Abstract
Abstract Objectives: to analyze the epidemiological profile and the spatial-temporal dynamics on maternal mortality in Alagoas and its relationship with social vulnerability and income inequality. Methods: a mixed ecological study involving maternal deaths who resided in Alagoas from 1996 to 2016. Sociodemographic variables (age, race/color, education, marital status), clinical (type of obstetric cause, death by category and ICD group) were analyzed, besides the indicators (Maternal Mortality Ratio-MMR, Social Vulnerability Index and Gini Index). For the temporal analysis, we used the inflection point regression model and for the spatial analysis, the local empirical Bayesian model, Moran Global and Local statistics, and the bivariate local spatial autocorrelation analysis. Results: a total of 586 deaths (47.63/100 thousand live births) were registered, with a trend of MMR growth (APC 2.8%), with a heterogeneous distribution between health regions and cities. The profile was characterized by the predominance of young, black / mixed skin color women with low schooling. Eight cities were considered priority. There was spatial correlation with the Social Vulnerability Index and income inequality. Conclusions: identifying priority areas may contribute to planning and targeting interventions.
Highlights
The World Health Organization (WHO) defines a woman’s death during pregnancy or up to 42 days after childbirth as maternal death, regardless of duration or location of the pregnancy, due to the cause related to or aggravated by the pregnancy or in relation to by its action, except for accidental or incidental causes.1Maternal mortality is one of the most severe human rights violations, preventable in 92% of the cases, focusing mainly in developing countries
The first macro-region concentrated 62.42% (n=366) deaths and demonstrated a tendency for mortality to increase (APC 3.1%; CI95%= 1.4 4.8; p
36.35% (n=213) correspond to the age group of 20 to 29 years old (32.44/100 thousand LB), the highest MMR was registered in the range of 40 to 49 years old (206.52/100 thousand)
Summary
Maternal mortality is one of the most severe human rights violations, preventable in 92% of the cases, focusing mainly in developing countries. The Southeast Region occupied the first position in the country with 12,686 cases and the Northeast, in second position with 11,777 deaths.. High MMR are indicative of poor socioeconomic conditions, low level of information and education, family dynamics in which violence is present and, above all, difficulties in accessing quality in the health services.. High MMR are indicative of poor socioeconomic conditions, low level of information and education, family dynamics in which violence is present and, above all, difficulties in accessing quality in the health services.3 This predictor is used for epidemiological, trend and territorial inequality analyzes, and assisting the planning in health policies. High MMR are indicative of poor socioeconomic conditions, low level of information and education, family dynamics in which violence is present and, above all, difficulties in accessing quality in the health services. This predictor is used for epidemiological, trend and territorial inequality analyzes, and assisting the planning in health policies.
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