1
|
Maza-Arnedo F, Paternina-Caicedo A, Sosa CG, de Mucio B, Rojas-Suarez J, Say L, Cresswell JA, de Francisco LA, Serruya S, Lic DCFP, Urbina L, Hilaire ES, Munayco CV, Gil F, Rousselin E, Contreras L, Stefan A, Becerra AV, Degraff E, Espada F, Conde V, Mery G, Castaño VHÁ, Umbarila ALT, Romero ILT, Alfonso YCR, Lovato Silva R, Calle J, Díaz -Viscensini CM, Frutos VNB, Laguardia EV, Padilla H, Ciganda A, Colomar M. Maternal mortality linked to COVID-19 in Latin America: Results from a multi-country collaborative database of 447 deaths. Lancet Reg Health Am 2022; 12:100269. [PMID: 35539820 PMCID: PMC9073212 DOI: 10.1016/j.lana.2022.100269] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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.
Collapse
Affiliation(s)
- Fabian Maza-Arnedo
- Grupo de Investigación en Cuidados Intensivos y Obstetricia (GRICIO), Universidad de Cartagena, Colombia
| | | | - Claudio G. Sosa
- Latin American Center for Perinatology, Women's Health, and Reproductive Health (CLAP/WR), Montevideo, Uruguay
| | - Bremen de Mucio
- Latin American Center for Perinatology, Women's Health, and Reproductive Health (CLAP/WR), Montevideo, Uruguay
| | - José Rojas-Suarez
- Grupo de Investigación en Cuidados Intensivos y Obstetricia (GRICIO), Universidad de Cartagena, Colombia,Corporación Universitaria Rafael Núñez, Cartagena, Colombia
| | - Lale Say
- Department of Sexual and Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Jenny A. Cresswell
- Department of Sexual and Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Luis Andrés de Francisco
- Family, Health Promotion and Life Course (FPL), Pan American Health Organization-World Health Organization, United States
| | - Suzanne Serruya
- Latin American Center for Perinatology, Women's Health, and Reproductive Health (CLAP/WR), Montevideo, Uruguay
| | | | | | - Erika Saint Hilaire
- San Lorenzo de Los Mina Children Maternity Hospital, Santo Domingo, Dominican Republic
| | - César V. Munayco
- National Epidemiology, Prevention, and Disease Control Center, Ministry of Health, Perú
| | - Fabiola Gil
- National Epidemiology, Prevention, and Disease Control Center, Ministry of Health, Perú
| | | | | | - Allan Stefan
- Dr Leonardo Martínez Valenzuela Hospital, San Pedro Sula, Honduras
| | | | | | | | | | - Gustavo Mery
- Family, Promotion and Life Course, PAHO Representation, Costa Rica
| | | | | | | | | | | | - Jakeline Calle
- Ministry of Public Health and Welfare, Asunción, Paraguay
| | | | | | | | | | - Alvaro Ciganda
- Clinical and Research Unit (UNICEM), Montevideo, Uruguay
| | - Mercedes Colomar
- Latin American Center for Perinatology, Women's Health, and Reproductive Health (CLAP/WR), Montevideo, Uruguay,Clinical and Research Unit (UNICEM), Montevideo, Uruguay,Corresponding author at: Latin American Center for Perinatology, Women's Health, and Reproductive Health (CLAP/WR), Montevideo, Uruguay.
| |
Collapse
|