Estimation of maternal mortality rates in Brazil, 2008-2011.

This study proposes a methodology for estimating maternal mortality rates (MMR) in Brazil between 2008 and 2011 using data obtained from Ministry of Health information systems. The method assesses underreporting of maternal deaths, the investigation rates of deaths among women of reproductive age, as well as the proportion of maternal deaths that were misclassified as other causes before investigation. MMR was estimated for each state in Brazil in the 2009 to 2011 triennium. Overall MMR in Brazil was lower in 2011 (60.8 per 100,000 live births) and higher in 2009 (73.1 per 100.000 live births) probably due to the H1N1 influenza epidemic that occurred in the same year. MMR was highest in the States of Maranhão and Piauí (over 100 per 100,000 live births) and lowest in the State of Santa Catarina, the only state with a MMR of less than 40 per 100,000 live births. The results show that rates are higher than the target rate of the fifth Millennium Development Goal, but indicated a significant decrease in MMR during the period 1990 to 2011.