ArticlePloS one2022
Excess maternal mortality in Brazil: Regional inequalities and trajectories during the COVID-19 epidemic.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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28 citing papers in PubMed, 66 citations in OpenAlex.
- Temporal trends in Group B Streptococcus colonization, serotype distribution, and antimicrobial resistance among pregnant women in the Brazilian Amazon across the COVID-19 pandemic, 2018-2023.International microbiology : the official journal of the Spanish Society for Microbiology · 2026Article
- Persistent subnational disparities in the recovery of maternal mortality magnitude in Brazil after the COVID-19 pandemic.BMC pregnancy and childbirth · 2026Article
- Factors Associated with Maternal Mortality from COVID-19 in Pernambuco, Brazil (2020-2021): A Case-Control Study.Diseases (Basel, Switzerland) · 2026Article
- Maternal Mortality Among Black Women in Brazil: A Retrospective Cohort Study.International journal of environmental research and public health · 2026Article
- A Comprehensive Strategy to Mitigate Institutional Maternal Mortality: Lessons From a Quality Improvement Initiative in Brazilian Maternity Hospitals.Global health, science and practice · 2025Article
- Strengthening equity and anti-racism in women's care: a quality improvement initiative reducing institutional maternal mortality in Brazil.International journal for equity in health · 2025Article
- Article
- Sex-specific public health data: analyzing the arboviral impact on women in Brazil.Revista de saude publica · 2025Article
- Effect of COVID-19 vaccination on the incidence, lethality and mortality of pregnant and postpartum women.PloS one · 2025Article
- Maternal and late mortality trends, emphasizing the H1N1 and COVID-19 pandemics, in the state of Rio de Janeiro, Brazil, from 2009 to 2021.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2025Article
- Sex- and age-specific differences in excess mortality in China during the COVID-19 pandemic: a study based on official vital statistics data.Frontiers in epidemiology · 2025Article
- Maternal mortality in Goiás: Causes of maternal death and barriers to underreporting.PLOS global public health · 2025Article
- [Overall excess mortality and COVID-19 mortality in Brazil and Brazilian regions in 2020].Cadernos de saude publica · 2025Article
- Social vulnerability and severe COVID-19 in pregnant women: an ecological study in Pernambuco State, Brazil, 2020-2021.Cadernos de saude publica · 2025Article
- Spatial analysis of maternal mortality in Pernambuco before and during the COVID-19 pandemic.Revista brasileira de enfermagem · 2025Article
- Analysis of the influence of the COVID-19 pandemic on maternal mortality trends, 2011-2021.Revista latino-americana de enfermagem · 2025Article
- Time series analysis of comprehensive maternal deaths in Brazil during the COVID-19 pandemic.Scientific reports · 2024Article
- Ethno-racial inequalities on adverse birth and neonatal outcomes: a nationwide, retrospective cohort study of 21 million Brazilian newborns.Lancet regional health. Americas · 2024Article
- Influence of sociodemographic and obstetric factors on maternal mortality in Brazil from 2011 to 2021.BMC women's health · 2024Article
- Maternal mortality: protocol of a study integrated to the Birth in Brazil II survey.Cadernos de saude publica · 2024Article
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe COVID-19 pandemic has exceeded 6 million known disease-related deaths and there is evidence of an increase in maternal deaths, especially in low- and middle-income countries. We aimed to estimate excess maternal deaths in Brazil and its macroregions as well as their trajectories in the first 15 months of the COVID-19 epidemic.
methodsThis study evaluated maternal deaths from the Mortality Information System of the Ministry of Health, with excess deaths being assessed between March 2020 and May 2021 by quasi-Poisson generalized additive models adjusted for overdispersion. Observed deaths were compared to deaths expected without the pandemic, accompanied by 95% confidence intervals according to region, age group, and trimester of occurrence. Analyses were conducted in R version 3.6.1 and RStudio version 1.2.1335.
resultsThere were 3,291 notified maternal deaths during the study period, resulting in a 70% excess of deaths regardless of region, while in the North, Northeast, South and Southeast regions, excess deaths occurred regardless of age group. Excess deaths occurred in the March-May 2021 trimester regardless of region and age group. Excess deaths were observed in the Southeast region for the 25-36-year-old age group regardless of the trimester assessed, and in the North, Central-West and South regions, the only period in which excess deaths were not observed was September-November 2020. Excess deaths regardless of trimester were observed in the 37-49-year-old age group in the North region, and the South region displayed explosive behavior from March-May 2021, with a 375% excess of deaths.
conclusionsExcess maternal deaths, with geographically heterogenous trajectories and consistently high patterns at the time of the epidemic's greatest impact, reflect not only the previous effect of socioeconomic inequalities and of limited access to maternal health services, but most of all the precarious management of Brazil's health crisis.
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