Keywords
COVID-19
Brazil
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Abstract
Objective: To review the scientific production related to maternal death caused by the COVID-19 infection in Brazil, identifying possible contributing factors to this outcome. Bibliographic review: The health system had to reorganize itself during the pandemic, compromising women's health care, as attention and resources were focused on controlling the disease, and the scenario was aggravated by overloaded services. Barriers to accessing care persist in many hospitals and outpatient clinics in the country. A small number of maternity hospitals have ICUs, and the availability of places is uneven. Municipalities with a high vulnerability index and high social inequalities were particularly affected. It is believed that the cause of so many deaths could also be linked to the greater aggressiveness of the Gamma variant of the SARS-Cov2 virus. There is strong evidence that vaccination against COVID-19 has a protective effect against adverse outcomes. Final considerations: At present, it is valuable to emphasize the importance of the experience of the pandemic to managers about the conditions of health services and the need for investments in the entire field of women's health, aiming to improve the efficiency of care, and preparing the system for future needs, including new pandemics.
References
ANDREUCCI CB, et al. Social determinants of COVID-19-related maternal deaths in Brazil. Lancet Reg Health, 2021; 3: 100104.
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.
BRASIL, Ministério da Saúde. DATASUS. Painel Coronavírus Brasil. Disponível em: https://covid.saude.gov.br/. Acessado em: 23 de dezembro de 2022.
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.
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.
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.
DE SÁ MFS. Maternal Mortality and the Public Health Service in Brazil. Rev Bras Ginecol Obstet, 2021; 43(9): 645–7.
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.
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.
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.
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.
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.
LEAL M DO C, et al. Prenatal care in the Brazilian public health services. Rev Saúde Pública, 2020; 54: 08.
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).
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.
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.
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.
NAKAMURA-PEREIRA M, et al. Worldwide maternal deaths due to COVID-19: A brief review. Int J Gynaecol Obstet, 2020; 151(1): 148–50.
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.
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.
ORELLANA J, et al. Excess maternal mortality in Brazil: Regional inequalities and trajectories during the COVID-19 epidemic. Plos one, 2022; 17(10): e0275333.
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.
PAGANOTI CDF, et al. The Influenza Vaccine May Protect Pregnant and Postpartum Women against Severe COVID-19. Vaccines, 2022; 10(2).
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.
RODRIGUES A, et al. Brazilian Obstetric Observatory. 2021. Disponível em: http://arxiv.org/abs/2105.06534. Acessado em: 23 de dezembro de 2022.
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.
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.
SERRA FE, et al. COVID-19 outcomes in hospitalized puerperal, pregnant, and neither pregnant nor puerperal women. PLoS One, 2021; 16(11).
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.
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.
SOUZA ASR e AMORIM MMR. Maternal mortality from COVID-19 in Brazil. Rev Bras Saúde Matern Infant, 2021; 21: 253–6.
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.
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.
TAKEMOTO, et al. Maternal mortality and COVID-19. The Journal of Maternal-Fetal & Neonatal Medicine, 2022; 35(12): 2355-2361.
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.
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.
World Health Organization (WHO). WHO Coronavirus (COVID-19) Dashboard. Disponível em: https://covid19.who.int/. Acessado em: 23 de dezembro de 2022.
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.
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.
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).