Nascimento Rita de Cássia de Sousa, Costa Maria da Conceição Nascimento, Braga José Uéleres, Natividade Márcio Santos da
Instituto de Saúde Coletiva. Universidade Federal da Bahia. Salvador, BA, Brasil.
Universidade Estadual do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Rev Saude Publica. 2017 Aug 17;51:73. doi: 10.11606/S1518-8787.2017051007076.
To identify the spatial distribution patterns and areas of higher risk of preventable perinatal mortality in the city of Salvador, State of Bahia, Brazil.
We carried out a spatial aggregated study in 2007, considering the weighting areas (census tracts contiguous sets) of Salvador, of which the center and north present low life conditions. Data were obtained from national vital statistics systems and the 2010 Census. Addresses of live births and stillbirths were geocoded by weighting area. The spatial distribution of the perinatal mortality rate was analyzed from thematic maps. Spatial dependence was evaluated by the Global and Local Geary's and Moran's Indexes.
Crude and smoothed perinatal mortality rates were high in areas situated to the north, west, and in center of Salvador. The smoothed rates in weighting areas ranged from 4.9/1,000 to 22.3/1,000 births. Of all perinatal deaths, 92.1% could have been prevented. We identified spatial dependence for preventable perinatal mortality for care in pregnancy, with neighboring areas with high risk in the north of the city.
The preventability potential of perinatal mortality was high in Salvador, in 2007. The spatial distribution pattern with higher rates in disadvantaged areas of the city suggests the existence of social inequalities in health. The characteristics of the process of urban development of Salvador, which has inadequate prenatal care, possibly influenced the magnitude and spatial distribution pattern of this mortality.
确定巴西巴伊亚州萨尔瓦多市可预防的围产期死亡率的空间分布模式及高风险区域。
2007年我们开展了一项空间聚集研究，考虑了萨尔瓦多的加权区域（连续的普查小区集合），其中心和北部生活条件较差。数据来自国家生命统计系统和2010年人口普查。活产和死产的地址按加权区域进行地理编码。通过专题地图分析围产期死亡率的空间分布。通过全局和局部Geary指数及Moran指数评估空间依赖性。
萨尔瓦多市北部、西部和中心区域的粗围产期死亡率和平滑围产期死亡率较高。加权区域的平滑率在每1000例出生4.9例至22.3例之间。在所有围产期死亡中，92.1%本可预防。我们确定了孕期护理可预防围产期死亡率的空间依赖性，城市北部相邻区域风险较高。
2007年萨尔瓦多市围产期死亡率的可预防潜力很高。城市贫困地区死亡率较高的空间分布模式表明存在健康方面的社会不平等。萨尔瓦多市城市发展过程中产前护理不足的特点，可能影响了这种死亡率的规模和空间分布模式。
