Soares Vânia Muniz Néquer, de Azevedo Elbens M Minorelli, Watanabe Terezinha L
Secretaria de Estado da Saúde do Paraná, Curitiba, Brasil.
Cad Saude Publica. 2008 Oct;24(10):2418-26. doi: 10.1590/s0102-311x2008001000022.
The objective of this article was to analyze the underreporting of maternal deaths in Paraná State, Brazil, from 1991 to 2005, identifying details on the basic causes that keep maternal deaths hidden and problems with completing items 43 and 44 on death certificates during a recent period (2003-2005). Data were obtained from the database of the Paraná State Committees for the Prevention of Maternal Mortality, which investigate maternal deaths using the Reproductive Age Mortality Survey (RAMOS). According to the data, maternal mortality decreased by 26% in 15 years, but the level of underreporting remained the same, generating adjustment factors ranging from 1.6 to 1.8. In conclusion, medical schools and the State medical board should provide more incisive and comprehensive orientation on completing death certificates in order to minimize this underreporting. The Paraná State Committees for the Prevention of Maternal Mortality help correct underreporting of maternal deaths by identifying their real causes and determinants and defining strategies to reduce them. More effective measures to reduce avoidable maternal deaths are still needed in the State.
本文旨在分析1991年至2005年巴西巴拉那州孕产妇死亡报告不足的情况，确定导致孕产妇死亡瞒报的基本原因细节，以及近期（2003 - 2005年）死亡证明第43项和第44项填写方面存在的问题。数据来自巴拉那州孕产妇死亡预防委员会的数据库，该委员会使用生殖年龄死亡率调查（RAMOS）对孕产妇死亡情况进行调查。根据数据，孕产妇死亡率在15年内下降了26%，但瞒报水平保持不变，产生的调整系数在1.6至1.8之间。总之，医学院校和州医学委员会应就死亡证明的填写提供更具针对性和全面性的指导，以尽量减少这种瞒报情况。巴拉那州孕产妇死亡预防委员会通过确定孕产妇死亡的真正原因和决定因素并制定减少死亡的策略，有助于纠正孕产妇死亡报告不足的问题。该州仍需要采取更有效的措施来减少可避免的孕产妇死亡。
