Tracking excess of maternal deaths directly and indirectly associated with covid-19 in brazil: a nationwide database analysis

Abstract The COVID-19 pandemic brought a new challenge to maternal mortality in Brazil. Throughout 2020, Brazil registered 549 maternal deaths, mainly concentrated in second and third-trimester pregnant women. We estimate the excess of maternal mortality for Brazil in 2020. Assuming the average number of previous years as expected, or even correcting the expectation for excess female mortality due to COVID-19, we found that maternal mortality was more penalized. We also observed that the difference between the odds of occurrence of symptoms and comorbidities among COVID-19 maternal and female deaths was marginal. Differences between the two groups of deaths are significantly associated with social determination and (in)adequate obstetric care. 2021 has been more severe for maternal mortality. We need to increase immunization and monitoring among pregnant women immediately.