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1997 - 2012年巴西孕产妇和新生儿死亡率的时空演变

Temporal and spatial evolution of maternal and neonatal mortality rates in Brazil, 1997-2012.

作者信息

Rodrigues Nádia Cristina Pinheiro, Monteiro Denise Leite Maia, Almeida Andréa Sobral de, Barros Mônica Barros de Lima, Pereira Neto André, O'Dwyer Gisele, Andrade Mônica Kramer de Noronha, Flynn Matthew Brian, Lino Valéria Teresa Saraiva

机构信息

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.

Universidade do Estado do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Rio de Janeiro, RJ, Brazil.

出版信息

J Pediatr (Rio J). 2016 Nov-Dec;92(6):567-573. doi: 10.1016/j.jped.2016.03.004. Epub 2016 May 25.

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.

摘要

目的

孕产妇和新生儿死亡率是低收入国家重要的公共卫生问题。本研究评估了1997年至2012年巴西孕产妇和新生儿死亡率的时空趋势。

方法

本研究采用空间分析技术,利用死亡率信息系统的死亡记录。按州、地区和时期(1997 - 2000年、2001 - 2004年、2005 - 2008年和2009 - 2012年)计算每10万例的孕产妇死亡率以及每1000例活产的新生儿死亡率(早期和晚期)。使用多变量负二项式模型来解释死亡风险。

结果

在1997 - 2012年整个期间,巴西孕产妇平均死亡率为55.63/10万。该比率从1997 - 2000年(58.92/10万)下降了10%至2001 - 2004年(52.77/10万),但随后在2009 - 2012年期间又上升了11%(58.69/10万)。在1997 - 2012年期间,早期和晚期新生儿死亡率分别下降了33%(降至7.36/1000)和21%(降至2.29/1000)。巴西每个地区的新生儿死亡率都有所下降。然而,东北部、北部和东南部地区的孕产妇死亡率有所上升。

结论

巴西的新生儿死亡率近期有所改善,但孕产妇死亡率停滞不前,未达到千年发展目标。公共政策和部门间的努力可能有助于改善这些健康指标。

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