Spatial analysis of maternal mortality in Pernambuco before and during the COVID-19 pandemic.
Henry Johnson Passos de Oliveira, Cristine Vieira do Bonfim, Amanda Priscila de Santana Cabral Silva
PMID 41172490WHAT IT FOUND
Maternal deaths in Pernambuco rose during the pandemic: 242 of 467 deaths occurred in 2020-2022, and the 2020 maternal mortality ratio was 77 per 100,000 live births, up from 47.2 in 2019.
Priority clusters were in the Agreste region.
Key findings
01Maternal deaths increased in the pandemic triennium: 242 of 467 deaths occurred then, and the 2020 maternal mortality ratio was 77 per 100,000 live births compared with 47.2 in 2019.
02Deaths were mostly in the puerperium and hospital, with hypertension and bleeding leading pre-pandemic and COVID-19 leading during the pandemic.
03Maternal mortality ratios clustered geographically rather than falling randomly, with priority clusters in the Agreste region in both periods.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used secondary death and birth records, so incomplete or incorrect death certificates can underreport maternal deaths and affect the ratio. The 2022 data were provisional and could change. Because the analysis was ecological, it describes municipality-level patterns and cannot be used to infer individual cause-effect. No comparison group or tested intervention was included, so the paper cannot show which health service changes reduced or increased mortality. Spatial smoothing changed the number of municipalities classified as high or very high, so the maps should not be read as exact individual risk.
Declared interests
The research was funded by the Pernambuco Foundation for Science and Technology through the PPSUS/PE-2020 shared health management program. The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not read the higher maternal mortality ratio during the pandemic as proof that COVID-19 caused all deaths. The study is ecological, uses death certificate data, and cannot show cause-effect at the individual level.