Fetal mortality before and during the COVID-19 pandemic: a single-center cohort study in Rio de Janeiro, Brazil.

Objective: The aim of this study was to compare the characteristics of pregnancies that resulted in fetal death before and during the COVID-19 pandemic in a private maternity hospital in Rio de Janeiro, Brazil.

Methods: This retrospective cohort study considered all pregnancies that ended in fetal death in a private maternity hospital in Rio de Janeiro, Brazil, from January 2018 to December 2021. Maternal and fetal characteristics were compared between the periods before the pandemic and during the pandemic. Data were extracted from electronic medical records, and statistical analyses included Student's t-test, chi-square test, and Fisher's exact test where applicable.

Results: Among 41,162 deliveries at Casa de Saúde Perinatal, 88 (0.21%) resulted in fetal death, with 38 (43.2%) occurring pre-pandemic (2018-March 2020) and 50 (56.8%) during the pandemic (March 2020-2021). Maternal demographics, comorbidities, and prepartum complications showed no statistically significant differences between groups. COVID-19 infection was identified in 12% of the pandemic-group pregnancies, but no significant disparities in fetal death causes or abnormalities were found.

Conclusions: No significant differences were observed in maternal or fetal characteristics, prepartum complications, or fetal mortality rates between the pre-pandemic and pandemic periods in this private hospital setting. However, this does not reflect the broader Brazilian healthcare reality, where disparities in access and resources may have influenced outcomes differently.