# Spatial analysis of maternal mortality in Pernambuco before and during the COVID-19 pandemic

## TL;DR

This study examines how maternal deaths in Pernambuco, Brazil, changed before and during the COVID-19 pandemic, highlighting regional disparities and risk factors.

## Contribution

The study provides a spatial analysis of maternal mortality in Pernambuco, identifying priority areas for intervention during and before the pandemic.

## Key findings

- Maternal deaths increased during the pandemic, with 51.8% occurring in 2020-2022.
- The Agreste region showed the highest concentration of risk areas in both periods.
- Lack of prenatal care and low education levels were strongly associated with higher maternal mortality.

## Abstract

to analyze the epidemiological characteristics and spatial distribution of maternal deaths in Pernambuco before (2017-2019) and during (2020-2022) the pandemic.

ecological study of spatial analysis. Using data from the Mortality and Live Birth Information Systems, maternal mortality ratios by municipality were calculated and smoothed using the local empirical Bayesian method, and spatial autocorrelation was assessed using the Moran index.

467 maternal deaths have been reported, with a higher incidence during the COVID-19 pandemic, constituting the main cause of maternal death. The spatial analysis identified priority areas in both periods, with the concentration of risk areas remaining in the state’s Agreste region.

identifying priority areas is crucial as it allows for effective local action and, with appropriate policies and investments, it is possible to reduce maternal deaths and achieve the targets of the Sustainable Development Goals.

analisar as características epidemiológicas e a distribuição espacial dos óbitos maternos em Pernambuco, Brasil, entre 2017 e 2022.

estudo ecológico cujas unidades de análise espacial foram os municípios. Calculou-se a razão de mortalidade materna por município e, por meio do índice de Moran, aplicou-se a técnica de autocorrelação espacial.

dos 467 óbitos maternos registrados, 242 (51,8%) ocorreram durante a pandemia (2020-2022). A COVID-19 foi a principal causa (n = 50). As mulheres com menos de oito anos de estudo e as primigestas apresentaram 40% e 46% mais chance de óbito, respectivamente. Entre as que não realizaram consultas de pré-natal, o risco foi 82% maior. A análise espacial identificou áreas prioritárias em ambos os períodos. Essas áreas se concentraram, em sua maior parte, no Agreste do estado.

a maior concentração de áreas prioritárias no Agreste pernambucano reforça as dificuldades de acesso e assistência aos serviços de saúde.