The number of deaths of women who are pregnant or up to 42 days after childbirth grew 41.9% in Brazil last year compared to 2020, according to data from the Mortality Information System (SIM), of the Ministry of Health.
The increase in deaths, caused by the Covid-19 pandemic, leaves Brazil even further from the goal of reducing maternal mortality, one of the United Nations (UN) Sustainable Development Goals (SDGs).
The Ministry of Health panel shows that the country had been registering a drop in deaths of pregnant and postpartum women between 2017 and 2019 — the latter with 1,575 deaths. However, in 2020, with the beginning of the spread of the coronavirus, the situation changed: there were 1,964 deaths, an increase of almost 25%. In 2021, the number jumped to 2,787.
Last year still showed a reversal in the reasons for deaths. Between 2017 and 2019, deaths directly linked to obstetric causes, such as hypertension and bleeding, predominated. In 2021, indirect ones, such as diseases of the respiratory and circulatory system, exceeded, totaling 1,737 cases — against 982 due to direct causes and 68 due to unspecified causes.
THE CNN contacted the Ministry of Health to comment on the numbers and awaits a return.
The obstetrician and researcher at the National Institute of Health for Women, Children and Adolescents Fernandes Figueira (IFF/Fiocruz), Marcos Nakamura, explains that pregnant women and postpartum women have shown to be a risk group for Covid-19.
“Since H1N1, we’ve known that these serious respiratory infections have a chance of disproportionately affecting pregnant women. Why that? The pregnant woman, because of the changes in the body, ends up having a reduced lung capacity. The lung is affected, this causes it to quickly decompensate, leading to a picture of respiratory failure ”, she told the CNN.
According to the doctor, who is also president of the Maternal Mortality Commission of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo), data from the Sivep-Gripe (Influenza Epidemiological Surveillance Information System, from the Ministry of Health) indicate 461 deaths. of pregnant women with confirmed diagnosis of Covid-19, in 2020, and 1,519, in 2021.
“In 2019, the maternal mortality ratio is 58 deaths per 100,000 live births. In 2020, 72 per 100,000 live births. In 2021, it should be above 100”, he added, noting that the Ministry of Health can still make small corrections to the statistics.
The Maternal Mortality Ratio is an index that expresses the number of deaths of pregnant women or mothers up to 42 days after delivery per 100,000 live births. In developed countries, it is around 10 per 100,000 live births.
Marcos Nakamura also says that another effect of the coronavirus has an impact on pregnant women.
“In addition to the respiratory issue, it has an inflammatory disorder, increasing the chance of thrombosis. And the pregnant woman or the woman who gave birth has a predisposition to have these complications, especially thrombosis, in relation to the normal population”, he added.
The medical director of the Maternity School of the Federal University of Rio de Janeiro, Jair Braga, points out that the pandemic has hampered the prenatal care of pregnant women, which is fundamental for the identification of problems and comorbidities, due to the cancellation of appointments and the fear of contamination. in hospitals and clinics.
“Pregnant women took a while to enter the Covid risk group. And after they went in, they stayed,” she added.
In view of the numbers, both doctors emphasize the importance of pregnant women receiving the coronavirus vaccine.
How to reach the UN target for 2030?
With the improvement in the epidemiological scenario of the pandemic, the focus is on how to improve care and reach the goal of 30 deaths per 100,000 live births by 2030.
For Jair Braga, prenatal care needs to be strictly followed. The follow-up consultations, according to the doctor, serve to identify problems such as hypertension and diabetes, some of the main causes of death.
The medical director of the UFRJ Maternity School also defends the qualification of health professionals. “It’s a very big challenge, especially in cities that have fewer resources,” he said.
The IFF/Fiocruz researcher, Marcos Nakamura, also argues the need to expand obstetric ICUs, improve the referral of high-risk pregnant women and solve infrastructure problems faced in some hospitals.
“The pandemic opened up some problems that were already chronic in the care network”, he evaluates.
Source: CNN Brasil
