From January 1st to July 20th, 2021, throughout Rio Grande do Norte, Covid-19 caused the deaths of 41 pregnant or postpartum women. In some cases, babies also did not survive the disease. The number is practically triple or 192.85% greater than the 14 deaths recorded from the disease last year in the state of Rio Grande do Norte. The survey was carried out by the Santos Dumont Institute (ISD) based on data from the State Department of Public Health (Sesap/RN). Pregnant and postpartum women are part of the risk group for the new coronavirus, and the ISD, through the Anita Garibaldi Health Education and Research Center (Anita), in Macaíba, develops actions with the aim of reducing maternal and child mortality.

One of the women who could not resist the complications caused by the new coronavirus was housewife Maria Aparecida Camilo de Souza, 39 years old. After being admitted twice to the Emergency Care Unit (UPA) in Macaíba with respiratory symptoms characteristic of Covid-19 and not being admitted, she was seen by infectious disease specialist Carolina Damásio, ISD preceptor. Upon noticing the worsening of the disease, the doctor sent Maria Aparecida to the Giselda Trigueiro Hospital, in Natal. She was admitted to an Intensive Care Unit (ICU) bed, but died a few days later. Maria Aparecida was six months pregnant and underwent an emergency cesarean section. The baby was born alive, but did not survive. 

“Pregnancy is a major risk factor for Covid-19. It increases the chance of complications, even if the pregnant woman has no other comorbidities, and also increases the chance of her dying. Therefore, we need to protect and vaccinate pregnant women”, highlights Carolina Damásio. She also reports that pregnant women who sought care at health units in the State already had serious symptoms. “They arrived with difficulty in orientation and monitoring at the beginning of treatment and arrived at hospitals in much more serious condition, requiring intubation”, declares the ISD infectious disease specialist. 

According to the deputy coordinator of Health Surveillance at Sesap/RN, Diana Rego, the increase considered “alarming” in deaths among pregnant and postpartum women was not caused by a more lethal strain of Covid-19, but by the dynamics of the pandemic's advancement in the State. “Between March and May this year we had a spike in deaths among pregnant and postpartum women, who are part of the risk group. There was an alarming spread of the virus during the end of year and summer holidays. There was no specific strain for this group. It was a reflection of the pandemic as a whole. We had alarming numbers”, analyzes Diana Rego. In total, the State recorded, as of this Wednesday (21/07), 55 deaths due to infection by the new coronavirus among people in these groups.

According to the numbers analyzed by the Santos Dumont Institute, between March and May this year, the number of deaths of pregnant or postpartum women reached its peak. In March there were 7; the following month 8, reaching 11 in May (the highest in a month since the start of the pandemic to date). To reduce occurrences, Sesap/RN promoted a specific immunization campaign for women in this context last June. The result was a reduction in deaths among them, with 8 cases in June and 2 between the beginning and the 20th of this month of July.

“We continue to maintain the vaccination dynamics for these groups and actively search for pregnant or postpartum women of all ages. The ideal is for all of them to take the vaccine against Covid-19 regardless of their age”, highlights Diana Rego. 

Brazil

In June this year, the Oswaldo Cruz Foundation (Fiocruz) published a survey with national data on the deaths of women in these groups. The situation of death of pregnant and postpartum women due to Covid-19, according to experts, worsens the critical problem of maternal mortality that Brazil has been experiencing for years. They note that this concern grew as Covid-19 began to present conditions that escaped the rule of a classic respiratory syndrome, but with a systemic effect. 

“In addition to the risk due to this biological plausibility, maternal mortality is strongly influenced by access and availability of care resources for prenatal care, childbirth and the postpartum period”, they highlight. The study points out that, in 2020, they were reported in the country. 560 deaths from Covid-19 in pregnant and postpartum women. In 2021, until the closing of this analysis (in June), maternal deaths had already surpassed the number reported in the previous year: 1,156 deaths were recorded, more than double the number in 2020. The majority of them, according to the analysis, occur during pregnancy and not in the postpartum period.

National law

In May of this year, the Presidency of the Republic sanctioned Law 14,151, which provides for “the removal of pregnant employees from face-to-face work activities during the public health emergency of national importance resulting from the new coronavirus”. The document regulates the removal of women in this profile from face-to-face work activities, without prejudice to their remuneration.

“The employee on leave (…) will be available to carry out activities at home, through teleworking, remote work or another form of distance work”, says the sole paragraph of the law in reference.