Pandemic: Maternal mortality due to COVID-19 rises in Colombia – health

Evidence indicates that in the first week of 2021, according to official reports from the National Institute of Health, eight premature maternal death (occurred during pregnancy, childbirth and up to 42 days after conception) In the last epidemiological week (between 10 and 16 October) this number has already reached 410 deaths, indicating that this indicator is in the middle pandemic jump.

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The problem is not simple because, according to health worker Pedro Leon Cifuentes, most of these deaths are preventable and their occurrence directly qualifies the characteristics of health systems.

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Indeed, maternal mortality is one of the sentinel indicators that, due to its characteristics, requires priority in binomial attention. mother’s sonEven before pregnancy. Not in vain, striving to reduce it is one of the sustainable development goals, a figure in the case of Colombia is 32 per 100,000 live births by 2030.

But the numbers are indicative if one takes into account that during 2020 there were 405 premature maternal deaths, a number according to records, a number that has not been presented since 2012, given that compared to 2019 these cases increased at 106.

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According to weekly information from the National Institute of Health, it can be seen that this type of death tends to increase, so much so that the 410 classified as early in week 41 already represents an increase of 26.5 percent compared to 2020.

epidemic

Although early maternal mortality is an important reference in this type of analysis, it is worth noting that the so-called late maternal death (occurring from day 43 to one year after the end of pregnancy) and coincidental deaths should be added, meaning that injuries from causes exogenous, affecting pregnant women, to make up for the total which similarly shows a worrying increasing trend.

In fact, the total maternal mortality in 2019 was 409; In 2020, 479 have been completed and so far in 2021, 559.

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When reviewing the maternal mortality ratio, defined as the number of mothers who died per 100,000 live births, there has been growth since 2019 that shows a marked upward turning point since 2020, so much so that, according to the National Institute of Health, if there were no deaths due to COVID-19, this ratio would have been 55.6, but adding the death rate in this covid-19-affected cohort, that figure comes to 82.1, which means that 47.6 percent of maternal deaths are directly related to SARS-CoV-2 infection.

Alarming numbers

In front of this panorama, says Luis Jorge Hernández, doctor of public health and professor at the University of the Andes, that the health targets set in the National Development Plan, which set a maternal mortality ratio of 45, obviously, by observing the above, will not be achieved.

But Hernandez goes further because he asserts that the increase in maternal deaths is not only a consequence of the epidemic because since 2018 it has already been increasing, and he argues that between 2018 and 2019 the proportion of deaths per 100,000 live births from 46.1 to 46.8 and this by 2020 was That’s 64.9 by August 2021 “The cumulative GPA was 86.9, which is a typical figure for a Central African country”.

the reasons

It’s normal, Cifuentes says, that within the pandemic, all population groups have been affected and maternal groups were not the exception, so SARS-CoV-2 is the number one determinant of maternal death at this point.

The same National Institute of Health enhances the risk of infection of this population with the virus because pregnancy reduces defenses and increases body volume which reduces lung adaptation, without neglecting that many pregnant women suffer from diabetes and hypertension classified as komorbelidades It is worrying in the face of this and other injuries, to which was added the non-attendance of pregnant women to hospitals for fear of being injured.

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However, Hernandez confirms this in saying thus before pandemic Quarantine has also reduced early care for pregnant women and prenatal control by about 30 percent, to the point where, according to the expert, “early detection of maternal risks is practically not done.”

In the same way, both Cifuentes and Hernández confirm that their caution has been lowered in the programs sexual health and reproductive health, as well as in counseling on fertility regulation, especially in young adolescents, in both women and men.

“We are facing a real public health emergency, and given that maternal deaths are preventable events, we must act immediately.Hernandez says.

Pregnant women should be given priority

The Pan American Health Organization (PAHO) has warned that if the factors determining maternal deaths that have now increased due to COVID-19 are not corrected immediately, more than 20 years of progress in reducing this indicator may be erased.

In this sense, its director, Carissa F Etienne, insists that pregnant women are primarily at risk and that it has been shown that if they contract COVID-19 they can become infected. More severe symptoms It not only puts their lives at risk, but theirs as well.

According to the same Pan American Health Organization, more than 250,000 women on the continent have been infected with SARS-CoV-2 and more than a thousand deaths have been recorded, without neglecting that survivors may have insurmountable sequelae, hence a call to strengthen protection measures in the context of inclusivity of all population.

(Read: Increased maternal mortality due to COVID-19 in Colombia)

In the same way, the National Institute of Health calls for the strengthening of biological protection measures, in addition to making all pregnant women aware that pollinate against covid-19.

Likewise, it calls on those responsible for ensuring coverage in care to prioritize antenatal controls, timely intervention if risk factors are detected, and constant monitoring for suspicious symptoms related to SARS infection.

For its part, the Ministry of Health has given priority to vaccination for this group of the population from the beginning on the basis that it is more vulnerable to complications from the Covid-19 virus, and in this sense it has made it clear that vaccination for all pregnant women over the age of 12 weeks of pregnancy until the 40th day after birth, does not have Impediments and must be submitted immediately and without any kind of requirement at all vaccination centers in the country; Hence, I have sent an urgent appeal to all officials to carry out this task.

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