Maternal Mortality and COVID-19 Pandemic: Looking Beyond SARS CoV-2 Infection (original) (raw)
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Factors Causing Maternal Death due to COVID-19 in Several Countries: A Literature Review
Jurnal Promosi Kesehatan Indonesia
Background: Since 2019, the world has been faced with a global crisis. The spread of SARS-CoV-2 has an impact on all populations, including pregnant women, who are among the most vulnerable and at-risk population groups. The worldwide spread of the virus is called the COVID-19 pandemic. This study aims to explore the factors that cause maternal death during pregnancy and postpartum due to COVID-19 in several countries.Method: A literature review was conducted to explore broadly the causes of maternal deaths due to COVID in several countries. Article search on three databases, namely PubMed, Google Scholar, and ScienceDirect. A total of 7 articles were analyzed. The data studied are cases of death and their causes.Results: The study was conducted in the period 2018 to 2021 with the type of research using retrospective data. When compared to before the pandemic, there was a significant increase in the number of maternal deaths. Factors that increase the risk of maternal death come fro...
Maternal mortality cases due to COVID-19 pandemic in a tertiary referral hospital
Perinatal Journal
Objective: This study aimed to report the clinical prognoses, laboratory findings, treatment procedures, and neonatal outcomes, from hospitalization to death, of Coronavirus Disease 2019 (COVID-19)-related cases of maternal mortality at our clinic. Methods: Fifteen cases of COVID-19-related maternal mortality, between April 2020 and October 2021, in the Department of Obstetrics & Gynecology of a Training and Research Hospital were retrospectively analyzed for the purpose of the study. Results: During the study period, a total of 501 symptomatic pregnant women received inpatient treatment for COVID-19. In our case group, 93.3% of maternal deaths due to COVID-19 occurred as a result of the worsening of the clinical condition of third-trimester pregnant women. In these patients whose clinical condition deteriorated, delivery was performed after the decision to give birth, and 86.6% of mortalities occurred in the postpartum period and 13.4% before delivery. There was at least one risk f...
Journal of South Asian Federation of Obstetrics and Gynaecology
Objective: India reported its first case of coronavirus in Kerala on 30th January, 2020. On March 24, 2020, the Government of India announced the first complete lockdown of the entire nation for 21 days for the containment of the virus. The immediate effect of the lockdown was that the cases and COVID-19-related deaths were significantly controlled. Besides the direct effects, the indirect impact of the pandemic and pandemiccontrol policies on healthcare services, communities, and the global economy may also affect vulnerable groups like pregnant women. The objective is to explore trends in maternal or neonatal outcomes during this pandemic by comparing the same in pre-pandemic, pandemic, and post-pandemic phases. Materials and Methods: This was a retrospective analysis of maternal and neonatal outcomes over the period from January 2020 to August 2021. The monthly statistics from the pre-pandemic period (2018 and 2019) were combined and then analyzed against the statistics from 2020 and 2021 using the Fisher's exact test or Chi-squared analysis as appropriate. Results: There was positive correlation between the monthly number of COVID-19-related deaths with the monthly number of stillbirths (p = 0.153). The diagnosis of antenatal complications such as hypertension in pregnancy occurred at the same rate pre-pandemic as in the months during the pandemic. There was a strong positive correlation between maternal mortality and the number of COVID-19-related deaths (p = 0.016). Conclusion: Women's healthcare is often adversely affected in humanitarian disasters, and our study highlights the importance of planning for powerfully built maternal services in any emergency services.
Maternal mortality and COVID-19
The Journal of Maternal-Fetal & Neonatal Medicine, 2020
Objective: The aim of this study was to collect and analyze data from different sources to have a general overview of COVID-19-related maternal deaths in Brazil, as well as to compare data with worldwide reports. Study design: We systematically searched data about COVID-19 maternal deaths from the Brazilian Ministry of Health surveillance system, State Departments of Health epidemiological reports, and media coverage. Data about timing of symptom onset and death (pregnancy or postpartum), gestational age, mode of birth, maternal age, comorbidities and/or risk factors, date of death, and place of death were retrieved when available. Results: We identified 20 COVID-19-related maternal deaths, age range 20-43 years. Symptoms onset was reported as on pregnancy for 12 cases, postpartum for 3 cases, and during the cesarean section for 1 case (missing data for 4). In 16 cases, death occurred in the postpartum period. At least one comorbidity or risk factor was present in 11 cases (missing data for 4). Asthma was the most common risk factor (5/11). Ten cases occurred in the Northeast region, and nine cases occurred in the Southeast region (5 of them in São Paulo, the first epicenter of COVID-19 in the country). Conclusions: To the best of our knowledge, this is the largest available series of maternal deaths due to COVID-19. Barriers to access healthcare, differences in pandemic containment measures in the country and high prevalence of concomitant risk factors for COVID-19 severe disease may play a role in the observed disparity compared to worldwide reports on maternal outcomes.
Journal of South Asian Federation of Obstetrics and Gynaecology
Objectives: To evaluate the obstetrics outcome in terms of maternal mortality in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected pregnant women in both the waves of coronavirus disease 2019 (COVID-19) pandemic. Design, settings, and participants: This is a prospective cohort study of obstetrics outcomes in SARS-CoV-2 infected pregnant women in both the waves of COVID-19 pandemic from 1 April 2020 to 30 May 2021 at Sri Aurobindo Institute of Medical Sciences with wide spread access to SARS-CoV-2 testing in outpatients, emergency department, and inpatient settings. Result: The primary outcome composed of maternal mortality in SARS-CoV-2 infected females during both waves of COVID-19 pandemic. Study shows that the second wave was more intense and fatal as compared to the first wave of COVID-19 pandemic in India with higher maternal mortality rate in the second wave than the first wave. Study also showed that an overall higher mortality with cesarean section was noted. Thus, our study concluded that the cesarean section is not the preferred mode of delivery in COVID-19 females suffering from respiratory distress. Conclusion: Our study concluded that cesarean section is not the preferred mode of delivery in COVID-19 with females suffering from respiratory distress. The SARS-CoV-2 infection during pregnancy was associated with adverse maternal outcomes post-delivery.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: By the end of 2019, WHO had identified COVID-19 disease as a public health emergency. Research has focused on the impact of SARS-CoV-2 infection during pregnancy, including symptoms, disease severity, risk of vertical transmission, and perinatal and neonatal prognosis. Methods: This was a cross sectional prospective observational study, conducted at Gynae and Obstetric Department, in Bangabandhu Sheikh Mujib Medical University, between July 2020 to August 2021. 75 pregnant women who tested positive for COVID-19 were included in this study. Results: Most of the patients 29(38.7%) were aged 25-29 years. Majority 96% (72) of the cases were asymptomatic, symptomatic cases with cough were 4% (3). On the basis of our data, 94.7% (71) of the cases were Antenatal, while Postnatal and Abortion were 4% (3) and 1.3% (1) respectively. Complications such as fetal distress 25.3% (19), scar tenderness 17.3% (13), pre-eclampsia 12% (9), post-dated pregnancy 9.3% (7), previous 2LSCS with...
International journal of health sciences
Following the Covid-19 Pandemic, certain components of the public health system, such as women's and children's health services, are more likely to experience decreased efficiency. A single-stranded RNA virus is the coronavirus. It can cause respiratory conditions ranging from minor nasal congestion to life-threatening respiratory infections. From June 2020 to September 2021, 70 mothers participated in a retrospective study at the Department of Obstetrics and Gynecology to assess the impact of COVID-19 on maternal and perinatal outcomes. In our study Only 20% of the patients were older than 30 years old, and 80% of the patients were under 30 years old. Out of 70 patients, 10 had no symptoms, 57.1% had a fever, 52.8% had a cough, 24.3% had trouble breathing, 7.14 percent had a headache, and 14.2 percent had anosmia. 36 patients (51.42%) had pneumonia with pleural effusion, 6 patients (8.57%) had ground glass opacity with consolidation, and 28 patients (40%) had minimal ground...
International Journal of Health Science, 2023
Introduction: The SARS-CoV-2 pandemic that started in December 2019 triggered significant consequences in the economic, psychosocial and health fields on a global scale. With the increasing number of cases, it was possible to identify groups more vulnerable to morbidity and mortality, with the maternal population being a prominent community due to relevant clinical outcomes. Thus, the study in question will provide a comprehensive understanding of maternal mortality, exploring qualitative and quantitative data from financial, social and ethnic perspectives, so far scarce in the literature. Objective: To carry out an epidemiological analysis of maternal mortality due to complications of COVID-19. Materials and methods: This is a descriptive, cross-sectional and retrospective population cohort, carried out on the platforms SIVEP Gripe and ``Observatório Obstetrico Brasileiro`` COVID-19 in order to look for cases of pregnant and puerperal women from the 14th epidemiological week of 2020 to the 26th of 2021. race, area of residence, age group, type of ventilatory support, level of education, Brazilian regions, gestational trimester and puerperium. Results: This study found that education is not associated with maternal mortality (p-value > 0.05). On the other hand, the less developed areas-North, Northeast (RR 1.30 [CI95% 1.09-1.40]) and rural areas (RR 1.26 [CI95% 1.19-1.70]), respectivelyare significantly related to higher mortality, as well as the brown (RR 1.13 [95%CI 1.02-1.26]) and black (RR 1.41 [95%CI 1.17-1.71]) populations., women aged over 35 years (RR 2.30 [95%CI 1.77-3.00]), pregnant women in the 2nd trimester (RR 1.61 [95%CI 1.26-2.06]), puerperium (RR 1.99 [95%CI 1.80-2.20]) and/or who were exposed to invasive procedures (RR 26.63 [95%CI 21.87-32.43]). Conclusion: The morbidity and mortality resulting from COVID-19 during pregnancy and the puerperium is directly associated with the sociodemographic and socioeconomic profiles evaluated in the research, except for the level of education. That said, it will be possible to direct measures to reduce maternal deaths related to SARS-CoV-2.
Mortality and morbidity among pregnant women with COVID-19 infection: a meta-analysis
International Journal of Public Health Science (IJPHS), 2022
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and declared as a global pandemic in March 2020. There is a special immune tolerance in pregnant woman, predisposes to a viral infection, then increased risk severe complication. Meta analysis was performed using preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidlines with comprehensive literature study was performed in July 2021 through Science Direct, Cochrane, and PubMed, with keywords "COVID-19", "SARS-CoV-2", "pregnancy", "pregnant", and "complication", and each parameter we assessed using review manager 5.3. Nine studies with 30,257 infected patients and 1,678,974 non infected patients were included. The data show that preterm birth (odds ratio (OR)=1.43, 95% confidence interval (CI): 1.17-1.74; p=0.0004, inconsistency (I2) =90%) less in non infected groups, no camparable finding in vaginal delivery (OR=0.93, 95% CI: 0.82-1.06; p<0.030, I2=75%) and caesarian delivery (OR=1.07, 95% CI: 0.90-1.28; p<0.045, I2=96%). Intensive care unit (ICU) admission reported high percentage in infected patients (OR=4.87, 95% CI: 3.08-7.71; p<0.0001, I2=93%), we found that obstetric complication in subgroup (OR=1.31, 95% CI: 0.13-1.52; p<0.0003, I2=54%) and mortality (OR=17.41, 95% CI: 11.04-27.46; p<0.0001, I2=0%) less in non infected patients. Pregnancy with infected COVID-19 has high percentage of mortality and morbidity events. Infected and non infected patient has equal chance for vaginal or caesarian delivery.
Study of maternal deaths with COVID-19 infection in a tertiary care centre
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2021
Background: COVID-19 has been a major speed braker not only for world economy and development but also for health sector. The susceptible population including elderly, co-morbid adults and pregnant females were likewise affected in both major COVID-19 waves in India. Association between COVID-19 cases and pregnancy has been studied throughout the world.COVID-19 is associated with substantial risk of morbidity and mortality in postpartum patients and their infants world-wide, compared with their not-infected pregnant counter-parts, especially if these individuals were symptomatic or have comorbidities.Methods: This single-centre prospective observational study, included all consecutive maternal mortalities with COVID-19 infection admitted to Lokmanya Tilak municipal medical college and general hospital (Mumbai, India), a tertiary referral hospital, from 1 April 2020, to June 2021.In this study, a total of 390 patients were included who were found COVID-19 positive during the study pe...