Severe maternal morbidity and mortality during the COVID-19 pandemic: a cohort study in Rio de Janeiro

Brendolin, Michelle; Fuller, Trevon; Wakimoto, Mayumi Duarte; Rangel, Larissa; Rodrigues, Gustavo Mourão; Rohloff, Roger D; Guaraldo, Lusiele; Nielsen‐Saines, Karin; Brasil, Patrícia

doi:10.1016/j.ijregi.2022.11.004

Cited by 15 publications

(9 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pregnant women who received the SARS-CoV-2 vaccine had a lower risk of severe maternal morbidity and mortality. On the other hand, women who had a caesarean section, contracted SARS-CoV-2 during their third trimester, or had comorbidities such as asthma, chronic hypertension, or obesity had an increased risk 23 .…”

Section: Discussionmentioning

confidence: 99%

The changes in fear of childbirth in pregnancy during and before the COVID-19 pandemic

Soysal,

Ulaş,

Işıkalan

et al. 2024

Sci Rep

View full text Add to dashboard Cite

We aimed to investigate how factors such as age, education level, planned delivery method and fear of childbirth were affected in pregnant women before and during the pandemic. This cross-sectional study compared a pre-pandemic pregnant group (July 2019 and December 2019) and a pandemic group (November 2020 and May 2021) of patients at Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital. A total of 696 pregnant women in their second trimester were included in the study. All of them were literate and voluntarily agreed to participate in the study. Data were collected with the Wijma delivery expectancy/experience questionnaire (WDEQ-A), and the outpatient doctor asked the questions face-to-face. The mean age of the pregnant women participating in the study was 31.6 ± 6.8 years. While the total Wijma score was 62.1 ± 25.1 in the pre-pandemic group, it was 61.3 ± 26.4 in the pandemic group, and there was no significant difference between the two groups (p = 0.738). Upon analyzing the fear of childbirth among groups based on education level, no statistically significant differences were observed between the pre-pandemic and pandemic periods within any of the groups. While 25.7% (n = 179) of all participants had a normal fear of childbirth, 22% (n = 153) had a mild fear of childbirth, 27% (n = 188) had a moderate fear of childbirth, and 25.3% (n = 176) had a severe fear of childbirth (Wijma score of 85 and above). When the pre-pandemic and the pandemic period were compared, the fear of childbirth was unchanged in pregnant women at all education levels (p = 0.079, p = 0.957, p = 0.626, p = 0.539, p = 0.202). When comparing fear of childbirth before and after the pandemic, it was found that patients with a high school education level have a significantly higher fear of childbirth. To alleviate the fear of childbirth in pregnant women who have completed high school, training or psychosocial support interventions may be prioritized.

show abstract

Section: Discussionmentioning

confidence: 99%

The changes in fear of childbirth in pregnancy during and before the COVID-19 pandemic

Soysal,

Ulaş,

Işıkalan

et al. 2024

Sci Rep

View full text Add to dashboard Cite

show abstract

“…The 35-49-year-old age group was also severely impacted by excess maternal mortality during the first two years of the epidemic in the country, with significant excess mortality in years one and two regardless of region, except in the Southeast during the first year. The North region was the only one in which peak excess maternal mortality occurred between November 2020 and February 2021 (135% [40/17]), which coincides not only with the likely emergence, but also with the unprecedented spread of the Gamma variant of concern throughout the North region (especially in Manaus [ 24 ]) and the rest of Brazil soon afterwards [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on excess maternal deaths in Brazil: A two-year assessment

Orellana,

Leventhal,

Flores-Quispe

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

Background Accurate estimates of the COVID-19 pandemic’s indirect impacts are crucial, especially in low- and middle-income countries. This study aims to update estimates of excess maternal deaths in Brazil during the first two years of the COVID-19 pandemic. Methods This was an exploratory mixed ecological study using the counterfactual approach. The observed maternal deaths were gathered from the Mortality Information System (SIM) for the period between March 2015 and February 2022. Expected deaths from March 2020 to February 2022 were estimated using quasipoisson generalized additive models, considering quadrimester, age group, and their interaction as predictor variables. Analyses were performed in R version 4.1.2, RStudio, version 2023.03.1+446 and carried out with support from the “mgcv” and “plot_model” libraries. Results A total of 5,040 maternal deaths were reported, with varying excess mortality across regions and age groups, resulting in 69% excess maternal mortality throughout Brazil during the first two years of the pandemic. The Southeast region had 50% excess mortality throughout the first two years and 76% excess in the second year. The North region had 69% excess mortality, increasing in the second year, particularly among women aged 20–34. The Northeast region showed 80% excess mortality, with a significant increase in the second year, especially among women aged 35–49. The Central-West region had 75% excess mortality, higher in the second year and statistically significant among women aged 35–49. The South region showed 117% excess mortality, reaching 203% in the second year among women aged 20–34, but no excess mortality in the 10–19 age category. Conclusions Over two years, Brazil saw a significant impact on maternal excess deaths, regardless of region and pandemic year. The highest peak occurred between March and June 2021, emphasizing the importance of timely and effective epidemic responses to prevent avoidable deaths and prepare for new crises.

show abstract

“…SARS-CoV-2 infection during pregnancy has been associated with adverse maternal and neonatal outcomes, including increased risk of prematurity 1 , stillbirths 2 , and severe maternal morbidity and mortality 3 . While estimates of vertical transmission of SARS-CoV-2 from mother to child are low 1 , 4 – 6 , there is growing concern for long-term neonatal consequences 7 .…”

Section: Introductionmentioning

confidence: 99%

Respiratory distress in SARS-CoV-2 exposed uninfected neonates followed in the COVID Outcomes in Mother-Infant Pairs (COMP) Study

Man,

Azamor,

Cambou

et al. 2024

Nat Commun

Self Cite

View full text Add to dashboard Cite

Respiratory distress (RD) has been reported in SARS-CoV-2 exposed uninfected (SEU) term neonates. Prior studies suggest that prenatal exposure to Coronavirus Disease 19 (COVID-19) may activate an inflammatory cascade in the newborn airway. In this study, we examine the relationship between maternal COVID-19 vaccination and neonatal RD using a longitudinal cohort of mother-infant pairs in Los Angeles, CA. Two-hundred and twenty-one mothers with laboratory confirmed SARS-CoV-2 during pregnancy and 227 exposed fetuses are enrolled in our study. Maternal disease severity and neonatal RD variables were defined based on current accepted clinical criteria. To explore the multifactorial associations between maternal COVID-19 parameters and infant RD, we utilize a multivariable logistic regression model and a proteomic sub-analysis to propose a pathway for the development of RD following in utero exposure to SARS-CoV-2. Unusually high rates of RD are observed in SEU infants (17%). The odds ratio of RD is 3.06 (95% CI:1.08-10.21) in term neonates born to unvaccinated individuals versus those born to individuals vaccinated prior to maternal infection. Proteomic analysis reveals a robust inflammatory response associated with ciliary dysregulation and enhanced IgE production among SEU neonates with RD. Maternal vaccination against COVID-19 reduces the frequency of neonatal RD.

show abstract

Severe maternal morbidity and mortality during the COVID-19 pandemic: a cohort study in Rio de Janeiro

Cited by 15 publications

References 35 publications

The changes in fear of childbirth in pregnancy during and before the COVID-19 pandemic

The changes in fear of childbirth in pregnancy during and before the COVID-19 pandemic

Impact of the COVID-19 pandemic on excess maternal deaths in Brazil: A two-year assessment

Respiratory distress in SARS-CoV-2 exposed uninfected neonates followed in the COVID Outcomes in Mother-Infant Pairs (COMP) Study

Contact Info

Product

Resources

About