[Excess of maternal deaths among immigrants, during the pandemic, in Brazil]

The aim of this study was to analyze the effect of the COVID-19 pandemic on maternal mortality among immigrants in Brazil. This was a descriptive study of maternal deaths that occurred between 2014 and 2021. The frequency of deaths and underlying causes of death were analyzed. The ratio between the average number of deaths before and during the pandemic were calculated. Of the 14,205 deaths, 136 were immigrants and 14,069 were Brazilian. The excess mortality was higher for immigrants (2.10; 1.40-3.04) than for Brazilian women (1.53; 1.40-1.59), with a significant increase for Venezuelans (7.46; 2.40-17.42) and Haitians (3.67; 2.11-5.91). Before the pandemic, direct obstetric causes predominated, accounting for more than 60% of deaths. During the pandemic, indirect obstetric causes gained importance, with the main one being "other viral diseases complicating pregnancy, childbirth and the puerperium (ICD-10 O98.5)", with 33.93% of deaths for immigrants and 39.44% for natives. In this group of causes, the codes related to COVID-19 infection for immigrants (94.7%) and Brazilians (97.8%) stand out. There was an excess of maternal deaths during the pandemic, with greater intensity for Venezuelans and Haitians, when compared to Brazilian women, suggesting greater difficulty in timely access to health services for immigrants.