Mortalidade feminina em idade reprodutiva no Estado de São Paulo, Brasil, 1991-1995: causas básicas de óbito e mortalidade materna

Abstract

To describe female mortality in the reproductive age (15 to 49 years old) in the State of S. Paulo, Brazil, from 1991 to 1995, according to the age and underlying causes of death. Underlying causes of death, according to the International Classification of Diseases, 9th Revision, were determined in the program Automated Classification of Medical Entities (ACME), developed by "Fundação Seade", which provided us data files and estimated women population by age groups and numbers of live births during the 1991 - 1995 period. Specific rates were calculated per 100,000 women and maternal mortality rates were given per 100,000 live births. Percentages of death were calculated for sub-groups. The median of the rates for a five-year-period was calculated to allow the comparison among the leading underlying causes of death. "Cellular immunity deficiency" increased from 1991 to 1995 in women aged 25 or more which seems to be concomitant to the spreading of the AIDS epidemic among women. Lesions and poisonings were the leading causes of death in younger women, but after the age of 35 cardiovascular diseases and neoplasms became the chief causes. Infectious and parasitic diseases were rated in the 7th or 8th positions in all ages. Accidents and homicides were high. Maternal mortality rates ranged from 43.7 to 49.6 per 100,000 live births, their leading causes were presented and discussed. Women in the reproductive age were exposed to external factors, chronic diseases and AIDS. The majority of maternal causes of death are preventable diseases. There is a lack of adequate and extensive antenatal care as well as in delivery and postpartum care.