Óbito em gestante e puérperas acometidas por covid-19: estado da Bahia.

Abstract

The COVID-19 pandemic changed the panorama of the reason for maternal mortality in Brazil and the world. The state of Bahia ranks first in the percentage of pregnant and postpartum women who died from the disease in relation to other states in the Northeast. This study aimed to describe the demographic characteristics, signs/symptoms, and access/supply to health resources for pregnant and postpartum women with COVID-19 and to verify the association between death from COVID-19 and signs/symptoms and access/supply to health resources in the State of Bahia, from March 2020 to December 2023.This is a cross-sectional study, with 636 pregnant and postpartum women diagnosed with COVID-19. The data were obtained from the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe), available at the Brazilian Obstetric Observatory (OObr). In analyzing the study, the Statistical Package for the Social Sciences (SPSS) program version 25.0® was used. The chi-square statistical test and Fisher's exact test were applied at a statistical significance level of 5% (p < 0.05). Our findings showed that the number of infected pregnant women was higher in relation to the group of postpartum women, but in relation to the outcome of death, the group of postpartum women stood out. Regarding demographic characteristics, the majority of pregnant and postpartum women belonged to the Eastern health macro-region, lived in an urban/peri-urban area, declared themselves black, used the public health service and were aged between 20 and 34 years old. Regarding the signs/symptoms presented in pregnant and postpartum women, fever, cough, sore throat, dyspnea, respiratory discomfort and O2 saturation <95% were noted. For the group of pregnant women, the results showed an association between death and signs and symptoms related to respiratory distress and O2 saturation < 95%. Regarding access/supply of health resources for this group, there was an association between progression to death and needing an Intensive Care Unit and using ventilatory support. With regard to postpartum women, our findings demonstrated that there is an association between having presented signs and symptoms of sore throat, dyspnea, respiratory distress and O2 saturation < 95%, and death. Regarding access/supply of health resources used during the hospitalization period, it is noted that postpartum women with an unfavorable outcome had a higher percentage of use of ventilatory support and health care in the ICU. Attention is drawn to the use of vaccination against COVID-19, it was observed that, both in the group of postpartum women and pregnant women, women who received the vaccine did not die; and although our results showed an association only for the group of postpartum women, the percentage differences also in the group of pregnant women signal the protective factor of the immunizer. The early identification of signs of severity is relevant for the management and management of cases and confirms the need to strengthen health promotion, prevention and reduction in the number of deaths due to COVID-19, especially in the health care scenario of woman. Keywords: Severe acute respiratory syndrome; maternal mortality; COVID-19; Epidemiological Surveillance Services.