Scientific Reports (Jul 2022)

The COVID-19 pandemic in Brazilian pregnant and postpartum women: results from the REBRACO prospective cohort study

  • Renato T. Souza,
  • Jose G. Cecatti,
  • Rodolfo C. Pacagnella,
  • Carolina C. Ribeiro-Do-Valle,
  • Adriana G. Luz,
  • Giuliane J. Lajos,
  • Guilherme M. Nobrega,
  • Thayna B. Griggio,
  • Charles M. Charles,
  • Silvana F. Bento,
  • Carla Silveira,
  • Fernanda G. Surita,
  • Maria J. Miele,
  • Ricardo P. Tedesco,
  • Karayna G. Fernandes,
  • Sérgio H. A. Martins-Costa,
  • Frederico J. A. Peret,
  • Francisco E. Feitosa,
  • Rosiane Mattar,
  • Evelyn Traina,
  • Edson V. Cunha Filho,
  • Janete Vettorazzi,
  • Samira M. Haddad,
  • Carla B. Andreucci,
  • José P. Guida,
  • Mario D. Correa Junior,
  • Marcos A. B. Dias,
  • Leandro De Oliveira,
  • Elias F. Melo Junior,
  • Marília G. Q. Luz,
  • Maria Laura Costa,
  • REBRACO Study Group

DOI
https://doi.org/10.1038/s41598-022-15647-z
Journal volume & issue
Vol. 12, no. 1
pp. 1 – 14

Abstract

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Abstract Brazil presented a very high number of maternal deaths and evident delays in healthcare. We aimed at evaluating the characteristics of SARS-CoV-2 infection and associated outcomes in the obstetric population. We conducted a prospective cohort study in 15 Brazilian centers including symptomatic pregnant or postpartum women with suspected COVID-19 from Feb/2020 to Feb/2021. Women were followed from suspected infection until the end of pregnancy. We analyzed maternal characteristics and pregnancy outcomes associated with confirmed COVID-19 infection and SARS, determining unadjusted risk ratios. In total, 729 symptomatic women with suspected COVID-19 were initially included. Among those investigated for COVID-19, 51.3% (n = 289) were confirmed COVID-19 and 48% (n = 270) were negative. Initially (before May 15th), only 52.9% of the suspected cases were tested and it was the period with the highest proportion of ICU admission and maternal deaths. Non-white ethnicity (RR 1.78 [1.04–3.04]), primary schooling or less (RR 2.16 [1.21–3.87]), being overweight (RR 4.34 [1.04–19.01]) or obese (RR 6.55 [1.57–27.37]), having public prenatal care (RR 2.16 [1.01–4.68]), planned pregnancies (RR 2.09 [1.15–3.78]), onset of infection in postpartum period (RR 6.00 [1.37–26.26]), chronic hypertension (RR 2.15 [1.37–4.10]), pre-existing diabetes (RR 3.20 [1.37–7.46]), asthma (RR 2.22 [1.14–4.34]), and anaemia (RR 3.15 [1.14–8.71]) were associated with higher risk for SARS. The availability of tests and maternal outcomes varied throughout the pandemic period of the study; the beginning was the most challenging period, with worse outcomes. Socially vulnerable, postpartum and previously ill women were more likely to present SARS related to COVID-19.