Impact of the SARS-CoV-2 pandemic on maternal mortality: the case of Chile
In this collaborative study, led by Professor Elard Koch, senior epidemiologist and Chairman of MELISA Institute (Chile), and conducted by a team of researchers belonging to the Universidad Católica Sedes Sapientiae (Peru), the Pontificia Universidad Católica Argentina, the Universidad Nacional of Buenos Aires (Argentina), and the University of Chile (Chile), the impact of the SARS-CoV-2 pandemic on maternal mortality from specific causes during its toughest stage in Chile was evaluated.
This research was carried out on the basis of a study with an observational and ecological design using official data on maternal deaths from 1997 to 2021 published in database format by the Department of Statistics and Health Information (DEIS) of the Ministry of Health of Chile. .
This natural experiment used two robust statistical analysis techniques
Interrupted time series analysis (ITS)
To evaluate the effect of SARS-CoV-2 on different maternal mortality groups on parallel trends in cause-specific mortality.
Autoregressive integrated moving average (ARIMA)
Estimate expected mortality rates in the absence of the pandemic event.
The Maternal Mortality Ratio (MMR) was classified as follows
MMR due to direct obstetric causes
MMR due to indirect obstetric causes
Abortive outcome
Respiratory
Sepsis, hemorrhage
Hypertension
Other direct causes
Non respiratory
Infectious
Non infectious
Viral infectious causes
This study revealed a significant impact of the COVID-19 pandemic on maternal mortality in Chile. Curiously, the pandemic did not affect direct obstetric deaths such as hemorrhage, sepsis and abortion, but non-respiratory indirect obstetric causes were the ones that increased the most.
Some factors that would explain this increase could be difficulties in accessing maternal health care and checkups, as well as interruptions in specialized services, mobility restrictions and other diseases that were not treated in time. Likewise, the role of fewer resources allocated to health, together with economic inequalities, may have increased the risk of maternal death from SARS-CoV-2.
Finally, this research underscores the critical need for robust and adaptable maternal health systems during global health emergencies. The information obtained in this study is key so that, in the face of pandemic viruses, public policies offer a rapid, comprehensive and effective response, and that they focus on guaranteeing the continuity of quality care, ensuring the recommended prenatal and postnatal controls and access to specialized obstetric services for high-risk pregnancies.