Temporal evolution and spatial distribution of maternal death

Detalhes bibliográficos
Autor(a) principal: Carreno, Ioná
Data de Publicação: 2014
Outros Autores: Bonilha, Ana Lúcia de Lourenzi, Costa, Juvenal Soares Dias da
Tipo de documento: Artigo
Idioma: eng
por
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/85716
Resumo: OBJECTIVE To analyze the temporal evolution of maternal mortality and its spatial distribution. METHODS Ecological study with a sample made up of 845 maternal deaths in women between 10 and 49 years, registered from 1999 to 2008 in the state of Rio Grande do Sul, Southern Brazil. Data were obtained from Information System on Mortality of Ministry of Health. The maternal mortality ratio and the specific maternal mortality ratio were calculated from records, and analyzed by the Poisson regression model. In the spatial distribution, three maps of the state were built with the rates in the geographical macro-regions, in 1999, 2003, and 2008. RESULTS There was an increase of 2.0% in the period of ten years (95%CI 1.00;1.04; p = 0.01), with no significant change in the magnitude of the maternal mortality ratio. The Serra macro-region presented the highest maternal mortality ratio (1.15, 95%CI 1.08;1.21; p < 0.001). Most deaths in Rio Grande do Sul were of white women over 40 years, with a lower level of education. The time of delivery/abortion and postpartum are times of increased maternal risk, with a greater negative impact of direct causes such as hypertension and bleeding. CONCLUSIONS The lack of improvement in maternal mortality ratio indicates that public policies had no impact on women’s reproductive and maternal health. It is needed to qualify the attention to women’s health, especially in the prenatal period, seeking to identify and prevent risk factors, as a strategy of reducing maternal death.
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spelling Temporal evolution and spatial distribution of maternal death Evolução temporal e distribuição espacial da morte materna OBJECTIVE To analyze the temporal evolution of maternal mortality and its spatial distribution. METHODS Ecological study with a sample made up of 845 maternal deaths in women between 10 and 49 years, registered from 1999 to 2008 in the state of Rio Grande do Sul, Southern Brazil. Data were obtained from Information System on Mortality of Ministry of Health. The maternal mortality ratio and the specific maternal mortality ratio were calculated from records, and analyzed by the Poisson regression model. In the spatial distribution, three maps of the state were built with the rates in the geographical macro-regions, in 1999, 2003, and 2008. RESULTS There was an increase of 2.0% in the period of ten years (95%CI 1.00;1.04; p = 0.01), with no significant change in the magnitude of the maternal mortality ratio. The Serra macro-region presented the highest maternal mortality ratio (1.15, 95%CI 1.08;1.21; p < 0.001). Most deaths in Rio Grande do Sul were of white women over 40 years, with a lower level of education. The time of delivery/abortion and postpartum are times of increased maternal risk, with a greater negative impact of direct causes such as hypertension and bleeding. CONCLUSIONS The lack of improvement in maternal mortality ratio indicates that public policies had no impact on women’s reproductive and maternal health. It is needed to qualify the attention to women’s health, especially in the prenatal period, seeking to identify and prevent risk factors, as a strategy of reducing maternal death. OBJETIVO Analisar a evolução temporal da mortalidade materna e sua distribuição espacial. MÉTODOS Estudo ecológico com análise dos dados referentes a 845 óbitos maternos entre 10 e 49 anos, ocorridos no período de 1999-2008, no estado do Rio Grande do Sul, Brasil. Os dados foram obtidos no Sistema de Informações sobre Mortalidade do Ministério da Saúde. Foram calculadas razões de mortalidade materna e razões de mortalidade materna específica, as quais foram analisadas por regressão de Poisson. Na distribuição espacial foram construídos três mapas do estado com as taxas de 1999, 2003 e 2008 das sete macrorregiões. RESULTADOS Houve aumento de 2,0% no período de dez anos (IC95% 1,00;1,04; p = 0,01), sem mudança expressiva na magnitude da razão de mortalidade materna. A macrorregião da Serra apresentou a maior razão de mortalidade materna (1,15; IC95% 1,08;1,21; p < 0,001). A maioria dos óbitos no estado do Rio Grande do Sul ocorreu entre mulheres acima de 40 anos, com baixa escolaridade e de cor branca. O momento do parto/aborto e o puerpério imediato foram os de maior risco materno, sendo a hipertensão arterial e hemorragia as causas diretas de maior impacto negativo. CONCLUSÕES A não redução da mortalidade materna indica que as políticas públicas não impactaram a saúde materna e reprodutiva das mulheres. Qualificar a atenção à saúde da mulher, sobretudo no período pré-natal, buscando identificar e prevenir fatores de risco, vem ao encontro da redução da morte materna. Universidade de São Paulo. Faculdade de Saúde Pública2014-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/8571610.1590/S0034-8910.2014048005220Revista de Saúde Pública; Vol. 48 No. 4 (2014); 662-670Revista de Saúde Pública; Vol. 48 Núm. 4 (2014); 662-670Revista de Saúde Pública; v. 48 n. 4 (2014); 662-6701518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPengporhttps://www.revistas.usp.br/rsp/article/view/85716/88484https://www.revistas.usp.br/rsp/article/view/85716/88485Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessCarreno, Ioná Bonilha, Ana Lúcia de Lourenzi Costa, Juvenal Soares Dias da 2014-10-17T20:03:34Zoai:revistas.usp.br:article/85716Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2014-10-17T20:03:34Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Temporal evolution and spatial distribution of maternal death
Evolução temporal e distribuição espacial da morte materna
title Temporal evolution and spatial distribution of maternal death
spellingShingle Temporal evolution and spatial distribution of maternal death
Carreno, Ioná
title_short Temporal evolution and spatial distribution of maternal death
title_full Temporal evolution and spatial distribution of maternal death
title_fullStr Temporal evolution and spatial distribution of maternal death
title_full_unstemmed Temporal evolution and spatial distribution of maternal death
title_sort Temporal evolution and spatial distribution of maternal death
author Carreno, Ioná
author_facet Carreno, Ioná
Bonilha, Ana Lúcia de Lourenzi
Costa, Juvenal Soares Dias da
author_role author
author2 Bonilha, Ana Lúcia de Lourenzi
Costa, Juvenal Soares Dias da
author2_role author
author
dc.contributor.author.fl_str_mv Carreno, Ioná
Bonilha, Ana Lúcia de Lourenzi
Costa, Juvenal Soares Dias da
description OBJECTIVE To analyze the temporal evolution of maternal mortality and its spatial distribution. METHODS Ecological study with a sample made up of 845 maternal deaths in women between 10 and 49 years, registered from 1999 to 2008 in the state of Rio Grande do Sul, Southern Brazil. Data were obtained from Information System on Mortality of Ministry of Health. The maternal mortality ratio and the specific maternal mortality ratio were calculated from records, and analyzed by the Poisson regression model. In the spatial distribution, three maps of the state were built with the rates in the geographical macro-regions, in 1999, 2003, and 2008. RESULTS There was an increase of 2.0% in the period of ten years (95%CI 1.00;1.04; p = 0.01), with no significant change in the magnitude of the maternal mortality ratio. The Serra macro-region presented the highest maternal mortality ratio (1.15, 95%CI 1.08;1.21; p < 0.001). Most deaths in Rio Grande do Sul were of white women over 40 years, with a lower level of education. The time of delivery/abortion and postpartum are times of increased maternal risk, with a greater negative impact of direct causes such as hypertension and bleeding. CONCLUSIONS The lack of improvement in maternal mortality ratio indicates that public policies had no impact on women’s reproductive and maternal health. It is needed to qualify the attention to women’s health, especially in the prenatal period, seeking to identify and prevent risk factors, as a strategy of reducing maternal death.
publishDate 2014
dc.date.none.fl_str_mv 2014-08-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/85716
10.1590/S0034-8910.2014048005220
url https://www.revistas.usp.br/rsp/article/view/85716
identifier_str_mv 10.1590/S0034-8910.2014048005220
dc.language.iso.fl_str_mv eng
por
language eng
por
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/85716/88484
https://www.revistas.usp.br/rsp/article/view/85716/88485
dc.rights.driver.fl_str_mv Copyright (c) 2017 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2017 Revista de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 48 No. 4 (2014); 662-670
Revista de Saúde Pública; Vol. 48 Núm. 4 (2014); 662-670
Revista de Saúde Pública; v. 48 n. 4 (2014); 662-670
1518-8787
0034-8910
reponame:Revista de Saúde Pública
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instname_str Universidade de São Paulo (USP)
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repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
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