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Mortality in pregnancy and the postpartum period in women with severe acute respiratory distress syndrome related to COVID‐19 in Brazil, 2020
Author(s) -
Scheler Carlos A.,
Discacciati Michelle G.,
Vale Diama B.,
Lajos Giuliane J.,
Surita Fernanda,
Teixeira Julio C.
Publication year - 2021
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13804
Subject(s) - ards , medicine , etiology , case fatality rate , comorbidity , pregnancy , obstetrics , mortality rate , postpartum period , pediatrics , epidemiology , lung , biology , genetics
Objective To estimate fatality rates due to severe acute respiratory distress syndrome (ARDS) related to COVID‐19 in Brazilian women, comparing pregnant and postpartum women with nonpregnant women. Methods A cross‐sectional study of 12 566 pregnant and postpartum women (obstetric group) and 90 025 nonpregnant women (nonobstetric group) aged 15–49 years reported with severe ARDS in 2020. The Brazilian ARDS Surveillance System was used to compare the outcome (death or cure) between the groups, considering age, race, or comorbidities. Results The mortality rate related to ARDS/COVID‐19 in the obstetric group was 7.8% (377/4853) compared with 13.9% (5946/42 915) in the nonobstetric group. Comorbidity was associated with increased fatality cases for both groups, but higher in the nonobstetric group (22.8% vs 13.3%). In the obstetric group, deaths related to COVID‐19 were concentrated in the third trimester or postpartum period. If comorbidity was present, deaths by COVID‐19 were 4.4 times higher than ARDS due to other etiologies, and twice higher in women who self‐reported as black (13.7%) than white women (6.7%). Considering ADRS etiology, deaths by COVID‐19 were 3.4–6.7 times higher than any other etiology. Conclusion ARDS related to COVID‐19 in obstetric patients was an important factor for worse clinical outcomes, with 3–6 times higher death rates than other ARDS etiologies. Pregnant and postpartum women with severe ARDS related to COVID‐19 had a lower fatality rate than nonpregnant women, even with associated comorbidity.