Vega Carlos Eduardo Pereira, Soares Vânia Muniz Néquer, Lourenço Francisco Nasr Acácia Maria
Comitê de Mortalidade Materna do Município de São Paulo, São Paulo, Brasil.
Comitê Estadual de Prevenção da Mortalidade Materna do Paraná, Curitiba, Brasil.
Cad Saude Publica. 2017 Apr 20;33(3):e00197315. doi: 10.1590/0102-311X00197315.
This population-based study included all the late maternal deaths from the case series of the Maternal Mortality Committees in the city of São Paulo and the state of Paraná, Brazil. The study compared 134 deaths identified by the São Paulo committee and 124 from the Paraná committee in 2004-2013, aimed at demonstrating the magnitude and causes of late maternal mortality. Late maternal deaths accounted for 13.4% of all maternal deaths in the case series of the São Paulo committee and 12.1% in the cases series of the Paraná committee. Direct obstetric causes accounted for 32.1% of the late maternal deaths in São Paulo and 42.1% in Paraná, with postpartum cardiomyopathy as the principal cause in both case series. Death occurred between 43 and 69 days postpartum in 44% of the cases in São Paulo and 39.5% in Paraná. The correction factor for late maternal death was 3.3 in São Paulo and 4.3 in Paraná. Late maternal death had a relevant impact on overall maternal mortality, and postpartum cardiomyopathy was the principal cause of late direct obstetric death.
这项基于人群的研究纳入了巴西圣保罗市和巴拉那州孕产妇死亡委员会病例系列中的所有晚期孕产妇死亡病例。该研究比较了圣保罗委员会在2004年至2013年期间确定的134例死亡病例和巴拉那委员会确定的124例死亡病例,旨在揭示晚期孕产妇死亡的规模和原因。晚期孕产妇死亡在圣保罗委员会病例系列中占所有孕产妇死亡的13.4%,在巴拉那委员会病例系列中占12.1%。直接产科原因在圣保罗的晚期孕产妇死亡中占32.1%,在巴拉那占42.1%,两个病例系列中产后心肌病均为主要原因。圣保罗44%的病例和巴拉那39.5%的病例在产后43至69天死亡。圣保罗晚期孕产妇死亡的校正系数为3.3,巴拉那为4.3。晚期孕产妇死亡对总体孕产妇死亡率有显著影响,产后心肌病是晚期直接产科死亡的主要原因。