Comorbidities and Sociodemographic Factors as Determinants of COVID-19 Outcome in Hospitalized Pregnant Women in Brazil

Abstract

Introduction

SARS-CoV-2 infection during pregnancy causes maternal health complications.

Objective

To investigate the relationship between comorbidities and sociodemographic factors with COVID-19 outcome (death/healing) among hospitalized pregnant women in Brazil.

Methodology

A longitudinal study, based on secondary data from the SIVEP Gripe. All hospitalizations of adult pregnant women with COVID-19 were assessed, with a total sample of 16,202 women. The dependent variable was the evolution of COVID-19 hospitalizations (death/healing), and the independent variables were age, ethnicity, gestational trimester, immunization, and comorbidities. R software version 4.3.2 was used to analyze the data. Descriptive statistics, the χ² test, and Poisson regression were used. Joinpoint regression analysis was used to assess trends in lethality during the pandemic.

Results

The median age of the pregnant women assessed was 30 years (P25- 25; P75- 35). Lethality was 7.62 % (n = 1,236), and death was associated with the group of women who did not receive any dose of vaccine in the second trimester of pregnancy, were aged ≥35 years, and had black/brown skin color. The risk of death was higher among unvaccinated women (RR: 4.29; CI: 2.97–6.50), those aged ≥35 years (RR: 1.37; CI: 1.13–1.67), and those with obesity (RR: 2.08; CI: 1.66–2.58). In the temporal analysis, the monthly percentage change (MPC) in lethality was significant in three periods.

Conclusion

Black ethnicity, obesity, and lack of vaccination were the main factors that increased the risk of death from COVID-19 among pregnant women.