Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 11;12(1):11758.
doi: 10.1038/s41598-022-15647-z.

The COVID-19 pandemic in Brazilian pregnant and postpartum women: results from the REBRACO prospective cohort study

Renato T Souza  1 , Jose G Cecatti  1 , Rodolfo C Pacagnella  1 , Carolina C Ribeiro-Do-Valle  1 , Adriana G Luz  1 , Giuliane J Lajos  1 , Guilherme M Nobrega  1 , Thayna B Griggio  1 , Charles M Charles  1 , Silvana F Bento  1 , Carla Silveira  1 , Fernanda G Surita  1 , Maria J Miele  1 , Ricardo P Tedesco  2 , Karayna G Fernandes  2 , Sérgio H A Martins-Costa  3 , Frederico J A Peret  4 , Francisco E Feitosa  5 , Rosiane Mattar  6 , Evelyn Traina  6 , Edson V Cunha Filho  7 , Janete Vettorazzi  3   7 , Samira M Haddad  8 , Carla B Andreucci  9 , José P Guida  10 , Mario D Correa Junior  11 , Marcos A B Dias  12 , Leandro De Oliveira  13 , Elias F Melo Junior  14 , Marília G Q Luz  15 , Maria Laura Costa  16 ; REBRACO Study Group
Collaborators, Affiliations

The COVID-19 pandemic in Brazilian pregnant and postpartum women: results from the REBRACO prospective cohort study

Renato T Souza et al. Sci Rep. .

Abstract

Brazil presented a very high number of maternal deaths and evident delays in healthcare. We aimed at evaluating the characteristics of SARS-CoV-2 infection and associated outcomes in the obstetric population. We conducted a prospective cohort study in 15 Brazilian centers including symptomatic pregnant or postpartum women with suspected COVID-19 from Feb/2020 to Feb/2021. Women were followed from suspected infection until the end of pregnancy. We analyzed maternal characteristics and pregnancy outcomes associated with confirmed COVID-19 infection and SARS, determining unadjusted risk ratios. In total, 729 symptomatic women with suspected COVID-19 were initially included. Among those investigated for COVID-19, 51.3% (n = 289) were confirmed COVID-19 and 48% (n = 270) were negative. Initially (before May 15th), only 52.9% of the suspected cases were tested and it was the period with the highest proportion of ICU admission and maternal deaths. Non-white ethnicity (RR 1.78 [1.04-3.04]), primary schooling or less (RR 2.16 [1.21-3.87]), being overweight (RR 4.34 [1.04-19.01]) or obese (RR 6.55 [1.57-27.37]), having public prenatal care (RR 2.16 [1.01-4.68]), planned pregnancies (RR 2.09 [1.15-3.78]), onset of infection in postpartum period (RR 6.00 [1.37-26.26]), chronic hypertension (RR 2.15 [1.37-4.10]), pre-existing diabetes (RR 3.20 [1.37-7.46]), asthma (RR 2.22 [1.14-4.34]), and anaemia (RR 3.15 [1.14-8.71]) were associated with higher risk for SARS. The availability of tests and maternal outcomes varied throughout the pandemic period of the study; the beginning was the most challenging period, with worse outcomes. Socially vulnerable, postpartum and previously ill women were more likely to present SARS related to COVID-19.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart of participants included in the REBRACO study according to test results and radiological criteria for confirmed and negative COVID-19 infection.
Figure 2
Figure 2
Flowchart of participants included in the REBRACO study according to the pregnancy status and outcomes availability.
Figure 3
Figure 3
Case series of total included women divided by the three study periods.
Figure 4
Figure 4
Risk ratios for confirmed COVID-19 in symptomatic women according to symptoms at enrolment.
Figure 5
Figure 5
Risk ratios for SARS in women with confirmed COVID-19 according to symptoms at enrolment.
See this image and copyright information in PMC

References

    1. WHO. World Health Organization. Coronavirus Disease 2019 (COVID-19). Situation Report—51 (2020). https://www.who.int/docs/default-source/coronaviruse/situation-reports/2... (Accessed 12 August 2020).
    1. Pfitscher LC, Cecatti JG, Pacagnella RC, et al. Severe maternal morbidity due to respiratory disease and impact of 2009 H1N1 influenza A pandemic in Brazil: Results from a national multicenter cross-sectional study. BMC Infect. Dis. 2016 doi: 10.1186/s12879-016-1525-z. - DOI - PMC - PubMed
    1. Siston AM, Rasmussen SA, Honein MA, et al. Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. J. Am. Med. Assoc. 2010;303(15):1517–1525. doi: 10.1001/jama.2010.479. - DOI - PMC - PubMed
    1. Menezes MO, Takemoto MLS, Nakamura-Pereira M, et al. Risk factors for adverse outcomes among pregnant and postpartum women with acute respiratory distress syndrome due to COVID-19 in Brazil. Int. J. Gynecol. Obstet. 2020;151(3):415–423. doi: 10.1002/ijgo.13407. - DOI - PMC - PubMed
    1. De Souza SD, De Oliveira MM, Andreucci CB, et al. Disproportionate impact of coronavirus disease 2019 (COVID-19) among pregnant and postpartum black women in Brazil through structural racism lens. Clin. Infect. Dis. 2021;72(11):2068–2069. doi: 10.1093/cid/ciaa1066. - DOI - PMC - PubMed

Publication types