Excess maternal mortality in Brazil: Regional inequalities and trajectories during the COVID-19 epidemic

• DOI: 10.1371/journal.pone.0275333
• Publication Date: 2022-10-20T18:33:30Z
• Authors: Jesem Orellana; Nadège Jacques; Daniel Gray Pasch...; Lihsieh Marrero; Lina Sofía Morón-...
• Keywords: 2019-20 coronavirus outbreak; Pandemic; Betacoronavirus; Epidemic model; Coronavirus Infections; Excess mortality

Background The COVID-19 pandemic has exceeded 6 million known disease-related deaths and there is evidence of an increase in maternal deaths, especially low- middle-income countries. We aimed to estimate excess Brazil its macroregions as well their trajectories the first 15 months epidemic. Methods This study evaluated from Mortality Information System Ministry Health, with being assessed between March 2020 May 2021 by quasi-Poisson generalized additive models adjusted for overdispersion. Observed were compared expected without pandemic, accompanied 95% confidence intervals according region, age group, trimester occurrence. Analyses conducted R version 3.6.1 RStudio 1.2.1335. Results There 3,291 notified during period, resulting a 70% regardless while North, Northeast, South Southeast regions, occurred group. Excess March-May region observed 25-36-year-old group assessed, Central-West only period which not was September-November 2020. 37-49-year-old North displayed explosive behavior 2021, 375% deaths. Conclusions geographically heterogenous consistently high patterns at time epidemic’s greatest impact, reflect previous effect socioeconomic inequalities limited access health services, but most all precarious management Brazil’s crisis.