Epidemiological analysis of maternal mortality in the state of Parana: the impact of the COVID-19 pandemic

Abstract

Introduction: Maternal mortality is a significant indicator in Brazilian public policies concerning women's health care. The Rede Mãe Paranaense program works to decrease these indicators, but the impacts of the pandemic on maternal-fetal mortality are not yet understood. Objectives: To analyze Maternal Mortality in the years 2015-2019 and compare it to the year 2020 in Paraná. Methods: Retrospective documentary study, through data collection from the DATASUS/SIM program. Results: An increase in indirect maternal deaths was observed, specifically in the ICD-10 category O98 (Maternal infectious and parasitic diseases [...]), which included deaths caused by COVID-19 (p < 0.0001). Puerperal deaths predominated, especially in the white population, with infectious and parasitic diseases being the main indirect causes. A relative comparison of the periods demonstrated that indirect deaths in 2020 exceeded the average of the previous 5 years, indicating the impact of COVID-19 on maternal mortality. Discussion: In both studied periods, deaths occurred predominantly in a hospital setting. However, in 2020, the proportion of deaths in hospitals increased from 76% to 91%, reflecting a consequence of the elevated maternal mortality due to the COVID-19 pandemic and higher rates of complications in the pregnancies of these patients. Conclusion: The pattern disruption of indirect maternal mortality demonstrated the significant impact of the COVID-19 pandemic on maternal health. Further studies should analyze and compare additional variables, due to the nature of the study and the sample taken from a specific state in Brazil limit the generalization of findings to other locations and populations. Additionally, epidemiological data collection research can serve as a planning tool to formulate intervention and prevention strategies for comorbidities that directly and indirectly influence pregnancies.