March 3, 2024

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Covid-19 | Sharp increase in maternal mortality in 2021

Covid-19 |  Sharp increase in maternal mortality in 2021

In 2021, the number of cases of perinatal deaths in the United States increased and this situation can be attributed specifically to COVID-19.


In 2021, 1,205 women in the United States died of maternal causes during pregnancy or within 42 days after delivery. That number was 861 in 2020 and 754 in 2019, according to a study by the National Center for Health Statistics (NCHS).

In 2021, the mortality rate reached 32.9 deaths per 100,000 births, compared to 23.8 per 100,000 in 2020, 20.1 per 100,000 in 2019, and 17.4 per 100,000.

In comparison, the maternal mortality rate in Canada was 8.37 per 100,000 in 2020 and 8.60 per 100,000 in 2019. Data for 2021 will be released in July.

“We’ll have to wait for the data, but I don’t expect any significant changes, DR Richard Brown, Director of Obstetrics and Maternal-Fetal Medicine at the MUHC. Cases of maternal mortality are extremely rare in the Montreal area. For those I have seen, the main causes of death are venous thromboembolism and bleeding. Not covid. »

The question of Covid-19 was raised

A close analysis of the NCHS statistics demonstrates unequivocally that the risk of death increases with age and is higher among Afro-descendant women. But the Covid-19 pandemic is responsible for many deaths.

That’s the conclusion of the U.S. Government Accountability Office (GAO), Canada’s equivalent of the Auditor General’s Office — in a publication dated October 19, 2022. The GAO later estimated the number of maternal deaths at 1,178 (provisional data). In 2021, 401 of those were due to Covid-19.

According to an article from The New York TimesPregnant women are vulnerable to infectious diseases, especially since the immune system is focused on the fetus.

“Usually, lung disease is more difficult during pregnancy,” says Dr.D Marjorie Meyer, Lerner College Professor of Medicine and Associate Professor at the University of Vermont Pres in Burlington. We don’t know why, but affected women must have a good heart reserve. »

On Thursday, the United States College of Obstetricians and Gynecologists (ACOG) responded to the NCHS statistics, recalling that it has raised the alarm in the past. “ACOG has previously expressed grave concern that the COVID-19 pandemic will worsen the maternal mortality crisis in the United States,” a statement said.

The World Health Organization (WHO), however, urges not to make hasty decisions. “The stagnation in maternal mortality reductions predates the onset of the epidemic. This may have contributed to the lack of progress, but does not represent the full explanation,” WHO said in a document released on February 23.

For example, it has been suggested that a distinction should be made between the association between pregnancy and Covid-19 and deaths due to interruption of health services during the pandemic.

differences

Always step The New York Times, the omicron variant is less virulent than the delta variant, leading to lower maternal mortality. “Preliminary figures for 2022 indicate that maternal mortality is declining to pre-pandemic levels,” the report said.

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However, what doesn’t seem to change are the differences. Among black American women, the maternal mortality rate is twice that of the general population. In 2021, that rate was 69.9 per 100,000 births, more than double that of white women (26.6 per 100,000).

In this regard, ACOG strongly condemned the “worsening racial disparities in health,” which has translated into an “alarming increase in the disproportionate number of maternal deaths” among black women.

“This trend must stop, the organization begins. ACOG strongly advocates for policies that focus on improving maternal health outcomes, including mandating the extension of postpartum health coverage from 60 days to 12 months. »

Observations shared by Bahman Kashi, assistant professor of economics at Queen’s University, Kingston. “Unlike in Canada, health care is not free in the United States,” he recalled in an interview. People “shop” for services, and when times get tough, they drop some of them. This can be caused by regular visits to the doctor during pregnancy. The less fortunate tend to abandon them. But doing so increases the risk of complications over time. »

with The New York Times and NPR

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  • 287,000
    Number of women who died during pregnancy or after childbirth worldwide in 2020. Almost 95% of these deaths occurred in low- and lower-middle-income countries and could have been prevented.

    World Health Organization