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Maternal Mortality Linked to COVID-19 in Latin America: Results From a Multicountry Collaborative Database of 447 Deaths

33 Pages Posted: 15 Feb 2022

See all articles by Fabian Maza-Arnedo

Fabian Maza-Arnedo

Universidad de Cartagena - Grupo de Investigación en Cuidados Intensivos y Obstetricia (GRICIO)

Angel Paternina

Universidad del Sinú

Claudio G. Sosa

Latin American Center for Perinatology, Women’s Health, and Reproductive Health (CLAP/WR)

Bremen de Mucio

Latin American Center for Perinatology, Women’s Health, and Reproductive Health (CLAP/WR)

José Rojas-Suarez

Universidad de Cartagena - Grupo de Investigación en Cuidados Intensivos y Obstetricia (GRICIO)

Lale Say

World Health Organization - UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research

Jenny A. Cresswell

World Health Organization - UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research

Andres de Francisco

Pan American Health Organization - Family, Health Promotion and Life Course (FPL)

Suzanne Serruya

Latin American Center for Perinatology, Women’s Health, and Reproductive Health (CLAP/WR)

Dolores Altagracia Rodríguez Lappot

Ministry of Health, Dominican Republic

Maria Santos

Ministry of Health, Dominican Republic

Luis Urbina

PAHO Representation

Erika Saint Hilaire

San Lorenzo de Los Mina Children Maternity Hospital

Cesar V Munayco

National Center for Epidemiology, Disease Prevention and Control

Fabiola Gil

National Center for Epidemiology, Disease Prevention and Control

Erick Rousselin

PAHO Representation

Leonardo Contreras

PAHO Representation

Allan Stefan

Dr Leonardo Martínez Valenzuela Hospital

Carlos Ochoa

San Felipe Hospital

Evelyn Degraff

PAHO Representation

Franco Espada

Health and Sports Ministry, Bolivia

Victor Conde

PAHO Representation

Gustavo Mery

PAHO Representation - Family, Promotion and Life Course

Julián Alfredo Fernández-Niño

Ministry of Health and Social Protection, Bogota - Department of Epidemiology and Demographics

Víctor Hugo Álvarez Castaño

Ministry of Health and Social Protection, Bogota

Leonor Guavita Cuta

Ministry of Health and Social Protection, Bogota

Aura Liliana Torres Umbarila

Ministry of Health and Social Protection, Bogota

Ivy Lorena Talavera

PAHO Representation

Yeimy Catherine Rodríguez Alfonso

PAHO Representation

Raquel Lovato Silva

National Epidemiological Surveillance Directorate

Jakeline Calle

Ministry of Public Health and Welfare, Asunción

Rosalinda Hernandez

PAHO Representation

Cynthia Marlene Díaz-Viscensini

Ministry of Public Health and Welfare, Asunción

Vicente Nicolas Bataglia Frutos

Asunción National University - Clinicas Hospital

Elodia Vysokolán Laguardia

PAHO Representation

Haydee Padilla

PAHO Representation

Alvaro Ciganda

Montevideo, Clinical and Research Unit (UNICEM)

Mercedes Colomar

Latin American Center for Perinatology, Women’s Health, and Reproductive Health (CLAP/WR)

More...

Abstract

Background: This study aimed to describe the clinical characteristics of maternal deaths associated with COVID-19 registered in a collaborative Latin-American multicountry database.

Methods: This was an observational study implemented from March 1st 2020 to November 29th 2021 in eight Latin American countries. Information was based on the Perinatal Information System from the Latin American Center for Perinatology, Women and Reproductive Health. We summarized categorical variables as frequencies and percentages and continuous variables into median with interquartile ranges.

Findings: We identified a total of 447 deaths. The median maternal age was 31 years. 86·4% of women were infected antepartum, with most of the cases (60·3%) detected in the third trimester of pregnancy. At first consultation and admission, the most frequent symptoms were dyspnea (73·0%), fever (69·0%), and cough (59·0%). Organ dysfunction was reported in 90·4% of women during admission. A total of 64·8% women was admitted to critical care for a median length of stay of eight days. In most of the cases the death occurred during puerperium, with a median of seven days between delivery and death. Preterm delivery was the most common perinatal complication (76·9%) and 59·9% were low birth weight.

Interpretation: This study describes the characteristics of maternal deaths in a comprehensive multicountry database showing existing barriers faced by pregnant women in Latin America during the COVID-19 pandemic to access intensive care services when required. Decision-makers should strengthen severity awareness, and referral strategies to avoid potential delays.

Funding Information: This work received a grant from the Latin American Center for Perinatology, Women and Reproductive Health (CLAP/WR), PAHO/WHO.

Declaration of Interests: None.

Ethics Approval Statement: This study was exempt from ethical approval by the PAHO Ethical Review Committee. The authors followed all relevant guidelines and ethical regulations for this study.

Keywords: COVID-19, SARS-CoV-2, pregnancy, puerperium, maternal mortality, maternal death

Suggested Citation

Maza-Arnedo, Fabian and Paternina, Angel and Sosa, Claudio G. and de Mucio, Bremen and Rojas-Suarez, José and Say, Lale and Cresswell, Jenny A. and de Francisco, Andres and Serruya, Suzanne and Rodríguez Lappot, Dolores Altagracia and Santos, Maria and Urbina, Luis and Saint Hilaire, Erika and Munayco, Cesar V and Gil, Fabiola and Rousselin, Erick and Contreras, Leonardo and Stefan, Allan and Ochoa, Carlos and Degraff, Evelyn and Espada, Franco and Conde, Victor and Mery, Gustavo and Fernández-Niño, Julián Alfredo and Álvarez Castaño, Víctor Hugo and Guavita Cuta, Leonor and Torres Umbarila, Aura Liliana and Talavera, Ivy Lorena and Rodríguez Alfonso, Yeimy Catherine and Silva, Raquel Lovato and Calle, Jakeline and Hernandez, Rosalinda and Díaz-Viscensini, Cynthia Marlene and Bataglia Frutos, Vicente Nicolas and Laguardia, Elodia Vysokolán and Padilla, Haydee and Ciganda, Alvaro and Colomar, Mercedes, Maternal Mortality Linked to COVID-19 in Latin America: Results From a Multicountry Collaborative Database of 447 Deaths. Available at SSRN: https://ssrn.com/abstract=4035411 or http://dx.doi.org/10.2139/ssrn.4035411

Fabian Maza-Arnedo

Universidad de Cartagena - Grupo de Investigación en Cuidados Intensivos y Obstetricia (GRICIO) ( email )

Colombia

Angel Paternina

Universidad del Sinú ( email )

Cartagena
Colombia

Claudio G. Sosa

Latin American Center for Perinatology, Women’s Health, and Reproductive Health (CLAP/WR) ( email )

Montevideo
Uruguay

Bremen De Mucio

Latin American Center for Perinatology, Women’s Health, and Reproductive Health (CLAP/WR) ( email )

Montevideo
Uruguay

José Rojas-Suarez

Universidad de Cartagena - Grupo de Investigación en Cuidados Intensivos y Obstetricia (GRICIO) ( email )

Colombia

Lale Say

World Health Organization - UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research ( email )

Geneva
Switzerland

Jenny A. Cresswell

World Health Organization - UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research ( email )

Geneva
Switzerland

Andres De Francisco

Pan American Health Organization - Family, Health Promotion and Life Course (FPL) ( email )

Switzerland

Suzanne Serruya

Latin American Center for Perinatology, Women’s Health, and Reproductive Health (CLAP/WR) ( email )

Montevideo
Uruguay

Dolores Altagracia Rodríguez Lappot

Ministry of Health, Dominican Republic ( email )

Dominican Republic

Maria Santos

Ministry of Health, Dominican Republic ( email )

Dominican Republic

Luis Urbina

PAHO Representation ( email )

Dominican Republic

Erika Saint Hilaire

San Lorenzo de Los Mina Children Maternity Hospital ( email )

Santo Domingo
Dominican Republic

Cesar V Munayco

National Center for Epidemiology, Disease Prevention and Control ( email )

Lima
Peru

Fabiola Gil

National Center for Epidemiology, Disease Prevention and Control ( email )

Lima
Peru

Erick Rousselin

PAHO Representation ( email )

Dominican Republic

Leonardo Contreras

PAHO Representation ( email )

Dominican Republic

Allan Stefan

Dr Leonardo Martínez Valenzuela Hospital ( email )

San Pedro Sula
Honduras

Carlos Ochoa

San Felipe Hospital ( email )

Tegucigalpa
Honduras

Evelyn Degraff

PAHO Representation ( email )

Dominican Republic

Franco Espada

Health and Sports Ministry, Bolivia ( email )

Bolivia

Victor Conde

PAHO Representation ( email )

Dominican Republic

Gustavo Mery

PAHO Representation - Family, Promotion and Life Course ( email )

Costa Rica

Julián Alfredo Fernández-Niño

Ministry of Health and Social Protection, Bogota - Department of Epidemiology and Demographics ( email )

Colombia

Víctor Hugo Álvarez Castaño

Ministry of Health and Social Protection, Bogota ( email )

Colombia

Leonor Guavita Cuta

Ministry of Health and Social Protection, Bogota ( email )

Colombia

Aura Liliana Torres Umbarila

Ministry of Health and Social Protection, Bogota ( email )

Colombia

Ivy Lorena Talavera

PAHO Representation ( email )

Dominican Republic

Yeimy Catherine Rodríguez Alfonso

PAHO Representation ( email )

Dominican Republic

Raquel Lovato Silva

National Epidemiological Surveillance Directorate ( email )

Ecuador

Jakeline Calle

Ministry of Public Health and Welfare, Asunción ( email )

Paraguay

Rosalinda Hernandez

PAHO Representation ( email )

Dominican Republic

Cynthia Marlene Díaz-Viscensini

Ministry of Public Health and Welfare, Asunción ( email )

Paraguay

Vicente Nicolas Bataglia Frutos

Asunción National University - Clinicas Hospital ( email )

Paraguay

Elodia Vysokolán Laguardia

PAHO Representation ( email )

Dominican Republic

Haydee Padilla

PAHO Representation ( email )

Dominican Republic

Alvaro Ciganda

Montevideo, Clinical and Research Unit (UNICEM) ( email )

Uruguay

Mercedes Colomar (Contact Author)

Latin American Center for Perinatology, Women’s Health, and Reproductive Health (CLAP/WR) ( email )

Montevideo
Uruguay

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