Factors Associated with Maternal Mortality from COVID-19 in Pernambuco, Brazil (2020-2021): A Case-Control Study.

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Public Health

Background:

• COVID-19 pandemic exacerbated maternal mortality globally.
• Increased maternal deaths linked to direct viral effects and strained healthcare systems.
• Study focuses on factors contributing to maternal deaths in Pernambuco, Brazil (2020-2021).

Purpose of the Study:

• To identify sociodemographic, gestational, and clinical factors associated with COVID-19-related maternal deaths.
• To analyze risk and protective factors in a specific high-impact region.
• To inform public health strategies for mitigating maternal mortality during health crises.

Main Methods:

• Case-control study comparing 37 maternal deaths (cases) with 112 survivors (controls).
• Utilized conditional and Firth's penalized logistic regression for crude and adjusted odds ratios.
• Evaluated sociodemographic, gestational, and clinical variables.

Main Results:

• Postpartum period, parity (≥1), and oxygen saturation <95% were independently associated with increased maternal death risk.
• Fever was identified as a potential protective factor against maternal death.
• Obesity and diabetes mellitus were not independent predictors in the final model, despite initial bivariate associations.

Conclusions:

• Maternal death is a complex, multifactorial issue exacerbated by pandemics.
• Identified clinical and obstetric vulnerabilities highlight the need for targeted interventions.
• Findings support improving public health strategies and clinical protocols to prevent future maternal deaths in emergencies.