Maternal mortality due to covid-19 in a reference unit in Goiânia - GO

Abstract

INTRODUCTION: The SARS-CoV-2 coronavirus has been impacting society since late 2019 and Brazil since early 2020, causing a global pandemic. Physiological changes during pregnancy can increase the severity of respiratory infections in these patients, leading to an increased risk of obstetric complications and mortality. Therefore, pregnant women and postpartum women are now considered at risk, requiring proper prevention and management.
OBJECTIVES: To evaluate maternal deaths due to COVID-19 at a reference unit in Goiânia - GO and to outline a profile of these patients.
METHODOLOGY: Observational, descriptive, and cross-sectional study conducted at the Hospital and Maternity Municipal Célia Câmara between November 2020 and December 2021, analyzing data from pregnant women hospitalized for COVID-19 who died.
RESULTS: Twenty-five maternal deaths due to COVID-19 were identified, out of a total of 908 hospitalized patients and 481 live births in the unit. The maternal mortality rate was 5.2 deaths per 100 live births. Half of the women were from Goiânia and the other half from cities in the interior of Goiás. Deaths in women aged 20 to 29 years accounted for 44% of the total, as did deaths in women aged 30 to 39 years, and 12% occurred in women aged 40 to 49 years. Of the deaths, 72% occurred in pregnant women in the third trimester, 16% in the second trimester, 4% in the first trimester, and 8% in the postpartum period. Comorbidities were identified in 80% of the patients, with 68% overweight or obese and 28% having hypertensive disease. Of the deliveries, 80% were cesarean sections and 8% were induced vaginal deliveries, with 8% maternal death with intrauterine fetal demise and 4% spontaneous abortion. Live births accounted for 79% of the outcomes of embryos or fetuses, 17% evolved with intrauterine fetal death, and 4% spontaneous abortion. Obstetric complications were reported in 48% of patients (oligohydramnios/ fetal distress, bleeding/placenta previa, wound dehiscence, and amniorrhexis).
CONCLUSION: The maternal mortality rate from COVID-19 at the Hospital and Maternity Municipal Célia Câmara was alarming when compared to pre-pandemic deaths in Goiás. The highest prevalence of maternal deaths occurred among women aged 20 to 39, with comorbidities such as overweight/obesity and hypertensive disease, in the third trimester of pregnancy. The majority underwent cesarean delivery, with live-born infants, and obstetric complications occurred in about half of the cases.