Abstract
ABSTRACTOBJECTIVE To estimate maternal mortality ratio according to occupation in Brazil.METHODS This is a mortality study conducted with national data from the Mortality Information System (SIM) and the Live Birth Information System (SINASC) in 2015. Maternal mortality ratios were estimated according to the occupation recorded in death certificates, using the Brazilian Classification of Occupation (CBO), version 2002.RESULTS A total of 1,738 maternal deaths records were found, corresponding to a maternal mortality ratio of 57.6/100,000 live births. It varied among occupational groups, with higher estimates among service and agricultural workers, particularly for domestic workers (123.2/100,000 live births), followed by general agricultural workers (88.3/100,000 live births). Manicurists and nursing technicians also presented high maternal mortality ratio. Maternal occupation was not reported in 17.0% of SIM registers and in 13.2% of SINASC data. Inconsistent records of occupation were found.“Housewife” prevailed in SIM (35.5%) and SINASC (39.1%).CONCLUSIONS Maternal mortality ratio differs by occupation, suggesting a work contribution, which requires further research focusing occupational risk factors. Socioeconomic factors are closely related to occupation, and their combination with work exposures and the poor access to health services need to be also addressed.
Highlights
The death of women in reproductive age, due to problems of pregnancy, childbirth or puerperium, is unacceptable as it is commonly preventable
Maternal mortality ratio differs by occupation, suggesting a work contribution, which requires further research focusing occupational risk factors
The maternal mortality ratio (MMR) reduction is a global priority and the existing declining time trend, it has remains at high levels worldwide, as for 216/100,000 live births (LB) in 20151
Summary
The death of women in reproductive age, due to problems of pregnancy, childbirth or puerperium, is unacceptable as it is commonly preventable. According to the 10th Revision of the International Classification of Diseases (ICD-10)[2], maternal death corresponds to “death during pregnancy or up to 42 days after the end of pregnancy, regardless of the duration or location of pregnancy, due to any cause related to or aggravated by pregnancy or by measures in relation to it.”. It does not include deaths from accidental causes. A study has shown the predominance of direct obstetric causes, especially hypertension, hemorrhages, puerperal infections and abortion[10], and the association of maternal death with limitations in quality and access to health services[10]. Despite the multiple evidence that exposure to occupational risk agents (such as chemical substances, physical overload and psychostressors, among others) affects maternal health, reproductive outcomes related to work are still poorly studied
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