University of California, Los Angeles, USA.
New York University, New York, USA.
Sci Rep. 2024 Oct 14;14(1):23960. doi: 10.1038/s41598-024-74704-x.
The effects of the COVID-19 pandemic on comprehensive maternal deaths in Brazil have not been fully explored. Using publicly available data from the Brazilian Mortality Information (SIM) and Information System on Live Births (SINASC) databases, we used two complementary forecasting models to predict estimates of maternal mortality ratios using maternal deaths (MMR) and comprehensive maternal deaths (MMRc) in the years 2020 and 2021 based on data from 2008 to 2019. We calculated national and regional standardized mortality ratio estimates for maternal deaths (SMR) and comprehensive maternal deaths (SMRc) for 2020 and 2021. The observed MMRc in 2021 was more than double the predicted MMRc based on the Holt-Winters and autoregressive integrated moving average models (127.12 versus 60.89 and 59.12 per 100,000 live births, respectively). We found persisting sub-national variation in comprehensive maternal mortality: SMRc ranged from 1.74 (95% confidence interval [CI] 1.64, 1.86) in the Northeast to 2.70 (95% CI 2.45, 2.96) in the South in 2021. The observed national estimates for comprehensive maternal deaths in 2021 were the highest in Brazil in the past three decades. Increased resources for prenatal care, maternal health, and postpartum care may be needed to reverse the national trend in comprehensive maternal deaths.
COVID-19 大流行对巴西综合产妇死亡率的影响尚未得到充分探索。利用巴西死亡率信息（SIM）和活产信息系统（SINASC）数据库中公开提供的数据，我们使用两种互补的预测模型，根据 2008 年至 2019 年的数据，使用产妇死亡（MMR）和综合产妇死亡（MMRc）预测 2020 年和 2021 年的产妇死亡率（MMR）估计值。我们计算了 2020 年和 2021 年全国和地区产妇死亡（SMR）和综合产妇死亡（SMRc）的标准化死亡率估计值。2021 年观察到的综合产妇死亡率（MMRc）是基于霍尔特-温特斯和自回归综合移动平均模型预测的 MMRc 的两倍多（分别为每 10 万活产 127.12、60.89 和 59.12）。我们发现综合产妇死亡率仍存在持续的国家以下差异：2021 年，南部的 SMRc 范围为 1.74（95%置信区间[CI]1.64，1.86）至 2.70（95%CI2.45，2.96），而东北部的 SMRc 为 1.74（95%置信区间[CI]1.64，1.86）。2021 年观察到的全国综合产妇死亡估计值是巴西过去三十年来的最高值。可能需要增加产前护理、产妇保健和产后护理方面的资源，以扭转全国综合产妇死亡的趋势。
