Maternal mortality in Brazil: case study

American Journal of BioMedicine  Volume 2, Issue 9, pages 1061-1078 September 2014


Jose Campbell; Eliana Duarte Osis; Joao Goufodji 

Maternal mortality, as a largely avoidable cause of death and reduction in maternal mortality has been a top priority in Brazil, despite massive program efforts to avert maternal deaths, the maternal mortality ratio (MMR) in Brazil is still high especially in the poor area. Estimates of maternal mortality rates in Brazil are affected by underreporting of deaths, especially in less developed areas of the country where maternal mortality tends to be higher, and the absence of specific information indicating maternal death in reported deaths of women of reproductive age The objective of this study is to identify the true number of maternal deaths. We use data obtained from Ministry of Health information systems from the 2000 and 2012 Brazil Maternal Mortality Surveys to measure change in the maternal mortality ratio (MMR) and to measure changes in factors potentially related to such change. We estimate the changes in risk of maternal death between the two surveys using Poisson regression. 
Keywords: Maternal mortality; MMR; Underreporting of deaths

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1. Bouvier-Colle MH, Varnoux N, Salanave B, Pierre-Yves A, Bréart G. Case–control study of risk factors for obstetric patients’ admission to intensive care units. Eur J Obstet Gynecol Reprod Biol 1997;74:173–177.

2. World Health Organization; United Nations Children’s Fund; United Nations Population Fund; World Bank. Trends in maternal mortality: 1990 to 2010. Geneva: World Health Organization; 2012. [Article]

3. Alaerte Leandro Martinse. Maternal mortality among black women in Brazil. Cad. Saúde Pública, Rio de Janeir 2006; 22(11):2473-2479. [Abstract/Full-Text]

4. United Nations Population Fund. Maternal mor-tality update 2004: delivering into good hands. (acessado em 26/Fev/2006).

5. Brazil. Ministry of Health. Health coverage Indicators. [web-site]

6. Bouvier-Colle MH, Varnoux N, Salanave B, Pierre-Yves A, Bréart G. Case–control study of risk factors for obstetric patients’ admission to intensive care units. Eur J Obstet Gynecol Reprod Biol 1997;74:173–177. [PubMed]

7. Victora CG, Aquino EM, Leal MC, Monteiro CA, Barros FC, Szwarcwald CL. Maternal and child health in Brazil: progress and challenges. Lancet 2011;377(9780):1863–1876. [PubMed]

8. Graham WJ, Ahmed S, Stanton C, Abou-Zahr C, Campbell OM. Measuring maternal mortality: an overview of opportunities and options for developing countries. BMC Medicine 2008; 6:12. [Abstract/Full-Text]

9. Ronsmans C, De Brouwere V, Dominique Dubourg D, Dieltiens G: Measuring the need for life-saving obstetric surgery in developing countries. BJOG 2004;111:1027-1030. [PubMed]

10. Fauveau V, Donnay F. Can process indicators for emergency obstetric care assess the progress of maternal mortality reduction programs? An examination of UNFPA projects 2000–2004. Int J Gynaecol Obstet 2006; 93:308-16. [PubMed]

11. Graham WJ, Foster LB, Wheeler EH, Davidson L, Campbell OMR. Measuring progress in reducing maternal mortality. Best Pract Res Clin Obstet Gynaecol 2008; 22:425-445. [PubMed]

12. Comitê Estadual de Morte Materna do Paraná. Relatório do triênio 2000-2002. Curitiba: Comitê Estadual de Morte Materna; 2004.

13. AbouZahr C, Wardlaw T.  Maternal mortality at the end of a decade: signs of progress? Bull World Health Organ 2001, 79:561-568. [PubMed]

14. Vasquez DN, Estenssoro E, Canales HC, Reina MGS, Neves AV, Toro MA, Loudet C. Clinical characteristics and outcomes of obstetric patient requiring ICU admission. Chest 2007;131:718–724. [PubMed]

15. Cecatti JG, Guerra GV, Sousa MH, Menezes GM. Abortion in Brazil: a demographic approach. Rev Bras Ginecol Obstet 2010; 32(3):105-11. [PubMed]

16. de Souza e Silva R. Patterns of induced abortion in urban area of southeastern region, Brazil. Rev Saude Publica 1998;32(1):7-17. [PubMed]

17. Brazil. Ministry of Health. Prenatal and puerperal humanized and qualified care technical manual. Brasília: Ministério da Saúde; 2006. []

18. Brazil. Ministry of Health. Health coverage Indicators. []

19. Souza JP, Cecatti JG, Parpinelli MA, Serruya SJ, Amaral E. Appropriate criteria for identification of near-miss maternal morbidity in tertiary care facilities: a cross sectional study. BMC Pregnancy Childbirth 2007;11:20. [Abstract/Full-Text]

20. Pattinson RC, Hall M. Near misses: a useful adjunct to maternal death inquiries. Br Med Bull 2003; 67:231-43. [PubMed]

21. Information on routine health data for 2002 from the Brazilian National Health System. []

22. Stones W, Lim W, Al-Azzawi F, Kelly M. An investigation of maternal morbidity with identification of life-threatening 'near miss' episodes. Health Trends 1991; 23:13-5. [PubMed]

23. Prual A, Bouvier-Colle MH, De Bernis L, Bréart G. Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates. Bull World Health Org 2000;78(5):593-602. [PubMed]

24. Waterstone M, Bewley S, Wolfe C. Incidence and predictors of severe obstetric morbidity: case-control study. BMJ 2001; 322:1089-94. [PubMed]

25. Filippi V, Brugha R, Browne E, Gohou V, Bacci A, De Brouwere V, Sahel A, Goufodji S, Alihonou E, Ronsmans C. Obstetric audit in resource-poor settings: lessons from a multi-country project auditing 'near miss' obstetrical emergencies. Health Policy Plan 2004; 19(1):57-66. [PubMed]

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