Infant mortality evolution in the metropolitan region of São Paulo (Brazil), 1980-2000

Abstract

To analyze IMR evolution in the São Paulo Metropolitan Area (SPMA) between 1980 and 2000, in terms of spatial, age and, causal differences. SPMA municipalities were divided into 5 groups, based on their 1980 IMRs: 90 per thousand lb (Group 1); 70-89 per thousand lb (Group 2); 50-69 per thousand lb (Group 3); <50 per thousand lb (Group 4). Group 5 comprised the municipality of São Paulo itself (IMR=51 per thousand lb). The analysis of trends was carried out using exponential regression models. IMR and its components showed a statistically significant decrease (p<0.05), with coefficients of determination between 66 and 98%, indicating goodness of fit of the exponential model to all the time series analyzed. SPMA IMR fell 69.4%, from 55.2 to 16.9 per thousand lb, and Groups 1-5 showed reductions of 83.9%, 76.2%, 71.3%, 58.7%, and 68.8%, indicating that the groups with highest IMRs also showed the greatest reductions during the studied period. IMRs were homogenized at around 18 lb in all municipality groups in the SPMA. One-half of all deaths were concentrated within the first week of life, and were due primarily to conditions originating in the perinatal period, indicating that greater care during the pre- and post-delivery periods will be required if the IMR in the SPMA is to descend to levels compatible with those of developed countries.