Abstract
INTRODUCTION Maternal death continues to be one of the most challenging public health problems that needs to be addressed in low and middle-income countries. The objective of this study was to describe the problem of maternal death in Brazil, using estimates from the Global Burden of Disease Study (GBD).METHODS This study used data from the GBD 2019 to show the numbers of deaths and the Maternal Mortality Ratio (MMR) - number of deaths/100,000 live births - in Brazil and its 27 Federated Units (FU), for ages 10 to 54 years, from 1990 to 2019. The annual variation of the MMR was estimated in 1990, 2010, and 2019. The MMR were shown for specific causes as well as for five-year age groups. The estimates were presented with 95% uncertainty intervals (UI).RESULTS The number of maternal deaths, as well as the MMR showed a 49% reduction from 1990 to 2019. This reduction occurred heterogeneously throughout the country, and the profile of the MMR for specific causes changed between 1990 and 2019: from hypertensive gestation diseases, to indirect maternal deaths, followed by hypertensive gestation diseases. In the extreme age groups, the MMR is higher, with mortality increasing exponentially in direct proportion with age.CONCLUSIONS Maternal deaths in Brazil have decreased substantially since 1990; however, the numbers still fall short of what was established by the World Health Organization (WHO). Indirect causes are the greatest problem in more than 60% of the FU, especially for hypertensive pregnancy diseases.
Highlights
Maternal death continues to be one of the most challenging public health problems that needs to be addressed in low and middle-income countries
The document seeks to standardize the identification of causes of death, to ensure their registration in a consistent manner, and to improve the reliability of the measurements established by the Millennium Development Goals (MDGs)[4] and subsequently by the Sustainable Development Goals (SDGs)[5]
Deaths associated with pregnancy and delivery have diminished in Brazil significantly since 1990, the reduction falls short of the target of 75%, defined by the World Health Organization (WHO) (35.8/100,000 live births)
Summary
Maternal death continues to be one of the most challenging public health problems that needs to be addressed in low and middle-income countries. Methods: This study used data from the GBD 2019 to show the numbers of deaths and the Maternal Mortality Ratio (MMR) - number of deaths/100,000 live births - in Brazil and its 27 Federated Units (FU), for ages 10 to 54 years, from 1990 to 2019. Results: The number of maternal deaths, as well as the MMR showed a 49% reduction from 1990 to 2019 This reduction occurred heterogeneously throughout the country, and the profile of the MMR for specific causes changed between 1990 and 2019: from hypertensive gestation diseases, to indirect maternal deaths, followed by hypertensive gestation diseases. The MMR is the indicator that demonstrates the ratio of the number of maternal deaths, using as denominator 100,000 live births[7], and its values subsidize decision-making related to providing adequate health services, from family planning to assistance in delivery and puerperium[8]
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