Maternal deaths due to COVID-19 in Recife, Brazil (2020-2021): Case Series

Abstract

Introduction:  the COVID-19 pandemic has had a strong impact on maternal health, amplifying biological and social vulnerabilities and highlighting regional inequalities. In Brazil, pregnant and postpartum women showed a high risk of complications and death, particularly in regions with limited health system response capacity. This study aimed to describe the clinical and care profile of maternal deaths due to COVID-19 in Recife, Brazil, between 2020 and 2021.

Description:  eighteen cases of maternal deaths due to COVID-19 were analyzed, based on records from the Mortality Information System of the Brazilian Unified Health System (SIM/SUS) and the Municipal Committee on Maternal Mortality (CMMM) of the city of Recife. Most women were 20-35 years old, of mixed race, and had comorbidities, mainly hypertensive syndromes (60.9%) and obesity (33.3%). Dyspnea and dry cough were the most common symptoms. Cesarean section was the predominant delivery route (61.1%), and 83.3% required intensive care, with mechanical ventilation used in 94.4% of cases. The CMMM classified 72.2% of the deaths as preventable, and the most frequent underlying causes were acute respiratory distress syndrome and septic shock.

Discussion:  the findings reveal high clinical severity and persistent weaknesses in obstetric care, reflected in delayed transfers and a high proportion of preventable deaths. Maternal deaths from COVID-19 expose structural inequalities and reinforce the need to strengthen epidemiological surveillance, improve data recording, and expand access to timely and qualified obstetric intensive care.

key words
Maternal mortality; COVID-19; Coronavirus infections; Maternal health; Pregnancy