Abstract
The aim of this cross-sectional hospital-based study of 7,845 pregnancies was to analyze deaths of women hospitalized for childbirth and abortion, and fetal and neonatal deaths, in public hospitals in the cities of São Paulo, Rio de Janeiro and Niteroi (RJ), Brazil, in 2011. Outcomes of the pregnancies were: one maternal death, 498 abortions, 65 fetal deaths, 44 neonatal deaths and 7,291 infant survivors. Data were collected through interviews, medical records and the women's pregnancy records, and from the Mortality Information System (SIM). The study population was described and kappa coefficients of causes of death (from the SIM, and certified by research) and mortality health indicators were estimated. The maternal mortality ratio was 13.6 per 100,000 live births (LB), the fetal death rate was 8.8‰ births and the neonatal mortality rate was 6.0‰ LB. The drug most used to induce abortion was Misoprostol. The main causes of fetal and neonatal deaths were respiratory disorders and maternal factors. Congenital syphilis, diabetes and fetal death of unspecified cause were under-reported in the SIM. Kappa coefficients by chapter were 0.70 (neonatal deaths) and 0.54 (stillbirths). Good quality care in reproductive planning, prenatal care, during labor and at birth will result in prevention of deaths.
Highlights
Women and their concepti are a group with higher vulnerability, expressed by the risk of illness and death[1], the biological determinants of which are exacerbated by socio-economic characteristics and factors in healthcare[2].Maternal death is a rare, tragic and avoidable event[3]
The aim of this cross-sectional hospital-based study of 7,845 pregnancies was to analyze deaths of women hospitalized for childbirth and abortion, and fetal and neonatal deaths, in public hospitals in the cities of São Paulo, Rio de Janeiro and Niteroi (RJ), Brazil, in 2011
The only maternal death was of a woman resident in the municipality of São Paulo, born in Bolivia, age 34, color described as ‘yellow’ and with low level of schooling
Summary
Women and their concepti are a group with higher vulnerability, expressed by the risk of illness and death[1], the biological determinants of which are exacerbated by socio-economic characteristics and factors in healthcare[2].Maternal death is a rare, tragic and avoidable event[3]. The risk of death is greater at the beginning of the pregnancy, when the pregnancy itself has not even been recognized or diagnosed[6]. These miscarriages, frequently reported as irregularities of menstruation, are not usually reported[6]. In 2010, the National Abortion Survey estimated that 15% of Brazilian women, by the completion of their reproductive life, had had an abortion, requiring hospitalization in 50% of those cases[8]. In spite of the reduction of 26% in the indirect national estimates of induced abortions in women of fertile age from 1995 to 2013, their magnitude is a source of concern[9]
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