Maternal mortality linked to COVID-19 in Latin America: Results from a multi-country collaborative database of 447 deaths

Fabian Maza-Arnedo; Angel Paternina-Caicedo; Claudio G. Sosa; Bremen de Mucio; José Rojas-Suarez; Lale Say; Jenny A. Cresswell; Luis Andrés de Francisco; Suzanne Serruya; Diana Carolina Franco Pulido Lic; Luis Urbina; Erika Saint Hilaire; César V. Munayco; Fabiola Gil; Erick Rousselin; Leonardo Contreras; Allan Stefan; Alvinzy Velásquez Becerra; Evelyn Degraff; Franco Espada; Victor 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; Haydee Padilla; Alvaro Ciganda; Mercedes Colomar

doi:10.1016/j.lana.2022.100269

Maternal mortality linked to COVID-19 in Latin America: Results from a multi-country collaborative database of 447 deaths

Fabian Maza-Arnedo
, Angel Paternina-Caicedo
, Claudio G. Sosa
, Bremen de Mucio
, José Rojas-Suarez
, Lale Say
, Jenny A. Cresswell
, Luis Andrés de Francisco
, Suzanne Serruya
, Diana Carolina Franco Pulido Lic
, Luis Urbina
, Erika Saint Hilaire
, César V. Munayco
, Fabiola Gil
, Erick Rousselin
, Leonardo Contreras
, Allan Stefan
, Alvinzy Velásquez Becerra
, Evelyn Degraff
, Franco Espada

Victor 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, Haydee Padilla, Alvaro Ciganda, Mercedes Colomar

Universidad de Cartagena
Universidad del Sinú
Women's Health
Corporación Universitaria Rafael Núñez
World Health Organization
Pan American Health Organization
District Health Secretariat of Bogota
PAHO Representation
San Lorenzo de Los Mina Children Maternity Hospital
Ministerio de Salud, Lima
PAHO Representation
PAHO Representation
Dr Leonardo Martínez Valenzuela Hospital
Alcaldía Mayor de Bogotá
Health and Sports Ministry
PAHO Representation
Family
Ministerio de Salud y Protección Social
PAHO Representation
National Epidemiological Surveillance Directorate
Ministry of Public Health and Welfare
Universidad Nacional de Asunción
PAHO Representation
Clinical and Research Unit (UNICEM)

Research output: Contribution to journal › Article › peer-review

45 Scopus citations

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.

Original language	English
Article number	100269
Journal	The Lancet Regional Health - Americas
Volume	12
DOIs	https://doi.org/10.1016/j.lana.2022.100269
State	Published - Aug 2022
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

COVID-19
Maternal death
Maternal mortality
Pregnancy
Puerperium
SARS-CoV-2

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10.1016/j.lana.2022.100269

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Maza-Arnedo, F., Paternina-Caicedo, A., Sosa, C. G., de Mucio, B., Rojas-Suarez, J., Say, L., Cresswell, J. A., de Francisco, L. A., Serruya, S., Lic, D. C. F. P., Urbina, L., Hilaire, E. S., Munayco, C. V., Gil, F., Rousselin, E., Contreras, L., Stefan, A., Becerra, A. V., Degraff, E., ... Colomar, M. (2022). Maternal mortality linked to COVID-19 in Latin America: Results from a multi-country collaborative database of 447 deaths. The Lancet Regional Health - Americas, 12, Article 100269. https://doi.org/10.1016/j.lana.2022.100269

@article{8d74b2d6672b484291217433df5cb298,

title = "Maternal mortality linked to COVID-19 in Latin America: Results from a multi-country collaborative database of 447 deaths",

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.",

keywords = "COVID-19, Maternal death, Maternal mortality, Pregnancy, Puerperium, SARS-CoV-2",

author = "Fabian Maza-Arnedo and Angel Paternina-Caicedo and Sosa, \{Claudio G.\} and \{de Mucio\}, Bremen and Jos{\'e} Rojas-Suarez and Lale Say and Cresswell, \{Jenny A.\} and \{de Francisco\}, \{Luis Andr{\'e}s\} and Suzanne Serruya and Lic, \{Diana Carolina Franco Pulido\} and Luis Urbina and Hilaire, \{Erika Saint\} and Munayco, \{C{\'e}sar V.\} and Fabiola Gil and Erick Rousselin and Leonardo Contreras and Allan Stefan and Becerra, \{Alvinzy Vel{\'a}squez\} and Evelyn Degraff and Franco Espada and Victor Conde and Gustavo Mery and Casta{\~n}o, \{V{\'i}ctor Hugo {\'A}lvarez\} and Umbarila, \{Aura Liliana Torres\} and Romero, \{Ivy Lorena Talavera\} and Alfonso, \{Yeimy Catherine Rodr{\'i}guez\} and \{Lovato Silva\}, Raquel and Jakeline Calle and \{D{\'i}az -Viscensini\}, \{Cynthia Marlene\} and Frutos, \{Vicente Nicolas Bataglia\} and Laguardia, \{Elodia Vysokol{\'a}n\} and Haydee Padilla and Alvaro Ciganda and Mercedes Colomar",

note = "Publisher Copyright: {\textcopyright} 2022 Pan American Health Organization",

year = "2022",

month = aug,

doi = "10.1016/j.lana.2022.100269",

language = "Ingl{\'e}s",

volume = "12",

journal = "The Lancet Regional Health - Americas",

issn = "2667-193X",

publisher = "Elsevier Ltd",

}

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 2022, 'Maternal mortality linked to COVID-19 in Latin America: Results from a multi-country collaborative database of 447 deaths', The Lancet Regional Health - Americas, vol. 12, 100269. https://doi.org/10.1016/j.lana.2022.100269

TY - JOUR

T1 - Maternal mortality linked to COVID-19 in Latin America

T2 - Results from a multi-country collaborative database of 447 deaths

AU - Maza-Arnedo, Fabian

AU - Paternina-Caicedo, Angel

AU - Sosa, Claudio G.

AU - de Mucio, Bremen

AU - Rojas-Suarez, José

AU - Say, Lale

AU - Cresswell, Jenny A.

AU - de Francisco, Luis Andrés

AU - Serruya, Suzanne

AU - Lic, Diana Carolina Franco Pulido

AU - Urbina, Luis

AU - Hilaire, Erika Saint

AU - Munayco, César V.

AU - Gil, Fabiola

AU - Rousselin, Erick

AU - Contreras, Leonardo

AU - Stefan, Allan

AU - Becerra, Alvinzy Velásquez

AU - Degraff, Evelyn

AU - Espada, Franco

AU - Conde, Victor

AU - Mery, Gustavo

AU - Castaño, Víctor Hugo Álvarez

AU - Umbarila, Aura Liliana Torres

AU - Romero, Ivy Lorena Talavera

AU - Alfonso, Yeimy Catherine Rodríguez

AU - Lovato Silva, Raquel

AU - Calle, Jakeline

AU - Díaz -Viscensini, Cynthia Marlene

AU - Frutos, Vicente Nicolas Bataglia

AU - Laguardia, Elodia Vysokolán

AU - Padilla, Haydee

AU - Ciganda, Alvaro

AU - Colomar, Mercedes

PY - 2022/8

Y1 - 2022/8

N2 - 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.

AB - 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.

KW - COVID-19

KW - Maternal death

KW - Maternal mortality

KW - Pregnancy

KW - Puerperium

KW - SARS-CoV-2

UR - https://www.scopus.com/pages/publications/85129981621

U2 - 10.1016/j.lana.2022.100269

DO - 10.1016/j.lana.2022.100269

M3 - Artículo

AN - SCOPUS:85129981621

SN - 2667-193X

VL - 12

JO - The Lancet Regional Health - Americas

JF - The Lancet Regional Health - Americas

M1 - 100269

ER -

Maternal mortality linked to COVID-19 in Latin America: Results from a multi-country collaborative database of 447 deaths

Abstract

UN SDGs

Keywords

Access to Document

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