazil: increase during the second wave of the pandemic. Revista Brasileira de Ginecologia e Obstetrícia/RBGO Gynecology and Obstetrics, 2022; 44(06): 567-572.
28. SERRA FE, et al. COVID-19 outcomes in hospitalized puerperal, pregnant, and neither pregnant nor puerperal women. PLoS One, 2021; 16(11).
29. SIQUEIRA TS, et al. Spatial clusters, social determinants of health and risk of maternal mortality by COVID-19 in Brazil: a national population-based ecological study. Lancet Reg Heal Am, 2021; 3: 100076.
30. SIQUEIRA TS, et al. Clinical characteristics and risk factors for maternal deaths due to COVID-19 in Brazil: A nationwide population-based cohort study. J Travel Med, 2022; 29(3): taab199.
31. SOUZA ASR e AMORIM MMR. Maternal mortality from COVID-19 in Brazil. Rev Bras Saúde Matern Infant, 2021; 21: 253–6.
32. TAKEMOTO MLS, et al. Clinical characteristics and risk factors for mortality in obstetric patients with severe COVID-19 in Brazil: a surveillance database analysis. BJOG, 2020; 127(13): 1618–26.
33. TAKEMOTO MLS, et al. The tragedy of COVID-19 in Brazil: 124 maternal deaths and counting. Int J Gynaecol Obstet, 2020; 151(1): 154–6.
34. TAKEMOTO, et al. Maternal mortality and COVID-19. The Journal of Maternal-Fetal & Neonatal Medicine, 2022; 35(12): 2355-2361.
35. VILLAR J. et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatr, 2021; 175(8): 817–26.
36. WESTGREN M, et al. Severe maternal morbidity and mortality associated with COVID-19: The risk should not be downplayed. Acta Obstet Gynecol Scand, 2020; 99(7): 815–6.
37. World Health Organization (WHO). WHO Coronavirus (COVID-19) Dashboard. Disponível em: https://covid19.who.int/. Acessado em: 23 de dezembro de 2022.
38. WHO, 2023. Maternal mortality. Public Health. Disponível em: https://www.who.int/en/news-room/fact-sheets/detail/maternal-mortality. Acessado em: 23 de dezembro de 2022.
39. ZAMBRANO LD, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep, 2020; 69(44): 1641–7.
40. ZANETTE E, et al. Maternal near miss and death among women with severe hypertensive disorders: a Brazilian multicenter surveillance study. Reprod Health, 2014; 11(1).