Spatial Approach of Perinatal Mortality in São Paulo State, 2003–2012

Abstract

To identifying spatial patterns in the distribution of perinatal mortality in the state of São Paulo from 2003 to 2012. An ecological and exploratory study with data on perinatal mortality rates of every thousand live births, which were registered on the digital database containing 645 municipalities in the state of São Paulo within the periods of 2003 to 2007 and 2008 to 2012. The spatial analysis provided Moran's index (MI) and thematic maps of rates, and the Moran maps of both periods were drawn. The average rates were compared by Student's test. The TerraView 4.2.2 software (INPE, S. José dos Campos, Brazil) was also used. There were 49,485 perinatal deaths during the first period, at a rate of 17.90 deaths/1,000 live births (standard deviation [SD] = 7.0; MI = 0.14; = 0.01), and 44,582 perinatal deaths during the second period, at a rate of 16.40 deaths/1,000 live births (SD = 11.14; MI = 0.04; = 0.03). These rates are statistically different ( < 0.01). There was a decrease in these rates in 413 municipalities when comparing the two periods. The Moran map has identified 35 municipalities that require special attention, which are located in the Eastern, Southwestern, Western and Northwestern regions of São Paulo state. The study provides municipal managers with subsidies so they can minimize these rates by implementing public policies and taking better care of pregnant women and newborns.

Infant mortality: surveillance, epidemiological characteristics and spatial distribution pattern in Recife, Brazil

“…The punctual analysis of deaths by characterizing the territory in detail reveals areas with a higher concentration of deaths and indicates the presence of risk factors in certain localities (MacQuillan et al, 2017). Studies on the spatial analysis of infant mortality point to the usefulness of these approaches for the elaboration and development of policies aimed at coping with the determinants of these deaths, particularly those related to healthcare (Rodrigues et al, 2014;Faria, 2016;Rodrigues et al, 2016;Venâncio, Tuan, Vaz, & Nascimento, 2016;Leal et al, 2017). Likewise, the characterization of the epidemiological profile of infant deaths is recognized as an important tool for drawing strategies to deal with the problem, in particular, by investigating the events, because it allows a better understanding of the circumstances of their occurrence (Vanderlei & Navarrete, 2013).…”

Desigualdades espaciais e mortalidade perinatal numa capital do nordeste brasileiro: estudo ecológico

“…Perinatal mortality is a health indicator that is associated, among other factors, with the conditions of access to services and the quality of maternal and child care (1) . In the world, perinatal deaths occur mainly in low-and middleincome countries, where the coefficient of 50.1 per thousand births is estimated (2) .…”

“…The early neonatal component went from 10.15 to 6.69 per thousand live births (a decrease of 34%) (3) . Besides the differences in the reduction of the age components, regional inequalities still persist in the country (1,3) . In 2015, the perinatal mortality rate in the Northeast region was 21.15 per thousand births, above the national average of 17.43 (3) .…”

“…Spatial inequalities in perinatal mortality may be influenced by social issues related to income, education, occupation, race/color, and place of residence or work (1) . The identification of these inequalities is the object of epidemiological studies that help detecting areas that need greater attention in the health sector (1,2) .…”

Infant Mortality and Obstetric Assistance's Quality

“…In this number of RBGO, two articles that have a direct or indirect intimate relation to this editorial are published. 11,12 In the first one, "Spatial Approach to Perinatal Mortality in São Paulo State from 2003 to 2012", the authors analyze perinatal mortality rates in the 645 municipalities of the state of São Paulo in two periods (2003 to 2007 and 2008 to 2012). They identify a significant global reduction comparing the 2 periods, with a drop of 8.4% in this rate.…”