Rise in deaths among pregnant women from Covid-19 worries Brazil

RIO DE JANEIRO, BRAZIL – The sharp increase in deaths among pregnant women from Covid-19 worries Brazilian authorities, who, amid a worsening pandemic, have called for postponing pregnancy plans and accelerating the vaccination of expectant mothers.

The average number of deaths of pregnant women from Covid-19 has doubled in Brazil in 2021 compared to 2020, increasing that specialists attribute to the spread of new variants and the country’s fragile health policies.

Between January and April of this year alone, at least 433 pregnant women or women who recently gave birth lost their lives due to covid-19, compared to the 546 deaths recorded throughout last year, according to data released by the Ministry of Health.

Likewise, a report by the Brazilian Obstetric Observatory Covid-19, maintained by researchers from three Brazilian universities, showed that the weekly average of deaths increased by 62% this year in the general population. At the same time, among pregnant women and puerperal (recent postpartum) women, this growth was 186%.

“Pregnant women who become infected with Covid have a higher risk of developing poorly and needing intensive care and intubation, which is also a risk for the pregnancy,” said professor and physician Rossana Pulcineli Vieira Francisco, one of the creators of the Observatory.

The researcher explained that, due to the physiological changes in the body during pregnancy, pregnant women are more exposed to the risk of infection and the development of complications. Still, she pointed out that the danger is “aggravated” by a “health system that already has many weaknesses in the care of pregnant women and postpartum women.”

With almost 400,000 deaths and 14.4 million infected by the coronavirus, Brazil has seen its health system on the verge of collapse, with a good part of the intensive care units overflowing and in the midst of a lack of drugs to keep critically ill patients intubated.

The situation was further exacerbated by the spread of new variants of the coronavirus, which have already proved to be more contagious than the original strain and led to a rapid escalation of the disease, especially among the younger population that gets pregnant the most.

LACK OF BASIC AND ADVANCED CARE

Given the catastrophic scenario in the country’s hospitals, Pulcineli pointed out that one in five pregnant women who developed severe cases of Covid-19 did not have access to intensive care. At the same time, one in three of those admitted to the ICU was never intubated.

“The high mortality in this population is a consequence of an unstructured and fragile health system for pregnant women’s health care, which was aggravated and worsened by the increased demand for Covid-19,” she said.

With more than 210 million inhabitants, Brazil has a maternal death rate of 55 women deaths per 100,000 live births, a rate much higher than the ideal stipulated by the World Health Organization (WHO) of 20 deaths per 100,000 births.

The president of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo), Agnaldo Lopes, pointed out that pregnant and puerperal women are a “very peculiar population that requires special care,” especially in more serious cases.

“In addition to these risks, the numbers of pregnant women who died without access to high complexity units reflects the entire health system and the complete collapse in our system that we are experiencing,” he stressed.

MINISTRY RECOMMENDS POSTPONING PREGNANCY AND VACCINATING PREGNANT WOMEN

In the midst of the rampant advance of the pandemic and the appearance of new strains of the virus in the country, the Ministry of Health recently recommended that Brazilian women, if possible, postpone their pregnancy plans.

In addition, this week, the Ministry included pregnant and postpartum women in the priority vaccination group, considering that they “have a high obstetric risk regardless of age.”

Thus, both Pulcineli and Lopes were in favor of the vaccination of these women, as long as the decision is previously discussed with their doctors, and defended the dialogue with specialists on the postponement or not of the pregnancy, since it is a “personal decision” that involves “multiple factors”.

“Our role is to inform that pregnant and puerperal women have a higher risk of developing poorly if they contract Covid and that in Brazil we have a very high mortality rate due to Covid in this group”, said Pulcineli.