Abstract
Abstract Objective: To analyze the intraurban spatial distribution of perinatal mortality, its avoidability, and relationship with socioeconomic indicators in Recife, Pernambuco, Brazil, in the period from 2013 to 2015. Method: An ecological study with data from the Information Systems on Mortality and Live Births and the Brazilian Institute of Geography and Statistics, using neighborhoods as the analysis unit. We elaborated an indicator of social deprivation formed by variables from the demographic census. We estimated the Kernel density of the deaths and calculated the Moran index of the perinatal mortality coefficients in the spatial analysis. We elaborated thematic maps of avoidable perinatal mortality and social deprivation. Results: The global statistical analysis of the mortality distribution indicated evidence of spatial aggregation. Moran's index was 0.18. We found clusters of perinatal mortality in neighborhoods of the Central, North, Northwest, and South Regions. In the North, Northwest, Southwest, and South Regions we identified neighborhoods with greater social deprivation and avoidable mortality coefficients. The primary cause of death was of fetuses and newborns affected by hypertensive maternal disorders. Conclusion: We demonstrated intraurban differentials in perinatal mortality among neighborhoods. The stratification of the urban space according to the social deprivation indicator presented a relation with the perinatal mortality and its avoidability.
Highlights
Perinatal mortality, the period comprised between the 22nd week of pregnancy and the first seven days of life, reflects the access to health care and the quality of the assistance to the prenatal, the labor, and the newborn, constituting an expressive indicator of maternal and infant health.[1]Around the world, perinatal deaths occur primarily in countries of low and medium income.[1]
In the North, Northwest, Southwest, and South Regions we identified neighborhoods with greater social deprivation and avoidable mortality coefficients.The primary cause of death was of fetuses and newborns affected by hypertensive maternal disorders
The stratification of the urban space according to the social deprivation indicator presented a relation with the perinatal mortality and its avoidability
Summary
The period comprised between the 22nd week of pregnancy and the first seven days of life, reflects the access to health care and the quality of the assistance to the prenatal, the labor, and the newborn, constituting an expressive indicator of maternal and infant health.[1]Around the world, perinatal deaths occur primarily in countries of low and medium income.[1]. The period comprised between the 22nd week of pregnancy and the first seven days of life, reflects the access to health care and the quality of the assistance to the prenatal, the labor, and the newborn, constituting an expressive indicator of maternal and infant health.[1]. Deaths considered avoidable are those unnecessary or potentially preventable by the effective action of health services.[4] To classify the avoidability of the deaths, the List of Causes of Death Avoidable by Interventionsof the Brazilian Unified Health System (UHS) was elaborated,[5] which contemplates the neonatal period, whose circumstances and etiologies are similar to the perinatal.[6] This list classifies the causes of avoidable deaths in reducible by the following: immunoprevention actions; proper care to the pregnant women, labor, fetus, and newborn; adequate actions of diagnosis and treatment; appropriate health promotion actions linked to suitable health care actions.[5]
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