Mortes maternas e de mulheres em idade reprodutiva na população indígena, Pernambuco, 2006-2012*

Estima, Nathalie Mendes; Alves, Sandra

doi:10.5123/s1679-49742019000200010

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…These disorders are most commonly associated with MD, which is in line with the period of obstetric transition that is taking place in the country. 15,16 Previous studies 17,18 have reported that hypertensive and hemorrhagic conditions are also the major causes of ICU admission, although our results revealed that clinical and surgical complications exceeded hemorrhagic conditions. A possible reason for this difference may be that the hospitals included in the present study are referral hospitals for severe cases in their areas.…”

Section: Discussionmentioning

confidence: 54%

Use of Intensive Care Unit in Women with Severe Maternal Morbidity and Maternal Death: Results from a National Multicenter Study

Soares

Guida

Pacagnella

et al. 2020

Rev Bras Ginecol Obstet

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Objective To assess the use of the intensive care unit (ICU) and its effect on maternal mortality (MM) among women with severe maternal morbidity (SMM). Materials and Methods A secondary analysis of a cross-sectional study on surveillance of SMM in 27 Brazilian obstetric referral centers. The analysis focused on the association between ICU use and maternal death according to individual characteristics and disease severity. Two multivariate regressions considering use of the ICU, age, ethnicity, adequacy of care and the human development index were performed to identify the factors associated to maternal death and maternal near-miss. Results Out of 82,388 deliveries during the period, there were 9,555 (11.6%) women with SMM, and the MM ratio was of 170.4/100 thousand live births. In total, 8,135 (85.1%) patients were managed in facilities in which ICUs were available; however, only 2,059 (25.3%) had been admitted to the ICU. On the multivariate analysis, when the severity of the maternal disease was measured by the maternal severity score (MMS), the strength of the association between the use of the ICU and maternal death was greatly reduced, along with inadequate care and non-availability of the ICU at the facility. On the assessment of only the more critical cases (SMO, severe maternal outcome), the same pattern of association between ICU and MM was observed. In the models used, only inadequate care and MSS were significantly associated with MM. Conclusion The current study indicates that the main variables associated with maternal death are the severity and adequacy of the case management, which is more frequent in ICU admissions. The use of the ICU without the stratification of the patients by severity may not produce the expected benefits for part of the women.

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Section: Discussionmentioning

confidence: 54%

Use of Intensive Care Unit in Women with Severe Maternal Morbidity and Maternal Death: Results from a National Multicenter Study

Soares

Guida

Pacagnella

et al. 2020

Rev Bras Ginecol Obstet

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“…However, there are still persistent inequalities and variations among the FU, which need to be addressed. It is necessary to evaluate the causes, the gaps in care and the structural problems of Brazil 24 - 27 . Widely known regional inequalities have been demonstrated by the GBD study.…”

Section: Discussionmentioning

confidence: 99%

Maternal Mortality in Brazil, 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019

Leal

Malta

Marinho

et al. 2022

Rev. Soc. Bras. Med. Trop.

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INTRODUCTION Maternal death continues to be one of the most challenging public health problems that needs to be addressed in low and middle-income countries. The objective of this study was to describe the problem of maternal death in Brazil, using estimates from the Global Burden of Disease Study (GBD). METHODS This study used data from the GBD 2019 to show the numbers of deaths and the Maternal Mortality Ratio (MMR) - number of deaths/100,000 live births - in Brazil and its 27 Federated Units (FU), for ages 10 to 54 years, from 1990 to 2019. The annual variation of the MMR was estimated in 1990, 2010, and 2019. The MMR were shown for specific causes as well as for five-year age groups. The estimates were presented with 95% uncertainty intervals (UI). RESULTS The number of maternal deaths, as well as the MMR showed a 49% reduction from 1990 to 2019. This reduction occurred heterogeneously throughout the country, and the profile of the MMR for specific causes changed between 1990 and 2019: from hypertensive gestation diseases, to indirect maternal deaths, followed by hypertensive gestation diseases. In the extreme age groups, the MMR is higher, with mortality increasing exponentially in direct proportion with age. CONCLUSIONS Maternal deaths in Brazil have decreased substantially since 1990; however, the numbers still fall short of what was established by the World Health Organization (WHO). Indirect causes are the greatest problem in more than 60% of the FU, especially for hypertensive pregnancy diseases.

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“…O estado com maior RMM foi o Piauí, e a menor taxa era a do Rio Grande do Norte. Vale ressaltar que a última difere consideravelmente de todos os indicadores registrados na região no mesmo período e do resultado do próprio estado nos anos seguintes, podendo ser fruto de falhas no sistema de notificação desse agravo no ano referido, já que apesar da confiabilidade dos dados do SIM, há uma estimativa de subnotificação de até 20% (Estima & Alves, 2019).…”

Section: Discussionunclassified

Perfil epidemiológico, clínico e razão de mortalidade materna no Nordeste brasileiro entre 2010 e 2019: um estudo ecológico

Morais

Melo

Campos

2022

RSD

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Objetivo: descrever o perfil epidemiológico, clínico e a razão de mortalidade materna no Nordeste entre 2010 e 2019. Métodos: estudo ecológico, descritivo, com dados provenientes do Sistema de Informação sobre Mortalidade (SIM) e Sistema de Informação sobre Nascidos Vivos (SINASC). As variáveis do perfil epidemiológico referem-se à idade, cor/raça, escolaridade e estado civil, enquanto as variáveis clínicas tratam do local de ocorrência, tipo de morte por causa obstétrica, período gravídico e investigação do óbito. Ainda, apresenta-se uma série temporal descritiva quanto à razão de mortalidade materna no período. Resultados: Foram registrados 4521 óbitos maternos no período, sendo 1144 (25,30%) na Bahia. O perfil epidemiológico demonstra que os registros se referem a mulheres entre 25 e 34 anos (42,68%), pardas (66,95%), com 8 a 11 anos de escolaridade (30,28%) e solteiras (46,25%). Quanto às características clínicas, 4057 (89,75%) dos óbitos ocorreram no ambiente hospitalar, 3141 (69,49%) por causas diretas e 2800 (61,93%) durante o puerpério. Em 2013 foi observada a maior razão de mortalidade materna, com 61 óbitos por 100.000 nascidos vivos, em contraste com 2019, apresentando 47 óbitos por 100.000 nascidos vivos. Conclusão: Foi possível elucidar o perfil epidemiológico e clínico dos óbitos maternos no Nordeste entre 2010 e 2019. Ainda, a variação da razão de mortalidade materna observada ao longo dos anos é um fato relevante, mas que deve ser analisado à luz de estudos analíticos que explorem a tendência, sobretudo em uma região historicamente negligenciada em termos de desenvolvimento socioeconômico e de acesso à saúde.

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Mortes maternas e de mulheres em idade reprodutiva na população indígena, Pernambuco, 2006-2012*

Cited by 6 publications

References 12 publications

Use of Intensive Care Unit in Women with Severe Maternal Morbidity and Maternal Death: Results from a National Multicenter Study

Use of Intensive Care Unit in Women with Severe Maternal Morbidity and Maternal Death: Results from a National Multicenter Study

Maternal Mortality in Brazil, 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019

Perfil epidemiológico, clínico e razão de mortalidade materna no Nordeste brasileiro entre 2010 e 2019: um estudo ecológico

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