Maternal mortality and COVID-19
Maternal mortality and COVID-19
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DOI：
10.1080/14767058.2020.1786056
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发表时间：
2020-07-16
影响因子：
1.8
通讯作者：
Amorim, Melania M. R.
中科院分区：
文献类型：
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作者：
Takemoto, Maira L. S.;Menezes, Mariane O.;Amorim, Melania M. R.
本研究的目的是收集和分析来自不同来源的数据，以总体了解巴西与covid -19相关的孕产妇死亡情况，并将数据与全球报告进行比较。研究设计我们系统地检索了巴西卫生部监测系统、州卫生部流行病学报告和媒体报道中有关COVID-19孕产妇死亡的数据。在可获得的情况下检索有关症状发生和死亡时间（妊娠期或产后）、胎龄、出生方式、产妇年龄、合并症和/或危险因素、死亡日期和死亡地点的数据。结果确定了20例与covid -19相关的孕产妇死亡，年龄范围为20-43岁。据报道，症状出现在妊娠期12例，产后3例，剖宫产期1例（4例资料缺失）。16例死亡发生在产后。11例患者至少存在一种合并症或危险因素（4例数据缺失）。哮喘是最常见的危险因素（5/11）。东北部地区发生10例，东南部地区发生9例（其中5例发生在巴西第一个疫情中心圣保罗）。据我们所知，这是目前可获得的由COVID-19导致的最大的孕产妇死亡系列。与全球孕产妇结局报告相比，观察到的差异可能与获得医疗保健的障碍、该国大流行疫情控制措施的差异以及COVID-19严重疾病的伴随风险因素的高发有关。
Objective The aim of this study was to collect and analyze data from different sources to have a general overview of COVID-19-related maternal deaths in Brazil, as well as to compare data with worldwide reports. Study design We systematically searched data about COVID-19 maternal deaths from the Brazilian Ministry of Health surveillance system, State Departments of Health epidemiological reports, and media coverage. Data about timing of symptom onset and death (pregnancy or postpartum), gestational age, mode of birth, maternal age, comorbidities and/or risk factors, date of death, and place of death were retrieved when available. Results We identified 20 COVID-19-related maternal deaths, age range 20-43 years. Symptoms onset was reported as on pregnancy for 12 cases, postpartum for 3 cases, and during the cesarean section for 1 case (missing data for 4). In 16 cases, death occurred in the postpartum period. At least one comorbidity or risk factor was present in 11 cases (missing data for 4). Asthma was the most common risk factor (5/11). Ten cases occurred in the Northeast region, and nine cases occurred in the Southeast region (5 of them in Sao Paulo, the first epicenter of COVID-19 in the country). Conclusions To the best of our knowledge, this is the largest available series of maternal deaths due to COVID-19. Barriers to access healthcare, differences in pandemic containment measures in the country and high prevalence of concomitant risk factors for COVID-19 severe disease may play a role in the observed disparity compared to worldwide reports on maternal outcomes.