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. 2023 Aug 17;18(8):e0290343.
doi: 10.1371/journal.pone.0290343. eCollection 2023.

The impact of COVID-19 on maternal death and fetal death, a cohort study in Brazil

Ana Paula Brioschi Dos Santos  1 , Creuza Rachel Vicente  2 , João Paulo Cola  1 , Luana Fiengo Tanaka  3 , Juliana Rodrigues Tovar Garbin  1 , Larissa Soares Dell'Antonio  4 , Cristiano Soares da Silva Dell'Antonio  4 , Angelica Espinosa Miranda  1
Affiliations

The impact of COVID-19 on maternal death and fetal death, a cohort study in Brazil

Ana Paula Brioschi Dos Santos et al. PLoS One. .

Abstract

Objective: The study aimed to evaluate the risk of maternal death and fetal death among pregnant women infected with SARS-CoV-2.

Methods: This is a retrospective cohort study among pregnant women with secondary data from the National Live Births System (Sistema Nacional de Nascidos Vivos), National Mortality System (Sistema Nacional de Mortalidade), and e-SUS Health Surveillance System (Sistema e-SUS Vigilância em Saúde). Pregnant women confirmed for COVID-19 had positive RT-PCR between March 2020 and May 2021, pregnant women without COVID-19 were those without notification for disease. Maternal death, fetal death, and stillbirth were assessed as primary outcomes.

Results: We included 68,673 pregnant women not notified as suspected of COVID-19 and 1,386 with a confirmed diagnosis of COVID-19. Among pregnant women with COVID-19, 1013 (73.0%) were aged 20 to 34 years, 655 (47.2%) were brown, 907 (65.4%) had ≥ 8 years of education, in the third trimester of pregnancy (41.5%), undergoing cesarean section (64.5%). In adjusted analyses, COVID-19 in pregnancy had a higher risk of maternal death (relative risk [RR] 18.73-95% confidence interval [95%CI] 11.07-31.69), fetal death/stillbirth (RR 1.96-95%CI 1.18-3.25), preterm birth [RR 1.18-95%CI 1.01-1.39], cesarean delivery (RR 1.07-95%CI 1.02-1.11), and cesarean delivery occurring before the onset of labor (RR 1.33-95%CI 1.23-1.44).

Conclusion: COVID-19 may contribute to unfavorable pregnancy outcomes. Results showed that pregnant women infected with SARS-CoV-2 had a higher risk of maternal death, fetal death/stillbirth, preterm birth, cesarean delivery, and cesarean section occurring before the onset of labor.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Sample constitution.
SINASC—Live Births Information System (Sistema de Informação de Nascidos Vivos); e-SUS VS- e-SUS Health Surveillance System (e-SUS VS- Sistema e-SUS Vigilância em Saúde); SIM—Mortality Information System (Sistema de Informação de Mortalidade).
See this image and copyright information in PMC

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