Comorbidades associadas à mortalidade materna na pandemia de COVID 19

Abstract

Introduction: Due to its high transmissibility through droplets, SARS-CoV-2 has acquired a dangerous global character, reaching pandemic status. The vulnerability of pregnant women to this virus is evident in their mortality rate. Therefore, understanding how COVID-19 infection, which triggers immune-inflammatory responses, correlates with the main maternal comorbidities, is crucial to provide safer and targeted care to these women. Objective: To analyze the evidence regarding comorbidities associated with maternal mortality from COVID19. Method: An integrative review was conducted, searching the EMBASE, SCOPUS, PUBMED, Web of Science, CINAHL, and BVS databases from September to October 2022. Articles were selected using the Rayyan QCRI software, fully read, and data were collected following the protocol. Results: Fifteen studies conducted in countries such as South Africa, Brazil, the United States of America, India, Iran, and Mexico were included. The number of maternal deaths investigated ranged from 1 to 1858 cases, depending on the sample size and study type. Eight studies were classified as Level III.2 evidence (53.3%), six as Level III.3 (40%), and one as Level IV (6.7%). The most frequently observed comorbidities were obesity, diabetes mellitus, cardiovascular diseases, hypertension, asthma, autoimmune disease/immunosuppression, and chronic kidney disease. Conclusion: The comorbidities that predominated in the study may be associated with maternal mortality due to COVID-19 infection. These findings emphasize the importance of further studies to better understand the interaction between maternal comorbidities and COVID-19 infection. Such knowledge is essential to enhance the clinical approach and provide more effective care to pregnant and postpartum women, aiming to reduce adverse outcomes and promote maternal health.