OBJETIVO: Descrever a mortalidade materna no período reprodutivo (15 a 49 anos) no Estado de São Paulo, de 1991 a 1995, segundo grupos etários e causas básicas de óbito. MÉTODOS: Foi fornecida pela Fundação Seade a listagem dos óbitos, com as causas básicas codificadas pela Classificação Internacional de Doenças, 9ª Revisão, utilizando-se o programa "Automated Classification of Medical Entities", as estimativas da população feminina segundo grupos etários e os números de nascidos vivos. Foram calculados coeficientes específicos por 100.000 mulheres, mortalidade materna por 100.000 nascidos vivos e percentagens de óbitos por subgrupos. Foram calculadas medianas dos coeficientes do quinquênio, para comparação das principais causas agrupadas nos capítulos. RESULTADOS: De 1991 a 1995 houve aumento da mortalidade por deficiência da imunidade celular a partir de 25 anos, parecendo traduzir um paralelismo com a curva ascendente da epidemia de AIDS em mulheres. Lesões e envenenamentos predominam nas mais jovens, porém a partir de 35 anos as doenças do aparelho circulatório e neoplasmas passaram a ser preponderantes. Doenças infecciosas e parasitárias ocupam a sétima ou oitava posição, em todas as idades. Acidentes e homicídios e suicídios foram elevados. A mortalidade materna variou de 43,7 a 49,6 por 100.000 nascidos vivos. CONCLUSÕES: Houve grande exposição das mulheres em idade fértil a fatores associados a causas externas, doenças crônicas e AIDS. A maioria das causas apontadas de mortalidade materna podem ser prevenidas e, portanto, revelam insuficiência de assistência pré-natal adequada e extensiva, bem como deficiências no atendimento ao parto e puerpério.
Objective -To describe mortality due to cardiovascular The significance of cardiovascular diseases as causes of morbidity and mortality in females has been reported in the last few years mainly for postmenopausal women [1][2][3][4] .Lotufo 4 compared mortality rates according to age, in persons ranging from 45 to 64 years old during the period from 1984 to 1987 in eight Brazilian capitals with similar statistics in European countries and in the United States. He found that heart diseases in these Brazilian cities have a high mortality rate, which is similar or even higher than that observed in those countries, especially among females.However, few studies have focused on young women in their reproductive age, that is, before menopause 5-8 .Haddad and Silva 8 studied the causes of death and maternal mortality in women 15-to 49 years old in the state of São Paulo during the period from 1991 to 1995. They noticed that in younger women (15 to 34 years old) underlying causes of death were frequently among those described in chapter XVII of the International Classification of Diseases, 9 th revision (CID-9) 9 , as well as lesions and poisoning, but in 35-to 49-year-old-women, diseases described in chapters II and VII of the CID-9 (neoplasms and circulatory system, respectively) became the most frequent causes. Lesions and poisoning occupied a third position in 35-to 44-yearold women and the fifth position in 45-to 49-year-old women. Respiratory diseases, reported in chapter VIII, were present in all studied ages of the five most frequent underlying causes of death, occupying the third position in the 45 to 49 year age group.Another observation was that diseases reported in chapter I of CID -infectious and parasitic diseases-in all age groups occupied the seventh or eighth position in the descending range of the median coefficients of mortality in five years. The great decrease in the incidence of these diseases, together with the increased incidence of chronic diseases and diseases of external causes, support the idea that an epidemiological transition has occurred in São Paulo secondary to the demographic, socioeconomic, and sanitary changes that have emerged in the last decades. The same authors also noted that among the main causes of maternal
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