Clinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study

TL;DR

This study examines the mortality of pregnant and postpartum women in Brazil due to COVID-19 or unspecified causes, highlighting disparities in outcomes based on race and health access.

Contribution

The study provides insights into the increased mortality risk among Black and Brown pregnant/postpartum women with comorbidities during the pandemic.

Findings

Black and brown women had higher mortality risks during the postpartum period.

Comorbidities like diabetes, cardiovascular diseases, and obesity increased death risk.

Limited ICU access was observed among women who died from unspecified SARS causes.

Abstract

To analyze the death of Brazilian pregnant and postpartum women due to COVID-19 or unspecific cause.

This is retrospective, descriptive-exploratory, population-based study carried out with the Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) database, with pregnant and postpartum women of reproductive age who died from confirmed COVID-19 between 2020 and 2021. The chosen variables were: age, gestational period, type and number of comorbidities, skin color, using the statistical software R Foundation for Statistical Computing Platform, version 4.0.3 and Statistical Package for Social Science, version 29.0 for analysis.

A total of 19,333 cases of pregnant and postpartum women aged between 10 and 55 years diagnosed with SARS were identified, whether due to confirmed COVID-19 or unspecific causes. Of these, 1,279 died, these cases were classified into two groups according to the cause of death: deaths from COVID-19 (n= 1,026) and deaths from SARS of unspecific cause (n= 253).

The risk of death increased among black and brown women, in the postpartum period and with the presence of comorbidities, mainly diabetes, cardiovascular diseases and obesity. The data presented here draw attention to the number of deaths from SARS, especially among sociodemographic profiles, precarious access to health, such as the black population. In addition, limitations in adequate access to health care are reinforced by even lower rates of ICU admissions among women who died from SARS of an unspecified cause.