La MORTALIDAD MATERNA EN LA REPÚBLICA DOMINICANA: DESENTRAÑANDO LAS DESIGUALDADES EN TIEMPOS DE LA PANDEMIA POR COVID-19

Authors

DOI:

https://doi.org/10.20947/S0102-3098a0313

Keywords:

RMM; COVID-19; Desigualdades; Salud materna; Determinantes sociales.

Abstract

In the context of the Dominican Republic, the COVID-19 pandemic led to an increase in maternal mortality, recording a ratio of 127 per 100,000 live births; furthermore, research indicates that the COVID-19 pandemic has exacerbated social disparities regarding maternal mortality. This research aims to analyze how the COVID-19 pandemic has influenced the magnitude and distribution of social inequalities related to maternal mortality in the Dominican Republic. An ecological, cross-sectional study was conducted, using descriptive and correlational techniques, calculating simple and complex measures to quantify inequalities associated with maternal mortality. A ratio of 153.6 maternal deaths per 100,000 live births was estimated, and high variability was observed at the provincial level. A positive correlation was observed with illiteracy (Rho=0.420) and socioeconomic level (Rho=0.343), while a negative correlation was found with female-headed households (Rho=-0.477) and urban residence (Rho=-0.400). The slope inequality index identified an inequality of -190.26 (95% CI -278.23; -102.29) fewer maternal deaths in provinces with lower levels of illiteracy. The COVID-19 pandemic has intensified the magnitude of social disparities in maternal mortality in the Dominican Republic.

 

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Author Biographies

Kary Desiree Santos Mercedes, Universidade de Brasilia

Kary Desiree Santos Mercedes es estadística y demógrafa, graduada de la Universidad Autónoma de Santo Domingo (UASD) con una licenciatura en Estadística con mención Socioeconómica. Posee una maestría en Demografía por la Universidad Federal de Minas Gerais (UFMG) y actualmente cursa un doctorado en Salud Colectiva en la Universidad de Brasília (UnB). Coordinadora del Grupo de Trabajo de Población y Género de la Asociación Brasileña de Estudios de Población (ABEP).

Jonathan Patricio Baldera, 1. Fundación Étikos, Unidad de Investigación, Santo Domingo, República Dominicana. 2. Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.

Statistician graduated from the Universidad Autónoma de Santo Domingo. Holds a Master's degree in Biostatistics from the Pontificia Universidad Javeriana, with training in Population and Development from the Latin American Faculty of Social Sciences (FLACSO-RD). Currently works as a Biostatistician and Research Assistant at the Centre for Age-Related Medicine (SESAM) at Stavanger University Hospital (Norway), where he collaborates on projects related to dementia and functionality in older adults. In addition, he is an Associate Researcher at the Research Unit of the Étikos Foundation (Dominican Republic), with lines of work in sexual and reproductive health, maternal and child health, and adolescent health.

Fernando Ruiz-Vallejo, Universidad Externado de Colombia

Sociologist from the Universidad Nacional de Colombia, holds a Master's degree in Population and Development from FLACSO (Mexico campus), and a PhD in Demography from the Universidad Autónoma de Barcelona. He has been a postdoctoral researcher at Profamilia, MinCiencias, and the Universitat Pompeu Fabra. He has taught at the Universidad Nacional de Colombia, Externado, Javeriana, Universitat Autònoma de Barcelona, and Universitat Pompeu Fabra, covering subjects such as research methodology, data analysis, demography, fertility and family, social sciences, and health.

References

− ALKEMA, L.; CHOU, D.; HOGAN, D.; ZHANG, S.; MOLLER, A.-B.; GEMMILL, A. et al. Global, regional, and national levels, and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. The Lancet, v. 387, n. 10017, p. 462-474, 2016. Disponível em: https://doi.org/10.1016/S0140-6736(15)00838-7. Acesso em: 25 mar. 2023.

− ALLOTEY, J.; FERNANDEZ, S.; BONET, M.; STALLINGS, E.; YAP, M.; KEW, T. et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ, 2020. Disponível em: https://doi.org/10.1136/bmj.m3320. Acesso em: 25 mar. 2023.

− BACALLAO GALLESTEY, J. Indicadores basados en la noción de entropía para la medición de las desigualdades sociales en salud. Revista Cubana Salud Pública, v. 33, n. 4, p. 1-12, 2007.

− CHINN, J.; SEDIGHIM, S.; KIRBY, K. A.; HOHMANN, S.; HAMEED, A. B.; JOLLEY, J. et al. Characteristics and Outcomes of Women With COVID-19 Giving Birth at US Academic Centers During the COVID-19 Pandemic. JAMA Network Open, v. 4, n. 8, e2120456, 2021. Disponível em: https://doi.org/10.1001/jamanetworkopen.2021.20456. Acesso em: 25 mar. 2023.

− CONSEJERÍA DE SANIDAD. JUNTA DE GALICIA. Epidat 4: Ayuda de Medición de desigualdades en salud. 2014 Disponível em: https://opendata.paho.org/sites/default/files/2022-09/EpiDat-4.1-Manual-de-Ayuda-al-Usuario-Medicion-de-desigualdades-en-salud-2014.pdf

−

− COLOMÉ-HIDALGO, M.; HERRERA, D.; BREA DEL CASTILLO, J.; CARRASCO SÁNCHEZ, C. M.; DAUHAJRE PIMENTEL, M. F.; JURCEV SAVICEVIC, A. et al. Determinantes del estado de vacunación infantil: abordando la brecha de equidad en República Dominicana-2019. Ciencia y Salud, v. 8, n. 1, p. 5-18, 2024. Disponível em: https://doi.org/10.22206/cysa.2024.v8i1.2830. Acesso em: 25 mar. 2023.

− EL FONDO DE LAS NACIONES UNIDAS PARA LA INFANCIA (UNICEF). "Más de un 80% de las muertes maternas y neonatales son evitables." UNICEF. 2021. Disponível em: https://www.unicef.org. Acesso em: 25 mar. 2023.

− ELLINGTON, S.; STRID, P.; TONG, V. T.; WOODWORTH, K.; GALANG, R. R.; ZAMBRANO, L. D. et al. Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status --- United States, January 22--June 7, 2020. MMWR. Morbidity and Mortality Weekly Report, v. 69, n. 25, p. 769-775, 2020. Disponível em: https://doi.org/10.15585/mmwr.mm6925a1. Acesso em: 25 mar. 2023.

− GUTIÉRREZ RAMOS, M. Mortalidad materna, ¿cambiando la causalidad el 2021? Revista Peruana de Ginecología y Obstetricia, v. 68, n. 1, 2022. Disponível em: https://doi.org/10.31403/rpgo.v68i2407. Acesso em: 25 mar. 2023.

− HAMAL, M.; DIELEMAN, M.; DE BROUWERE, V.; DE COCK BUNING, T. Social determinants of maternal health: a scoping review of factors influencing maternal mortality and maternal health service use in India. Public Health Reviews, v. 41, n. 1, p. 13, 2020. Disponível em: https://doi.org/10.1186/s40985-020-00125-6. Acesso em: 25 mar. 2023.

− MARÍ-DELL'OLMO, M.; GOTSENS, M.; PASARÍN, M. I.; RODRÍGUEZ-SANZ, M.; ARTAZCOZ, L.; GARCÍA DE OLALLA, P. et al. Socioeconomic Inequalities in COVID-19 in a European Urban Area: Two Waves, Two Patterns. International Journal of Environmental Research and Public Health, v. 18, n. 3, p. 1256, 2021. Disponível em: https://doi.org/10.3390/ijerph18031256. Acesso em: 25 mar. 2023.

− MENÉNDEZ C, L. A. Analizando la mortalidad materna desde un enfoque de equidad: la importancia de contar con datos de calidad. ISGlobal Barcelona, 2019.

− MINISTÉRIO DE SAÚDE PÚBLICA (MSP). Situación de la Mortalidad Materna en República Dominicana, 2016. 2016.

− MINISTÉRIO DE SAÚDE PÚBLICA (MSP). Situación de los determinantes sociales de la salud en República Dominicana, 2013: Salud materna, infantil y adolescente. 2017.

− OFICINA NACIONAL DE ESTADÍSTICA (ONE). Encuestas de Hogares de Propósitos Múltiples (ENHOGAR), 2021. 2022.

− ORGANIZAÇÃO MUNDIAL DA SAÚDE (OMS). CONSTITUCION DE LA ORGANIZACION MUNDIAL DE LA SALUD. 1949.

− ORGANIZAÇÃO MUNDIAL DA SAÚDE (OMS). Mortalidad Materna. 2018.

− ORGANIZAÇÃO PARA A COOPERAÇÃO E DESENVOLVIMENTO ECONÔMICO (OECD). COVID-19 na região da América Latina e Caribe: implicações sociais e econômicas e políticas prioritárias. 2020.

− PEÑA, E.; PATRICIO BALDERA, J.; RODRÍGUEZ, J. AVANCES EN EL REGISTRO DE NACIDOS VIVOS AL 2018. 2019.

− RODRÍGUEZ CORREDOR, Z. A. Los determinantes sociales y su importancia para los profesionales de la salud. 2020. Disponível em: https://doi.org/10.16925/gcnc.15. Acesso em: 25 mar. 2023.

− SANHUEZA, A.; CALLE ROLDÁN, J.; RÍOS-QUITUIZACA, P.; ACUÑA, M. C.; ESPINOSA, I. Social Inequalities in maternal mortality among the provinces of Ecuador. Revista Panamericana de Salud Pública, v. 41, n. 97, p. 1-7, 2017.

− SANTOS MERCEDES, K. D.; PATRICIO BALDERA, J. Desigualdades sociales en la mortalidad materna, República Dominicana, 2016. Ciencia y Salud, v. 7, n. 3, p. 23-36, 2023. Disponível em: https://doi.org/10.22206/cysa.2023.v7i3.pp23-36. Acesso em: 25 mar. 2023.

− SANTOS MERCEDES, K. D.; ZANATTA COUTINHO, R. Impacto de la pandemia por Covid-19 en la morbi-mortalidad materna en la República Dominicana. Universidade Federal de Minas Gerais (UFMG), 2023.

− STEPHENSON, J. US Maternal Mortality Rate Rose Sharply During COVID-19 Pandemic's First Year. JAMA Health Forum, v. 3, n. 3, e220686, 2022. Disponível em: https://doi.org/10.1001/jamahealthforum.2022.0686. Acesso em: 25 mar. 2023.

- WESTGREN, M.; PETTERSSON, K.; HAGBERG, H.; ACHARYA, G. Severe maternal morbidity and mortality associated with COVID‐19: The risk should not be downplayed. Acta Obstetricia et Gynecologica Scandinavica, v. 99, n. 7, p. 815-816, 2020. Disponível em: https://doi.org/10.1111/aogs.13900. Acesso em: 25 mar. 2023.

- ZAMBRANO, L. D.; ELLINGTON, S.; STRID, P.; GALANG, R. R.; ODUYEBO, T.; TONG, V. T. et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status --- United States, January 22--October 3, 2020. MMWR. Morbidity and Mortality Weekly Report, v. 69, n. 44, p. 1641-1647, 2020. Disponível em: https://doi.org/10.15585/mmwr.mm6944e3. Acesso em: 25 mar. 2023.

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Published

2025-12-22

How to Cite

Santos Mercedes, K. D., Patricio Baldera, J., & Ruiz-Vallejo, F. (2025). La MORTALIDAD MATERNA EN LA REPÚBLICA DOMINICANA: DESENTRAÑANDO LAS DESIGUALDADES EN TIEMPOS DE LA PANDEMIA POR COVID-19 . Brazilian Journal of Population Studies, 42. https://doi.org/10.20947/S0102-3098a0313

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Vol. 42 (2025)

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Original Articles

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