Abstract
This is an ecological and time-series study using secondary data on perinatal mortality and its components from 2008 to 2017 in Espírito Santo, Brazil. The data were collected from the Mortality Information System (SIM) and Live Births Information System (SINASC) of the Unified Health System Informatics Department (DATASUS) in June 2019. The perinatal mortality rate (×1000 total births) was calculated. Time series were constructed from the perinatal mortality rate for the regions and Espírito Santo. To analyze the trend, the Prais–Winsten model was used. From 2008 to 2017 there were 8132 perinatal deaths (4939 fetal and 3193 early neonatal) out of a total of 542,802 births, a perinatal mortality rate of 15.0/1000 total births. The fetal/early neonatal ratio was 1.5:1, with a strong positive correlation early neonatal mortality rate, perinatal mortality rate, r (9) = 0.8893, with a significance level of p = 0.000574. The presence of differences in trends by health region was observed. Risk factors that stood out were as follows: mother’s age ranging between 10 and 19 or 40 and 49 years old, with no education, a gestational age between 22 and 36 weeks, triple and double pregnancy, and a birth weight below 2499 g. Among the causes of death, 49.70% of deaths were concentrated in category of the tenth edition of the International Classification of Diseases, fetuses and newborns affected by maternal factors and complications of pregnancy, labor, and delivery (P00–P04), and 11.03% were in the category of intrauterine hypoxia and birth asphyxia (P20–P21), both related to proper care during pregnancy and childbirth. We observed a slow reduction in the perinatal mortality rate in the state of Espírito Santo from 2008 to 2017.
Highlights
Perinatal mortality is characterized by the number of fetal deaths from 22 complete weeks of pregnancy to the sixth full day of life, reflecting access to health services and the quality of prenatal, delivery, and newborn care [1,2]
It has a territorial area of 46,074.477 km2, an estimated population of 4,064,052 people, a demographic density of 76.25 inhabitants/km2, an HDI of 0.74, a humid coastal tropical climate influenced by the Atlantic tropical air mass, an average temperature between 22 and 24 ◦ C, and annual rainfall of between 1000 and 1500 mm
Of the 542,802 total births that occurred in the state of Espírito Santo, Brazil, 537,863 were live births, and 4939 were stillbirths while there were 3193 early neonatal deaths, totaling 8132 perinatal deaths (Table 1), between 2008 and 2017
Summary
Perinatal mortality is characterized by the number of fetal deaths from 22 complete weeks of pregnancy to the sixth full day of life, reflecting access to health services and the quality of prenatal, delivery, and newborn care [1,2]. In Brazil, most are avoidable and currently invisible [6], with a total of 53,170 deaths [7]. In 2010, perinatal mortality in Brazil declined compared to 2000, reaching 21.5 deaths/1000 total births in 2010, while in 2000 the rate was 26.6/1000, representing a reduction of. In 2014, the World Health Organization (WHO) launched an action plan to reduce preventable deaths and fetal deaths by 2035 [4].
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