Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Instituto de Saúde Coletiva, Universidade Federal Fluminense, Rio de Janeiro, Brasil.
Cad Saude Publica. 2020 Feb 10;36Suppl 1(Suppl 1):e00190418. doi: 10.1590/0102-311X00190418. eCollection 2020.
This study sought to update knowledge on unsafe abortion in Brazil. We carried out a systematic review with study search and selection on MEDLINE and LILACS, with no language restriction, from 2008 to 2018. We evaluated article quality using the Joanna Briggs Institute instruments. We evaluated 50 articles. The prevalence of induced abortion in Brazil was estimated by a direct method to be 15% in 2010 and 13% in 2016. Higher prevalences were observed in more socially vulnerable populations. There was a decrease in the ratio of induced abortions by 1,000 women of reproductive age in the period 1995-2013, reaching 16 per 1,000 in 2013. Half of all women reported using medications for terminating pregnancies and the number of hospital admissions due to complications from abortion, especially severe complications, decreased from 1992 to 2009. Maternal morbimortality from abortion had a reduced frequency but reached high values in specific contexts. It is likely that maternal deaths from abortion are under-reported. Common mental disorders during pregnancy and postpartum depression were more frequent among women who unsuccessfully attempted to induce an abortion. Findings indicate that abortion is frequently used in Brazil, especially in less-developed regions and by more socially-vulnerable women. Access to safer methods probably contributed to the reduction in hospitalizations due to complications and to the reduction in morbimortality from abortion. However, half of all women still resort to other methods and the number of admissions due to complications from abortion is still high.
本研究旨在更新巴西不安全堕胎的知识。我们在 MEDLINE 和 LILACS 上进行了系统评价，研究检索和选择，没有语言限制，时间范围为 2008 年至 2018 年。我们使用 Joanna Briggs 研究所的工具评估文章质量。我们评估了 50 篇文章。2010 年和 2016 年，巴西人工流产的流行率通过直接方法估计分别为 15%和 13%。在社会弱势群体中观察到更高的流行率。1995-2013 年间，每 1000 名育龄妇女的人工流产率下降了 16 例，达到 16 例。一半的妇女报告使用药物终止妊娠，因堕胎并发症，特别是严重并发症而住院的人数从 1992 年到 2009 年减少。堕胎导致的孕产妇发病率和死亡率的频率降低，但在特定情况下仍达到很高的值。可能堕胎导致的孕产妇死亡报告不足。在试图人工流产失败的妇女中，妊娠期和产后常见精神障碍和抑郁症更为常见。这些发现表明，堕胎在巴西经常使用，特别是在欠发达地区和社会弱势群体中。获得更安全的方法可能有助于减少因并发症导致的住院治疗和堕胎导致的发病率和死亡率。然而，仍有一半的妇女仍然求助于其他方法，因堕胎并发症导致的住院人数仍然很高。
