Evolução temporal e diferenciais intra-urbanos da Mortalidade Materna em Aracaju, Sergipe, 2000-2010

Abstract

ResumoObjetivo: analisar a evolução temporal e diferenciais intraurbanos da mortalidade materna, em Aracaju, no período 2000-2010. Método: estudo ecológico com dados dos Sistemas de Informação sobre Mortalidade e de Nascidos Vivos e do Comitê Municipal de Prevenção da Mortalidade Materna. Calculou-se Razão de Mortalidade Materna (RMM/100.000NV) anual e por estratos socioeconômicos. Resultados: a mortalidade materna foi estável no período investigado (p=0,35). Dos óbitos maternos com informação registrada, a maioria era de mulheres pardas (50,6%), solteiras (43,7%), com até sete anos de estudo (64,5%) e por causas obstétricas diretas (72,4%). A RMM (83,3/100.000NV no período) foi 1,9 vezes maior em áreas de baixa condição socioeconômica do que naquelas de condição intermediária (p=0,021). Conclusões: a elevada mortalidade materna em Aracaju, com maiores riscos em estratos de baixa condição socioeconômica, indica a necessidade de melhorar a qualidade do pré-natal e a assistência ao parto para gestantes residentes em áreas mais pobres.

Profile and spatial distribution on maternal mortality

“…11 More recent data show that in Brazil, 1,670 maternal deaths occurred in 2016, which ranks outside the established goal. 14 As for the socio-demographic profile and the classifications of maternal deaths according to causes and avoidability, this study showed results similar to other studies regarding age, 15 race, 9,16 schooling, 9 marital status, 7,9,16 in direct obstetric maternal death 6,9 and preventable deaths. 6,16 It is a fact that maternal mortality has a close relation with discrimination and with Brazilian women's biological and socio-cultural determinants, especially with inequalities of gender, low schooling Table 4 Distribution in absolute number and percentage (%) of variables related to childbirth and postpartum on maternal deaths and the characteristics of these maternal deaths in the city of Montes Claros-MG in the period of 2009 to 2013.…”

“…Despite the complexity of its determinants, maternal death is socially unacceptable, as it is recognized as a protective role in care received by women during the entire gestational process. 9 This present study has a general objective, to describe the profile and spatial distribution on maternal mortality in a city in the North of Minas Gerais, Brazil, from 2009 to 2013. It is believed that the knowledge on profile and spacial distribution of this mortality needs to be expanded, to better understand the causes that lead to women's death in order to produce and disseminate information that can support the plan of action and public policies that seek to reduce maternal mortality in the studied scenario.…”

Epidemiological profile of maternal deaths in a referral hospital for high-risk pregnancy

“…Most of the cases were women living in the metropolitan area of Recife, but a significant amount came from other mesoregions of the state of Pernambuco. A research in the city of Aracajú showed a similar profile, reporting high demand of patients living in the interior of the state, overloading health services in large urban centers and the capital (14) . This context suggests that many patients go searching for access to a high-risk care and end up overcrowding complex maternities, reaching sometimes to situations that are more serious.…”

“…In several studies, as well as this one, there is a predominance of maternal mortality from direct obstetric causes (2,8,(12)(13)(14) . These deaths are mostly preventable through health education, prenatal care quality and adequate hospital obstetric care (12) .…”

“…It is important to highlight the number of information not recorded on death certifications and the maternal mortality investigation forms, making difficult to analyze and discuss the results, decreasing the accuracy of information useful to trace the epidemiological profile. Failure in the information record pattern occurred in many studies involving secondary database (12)(13)(14) . The variables with the greater incompleteness of the cases were race, education, marital status, occupation and prenatal care.…”