Nádia Cristina Pinheiro Rodrigues1, Denise Leite Maia Monteiro2, Andréa Sobral de Almeida3, Mônica Barros de Lima Barros3, André Pereira Neto3, Gisele O'Dwyer3, Mônica Kramer de Noronha Andrade4, Matthew Brian Flynn5, Valéria Teresa Saraiva Lino3. 1. Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Rio de Janeiro, RJ, Brazil; Universidade do Estado do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Rio de Janeiro, RJ, Brazil. Electronic address: nadia@lampada.uerj.br. 2. Universidade do Estado do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Rio de Janeiro, RJ, Brazil. 3. Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Rio de Janeiro, RJ, Brazil. 4. Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Rio de Janeiro, RJ, Brazil; Instituto Vital Brazil, Centro de Estudo e Pesquisa do Envelhecimento, Niterói, RJ, Brazil. 5. Georgia Southern University, Department of Sociology & Anthropology, Statesboro, United States.
Abstract
OBJECTIVE: Maternal and neonatal mortality are important public health issues in low-income countries. This study evaluated spatial and temporal maternal and neonatal mortality trends in Brazil between 1997 and 2012. METHODS: This study employed spatial analysis techniques using death records from the mortality information system. Maternal mortality rates per 100,000 and neonatal mortality rates (early and late) per 1000 live births were calculated by state, region, and period (1997-2000, 2001-2004, 2005-2008, and 2009-2012). Multivariate negative binomial models were used to explain the risk of death. RESULTS: The mean Brazilian maternal mortality rate was 55.63/100,000 for the entire 1997-2012 period. The rate fell 10% from 1997-2000 (58.92/100,000) to 2001-2004 (52.77/100,000), but later increased 11% during 2009-2012 (58.69/100,000). Early and late neonatal mortality rates fell 33% (to 7.36/1000) and 21% (to 2.29/1000), respectively, during the 1997-2012 period. Every Brazilian region witnessed a drop in neonatal mortality rates. However, maternal mortality increased in the Northeast, North, and Southeast regions. CONCLUSION: Brazil's neonatal mortality rate has improved in recent times, but maternal mortality rates have stagnated, failing to meet the Millennium Development Goals. Public policies and intersectoral efforts may contribute to improvements in these health indicators.
OBJECTIVE: Maternal and neonatal mortality are important public health issues in low-income countries. This study evaluated spatial and temporal maternal and neonatal mortality trends in Brazil between 1997 and 2012. METHODS: This study employed spatial analysis techniques using death records from the mortality information system. Maternal mortality rates per 100,000 and neonatal mortality rates (early and late) per 1000 live births were calculated by state, region, and period (1997-2000, 2001-2004, 2005-2008, and 2009-2012). Multivariate negative binomial models were used to explain the risk of death. RESULTS: The mean Brazilian maternal mortality rate was 55.63/100,000 for the entire 1997-2012 period. The rate fell 10% from 1997-2000 (58.92/100,000) to 2001-2004 (52.77/100,000), but later increased 11% during 2009-2012 (58.69/100,000). Early and late neonatal mortality rates fell 33% (to 7.36/1000) and 21% (to 2.29/1000), respectively, during the 1997-2012 period. Every Brazilian region witnessed a drop in neonatal mortality rates. However, maternal mortality increased in the Northeast, North, and Southeast regions. CONCLUSION: Brazil's neonatal mortality rate has improved in recent times, but maternal mortality rates have stagnated, failing to meet the Millennium Development Goals. Public policies and intersectoral efforts may contribute to improvements in these health indicators.
Authors: Alexandre Bugelli; Roxane Borgès Da Silva; Ladislau Dowbor; Claude Sicotte Journal: Int J Environ Res Public Health Date: 2021-06-15 Impact factor: 3.390