Maternal mortality during the COVID-19 pandemic in Mexico: a preliminary analysis during the first year

BMC Public Health. 2021 Jul 2;21(1):1297. doi: 10.1186/s12889-021-11325-3.


Background: In Mexico, the COVID-19 pandemic led to preventative measures such as confinement and social interaction limitations that paradoxically may have aggravated healthcare access disparities for pregnant women and accentuated health system weaknesses addressing high-risk patients' pregnancies. Our objective is to estimate the maternal mortality ratio in 1 year and analyze the clinical course of pregnant women hospitalized due to acute respiratory distress syndrome and COVID-19.

Methods: A retrospective surveillance study of the national maternal mortality was performed from February 2020-February 2021 in Mexico related to COVID-19 cases in pregnant women, including their outcomes. Comparisons were made between patients who died and those who survived to identify prognostic factors and underlying health conditions distribution.

Results: Maternal Mortality Ratio increased by 56.8% in the studied period, confirmed COVID-19 was the cause of 22.93% of cases. Additionally, unconfirmed cases represented 4.5% of all maternal deaths. Among hospitalized pregnant women with Acute Respiratory Distress Syndrome consistent with COVID-19, smoking and cardiovascular diseases were more common among patients who faced a fatal outcome. They were also more common in the age group of < 19 or > 38. In addition, pneumonia was associated with asthma and immune impairment, while diabetes and increased BMI increased the odds for death (Odds Ratio 2.30 and 1.70, respectively).

Conclusions: Maternal Mortality Ratio in Mexico increased over 60% in 1 year during the pandemic; COVID-19 was linked to 25.4% of maternal deaths in the studied period. Lethality among pregnant women with a diagnosis of COVID-19 was 2.8%, and while asthma and immune impairment increased propensity for developing pneumonia, obesity and diabetes increased the odds for in-hospital death. Measures are needed to improve access to coordinated well-organized healthcare to reduce maternal deaths related to COVID-19 and pandemic collateral effects.

Keywords: COVID-19; Maternal mortality; Mexico; Pandemics.

MeSH terms

  • COVID-19*
  • Female
  • Hospital Mortality
  • Humans
  • Maternal Mortality
  • Mexico / epidemiology
  • Pandemics
  • Pregnancy
  • Pregnancy Complications, Infectious* / epidemiology
  • Retrospective Studies
  • SARS-CoV-2