Causas externas e mortalidade materna: proposta de classificacao

Mercia Maria Rodrigues Alves,Sandra Valongueiro Alves,Dirce Luiza Pereira Dos Santos,Maria Bernadete De Cerqueira Antunes

doi:10.1590/s0034-8910.2013047003642

Mercia Maria Rodrigues Alves, Sandra Valongueiro Alves + Show 2 more

Open Access

https://doi.org/10.1590/s0034-8910.2013047003642

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Abstract

To analyze deaths from external causes and undefined causes in women of childbearing age occurring during pregnancy and early postpartum. The deaths of 399 women of childbearing age, resident in Recife, Northeastern Brazil, in the period 2004 to 2006, were studied. The survey utilized the Reproductive Age Mortality Survey method and a set of standardized questionnaires. Data sources included reports from the Institute of Legal Medicine, hospital and Family Health Strategy records and interviews with relatives of the deceased women. External causes of death during pregnancy were classified according to the circumstance of death, using the O93 code (ICD) and maternal mortality ratios before and after the classification were calculated. Eighteen deaths during pregnancy were identified. The majority were aged between 20 and 29, had between 4 and 7 years of schooling, were black and single parents. Fifteen deaths were classified using the O93 code as pregnancy related death (13 for homicide - code 93.7; 2 by suicide - code 93.6) and three were classified as indirect obstetric maternal deaths (one homicide - code 93.7 and two by suicide - code 93.6). There was an average increment of 35% in the RMM after classification. Deaths from undefined causes in and in early postpartumdid not occur by chance and their exclusion from the calculations of maternal mortality indicators only increases levels of underreporting.

Highlights

Violence against women became an object of study and intervention in the health care area from the 1990s onwards, at the same time as it secured its position internationally as a question of human rights
Deaths from undefined causes in and in early postpartumdid not occur by chance and their exclusion from the calculations of maternal mortality indicators only increases levels of underreporting
Deaths by homicide were the highest number in all age groups, with a mean of 57.0%, except in the 40 to 49 age group, in which 36.5% of deaths were caused by accidents

Summary

Introduction

Violence against women became an object of study and intervention in the health care area from the 1990s onwards, at the same time as it secured its position internationally as a question of human rights. Studies have shown prevalence varying between 0.9% and 35% and that the violence is associated with a pattern of violence having begun before the pregnancy.[4,10,11,13,14] In the city of São Paulo, the prevalence of physical violence during pregnancy has been estimated at 8.0% and 11.0% in the Zona da Mata area of Pernambuco (PE), Northeastern Brazil.[22] According to Durand & Schraiber,8 20.0% of the women using public health care services in São Paulo reported having suffered some type of violence whilst pregnant. Ludermir et al[16] (2010) found a prevalence of violence (psychological, physical or sexual) of 30.7% in Recife, PE

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