{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T06:05:23Z","timestamp":1771308323058,"version":"3.50.1"},"reference-count":56,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Autoimmune Research Institute, Recife, Brazil"},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior\u2013Brasil","doi-asserted-by":"crossref","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background: The COVID-19 pandemic has contributed to the increase in maternal mortality due to the direct effects of the viral infection and the indirect effects caused by the overload of health services, and the resulting economic and social crises. This study aims to analyze sociodemographic, gestational, and clinical factors associated with maternal deaths from COVID-19 in Pernambuco between 2020 and 2021. Method: The study included 37 cases (deaths) and 112 controls (survivors). Crude and adjusted odds ratios were estimated using conditional and Firth\u2019s penalized logistic regression models, respectively, to evaluate sociodemographic, gestational, and clinical factors. Results: In the bivariate analysis, the main factors associated with maternal death from COVID-19 were \u22648 years of schooling, the postpartum period, multiparity, oxygen saturation below 95%, obesity, and diabetes mellitus. The presence of fever and cough was associated with a lower probability of death. The independent factors that remained associated with maternal death were the postpartum period (aOR: 80.78; 95% CI: 16.54\u2013394.37), parity \u2265 1 (aOR: 5.74; 95% CI: 1.16\u201328.22), and oxygen saturation below 95% (aOR: 7.16; 95% CI: 1.37\u201337.44), with fever acting as a possible protective factor (aOR: 0.08; 95% CI: 0.01\u20130.42). Factors such as obesity and diabetes were not independent predictors in the final multivariable model. Conclusions: The findings reinforce that maternal death is a multifactorial phenomenon. The relevance of this investigation lies in identifying clinical and obstetric vulnerability profiles in a region heavily impacted by the health crisis. Knowledge gained from past crises contributes to the improvement of public health strategies and clinical management protocols, aiming to mitigate preventable maternal deaths in future public health emergencies.<\/jats:p>","DOI":"10.3390\/diseases14020071","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T14:55:47Z","timestamp":1771253747000},"page":"71","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated with Maternal Mortality from COVID-19 in Pernambuco, Brazil (2020\u20132021): A Case\u2013Control Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8553-122X","authenticated-orcid":false,"given":"Tacilene Luzia da","family":"Silva","sequence":"first","affiliation":[{"name":"Postgraduate Program in Tropical Medicine, Center of Medical Sciences, Federal University of Pernambuco, Recife 50670-901, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4495-9673","authenticated-orcid":false,"given":"Cristine Vieira do","family":"Bonfim","sequence":"additional","affiliation":[{"name":"Directorate of Social Research, Joaquim Nabuco Foundation, Recife 52061-540, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8967-5693","authenticated-orcid":false,"given":"Ulisses Ramos","family":"Montarroyos","sequence":"additional","affiliation":[{"name":"Institute of Biological Sciences, University of Pernambuco, Recife 50100-130, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5963-8178","authenticated-orcid":false,"given":"Carlos Alexandre Antunes de","family":"Brito","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Tropical Medicine, Center of Medical Sciences, Federal University of Pernambuco, Recife 50670-901, Brazil"},{"name":"Department of Immunology, Autoimune Research Institute, Recife 52011-040, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e306","DOI":"10.1016\/S2214-109X(23)00468-0","article-title":"A global analysis of the determinants of maternal health and transitions in maternal mortality","volume":"12","author":"Souza","year":"2024","journal-title":"Lancet Glob. 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