Maternal mortality linked to COVID-19 in Latin America: Results from a multi-country collaborative database of 447 deaths
Fabian Maza-Arnedo, Ángel Paternina‐Caicedo, Claudio Sosa, Bremen De Mucio, José Rojas‐Suarez, Lale Say, Jenny A. Cresswell, Luis Andrés de Francisco, Suzanne Jacob Serruya, Diana Carolina Franco Pulido Lic, Luis Fabian Yáñez Urbina, Erika Saint Hilaire, César V. Munayco, Fabiola Gil, Erick Rousselin, Leonardo Contreras, Allan Stefan, Alvinzy Velásquez Becerra, Evelyn Degraff, Franco Espada, Víctor Conde, Gustavo Mery, Víctor Hugo Álvarez Castaño, Aura Liliana Torres Umbarila, Ivy Lorena Talavera Romero, Yeimy Catherine Rodríguez Alfonso, Raquel Lovato Silva, Jakeline Calle, Cynthia Marlene Díaz -Viscensini, Vicente Nicolas Bataglia Frutos, Elodia Vysokolán Laguardia, Haydeé Padilla, Alvaro Ciganda, Mercedes Colomar
Abstract
Background: This study aimed to describe the clinical characteristics of maternal deaths associated with COVID-19 registered in a collaborative Latin-American multi-country 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. The most frequent symptoms at first consultation and admission 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 were admitted to critical care for a median length of eight days. In most cases, the death occurred during the 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 multi-country database in Latin America during the COVID-19 pandemic. Barriers faced by Latin American pregnant women to access intensive care services when required were also revealed. Decision-makers should strengthen severity awareness, and referral strategies to avoid potential delays. Funding: Latin American Center for Perinatology, Women and Reproductive Health.