Maternal Mortality Soars in Brazil During the Pandemic – Medscape

A recent Brazilian study yielded alarming data about the effect of the COVID-19 pandemic on maternal health. In 2020, the rate of maternal mortality was 40% higher than the average of the previous years. In 2021, there was a surge in the number of cases, and COVID-19 was responsible for 60% of maternal deaths that year.

These data suggest that the pandemic has disproportionately affected pregnant women and postpartum women, according to the investigators. The maternal mortality rate observed in 2021 significantly exceeded the global target of the Sustainable Development Goals for this indicator (70 maternal deaths per 100,000 live births), reaching a level of approximately 110 maternal deaths per 100,000 live births. This level was similar to the levels that Brazil recorded in the 1980s.

Another Brazilian study showed that the country's northern and northeastern regions were most affected by excess maternal mortality in 2020. In 2021, the impact was greater in the midwestern and southern regions. The worst scenario occurred between March and June 2021 nationwide, with an excess of 413% in the mortality of mothers between ages 35 and 49 years in the southern region.

Brazil's numbers are significantly higher than those of other developing countries. In Chile, for example, maternal mortality increased from 19.2 to 28.1 per 100,000 live births. In countries in Central Asia, maternal mortality ranged from 18.5 to 36.5 per 100,000 live births during the pandemic, which was higher than in previous years. Colombia, which already had a high maternal mortality rate of 80 per 100,000 live births before the pandemic, saw an increase to 87 per 100,000 live births.

The data from the United States are also noteworthy. The maternal mortality rate, which was 20.1 per 100,000 live births in 2019, rose to 23.8 in 2020 and to 32.9 in 2021. Racial issues are important here: Among the Black population, maternal mortality reached 69.9 per 100,000 live births, which is more than two and a half times the rate in the White population (26.6 per 100,000 live births).

In addition, a US study conducted in the first year of the pandemic showed that the incidence of maternal mortality coincident with a confirmed COVID-19 infection ranged from 79.1 to 232.9 per 100,000 deliveries between April and December 2020. These numbers are more than 10 times higher than those for maternal mortality unrelated to COVID-19.

Maternal mortality is influenced by the quality of care, which involves issues such as access and availability of resources; prenatal, childbirth, and postpartum practices; and social, economic, and ethnic disparities in women's health overall.

The difference between the Brazilian numbers and those of other countries cannot be explained by biologic factors alone. During the pandemic, Brazil experienced significant strain on its healthcare system, including difficulty promoting prenatal care for pregnant women, barriers to accessing childbirth assistance, and the low availability of intensive care beds. The occurrence of a critical period in 2021 also suggests the slow adoption of measures to control and mitigate the effects of the pandemic, such as vaccinating pregnant women and postpartum women.

In 2022, the rate of maternal mortality decreased to 57.7 per 100,000 live births. The statistics for 2023 are not yet available. But much work remains to be done before the country reaches its target, as part of the Sustainable Development Goals, of fewer than 30 maternal deaths for every 100,000 live births.

Many of the women who died during the pandemic left behind families and children. A 2022 Brazilian study showed that in the first 2 years of the pandemic, over 40,000 children were left motherless. This phenomenon has implications for the well-being and structure of families and increases children's vulnerability to emotional and behavioral issues, even in the long term.

Finally, Brazil may observe changes in its population in the coming years as a consequence of the pandemic. There is an expectation, for example, that the observed population decline may accelerate. It may be too early to state that the excess of maternal deaths will have a population-level impact, but it is certainly something to monitor closely.

This story was translated from the Medscape Portuguese edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

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Maternal Mortality Soars in Brazil During the Pandemic - Medscape