Factors associated with death among postpartum women with COVID-19: a Brazilian population-based study.
Anelise de Toledo Bonatti, Nathassia Miller, Maria Antonieta de Barros Leite Carvalhaes and 2 others
PMID 34816876WHAT IT FOUND
Among Brazilian postpartum women with lab-confirmed COVID-19, dyspnea, respiratory distress, oxygen saturation below 95%, ventilatory support, and ICU admission were linked to death.
Older age, Afro-descendant race, and Northeast residence were linked in one period.
Key findings
01Dyspnea, respiratory distress, and oxygen saturation below 95% were associated with higher odds of death in both study periods.
02Need for ventilatory support and ICU admission were associated with higher odds of death in both study periods.
03In the first period, age 35 or older was associated with higher odds of death; in the second period, Afro-descendant race and Northeast residence were associated with higher odds of death.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary database study, not a treatment trial, so it cannot show that any factor caused death. Testing was mainly symptom-based, so milder or untested postpartum infections may be missing. Missing data were common for race and nosocomial infection, and blank comorbidity or symptom fields were counted as absent, which can bias associations. Deaths may have been underreported because data were collected close to the end of the study period and the database is continually updated. The study included only postpartum women with recorded outcomes, so results may not apply to pregnant women, miscarriage, or fetal loss. The narrative and the table differ for some second-period respiratory odds ratios. The protective association for multiple clinical symptoms in the first period was unexplained by the authors.
The easy way to misread this
Do not read the lower death proportion in the second period as proof that monitoring or treatment changes caused it. This was a population surveillance study with possible underreporting and no intervention comparison.