Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, Brasil.
Cad Saude Publica. 2020 Feb 21;36Suppl 1(Suppl 1):e00188718. doi: 10.1590/01002-311X00188718. eCollection 2020.
According to the World Health Organization, from 2010 to 2014, there were around 55 million abortions worldwide, 45% of which were unsafe. In Brazil, data on abortion and its complications are incomplete. Health care data are only available for the public sector and mortality data depend on investigations of deaths. This study sought to describe the situation of abortion in the country using public data available in the different Information Systems - SIM (mortality), SINASC (live births) and SIH (hospitalization). From 2008 to 2015, there were around 200,000 hospitalizations/year for procedures related to abortion, 1,600 of which for medical and legal reasons. From 2006 to 2015, we found 770 maternal deaths in SIM whose underlying cause was abortion. There was a discreet reduction in the number of deaths from abortion in the period, with regional variation. This number could be increased by around 29% per year if deaths with mentions of abortion and declared with a different underlying cause were considered. Among the deaths reported as resulting from abortion, 1% were abortions due to medical and legal reasons and 56.5% were non-specified abortions. The proportion of deaths from abortion identified in SIH, in relation to the total number of deaths from abortion identified in SIM, varied between 47.4% in 2008 and 72.2% in 2015. Although official health data do not allow us to estimate the number of abortions in Brazil, we were able to establish the profile of women at higher risk for death from abortion: black and indigenous women, with low educational levels, under 14 and over 40 years of age, living in the North Northeast and Central regions, without a partner.
根据世界卫生组织的数据，2010 年至 2014 年期间，全球约有 5500 万例堕胎，其中 45%为不安全堕胎。在巴西，关于堕胎及其并发症的数据并不完整。医疗保健数据仅可用于公共部门，而死亡率数据则依赖于对死亡的调查。本研究使用不同信息系统中的公共数据（死亡率的 SIM、活产的 SINASC 和住院的 SIH）来描述该国的堕胎情况。2008 年至 2015 年期间，每年约有 20 万例与堕胎相关的住院治疗，其中 1600 例为医疗和法律原因。2006 年至 2015 年，我们在 SIM 中发现了 770 例因堕胎为根本死因的产妇死亡。在此期间，堕胎死亡率呈下降趋势，但存在地区差异。如果考虑到提到堕胎并宣布为其他根本死因的死亡人数，则该数字每年可能增加约 29%。在所报告的因堕胎导致的死亡中，有 1%是因医疗和法律原因导致的堕胎，56.5%是非特定的堕胎。在 SIH 中报告的因堕胎导致的死亡人数与在 SIM 中确定的因堕胎导致的总死亡人数的比例，从 2008 年的 47.4%到 2015 年的 72.2%有所不同。尽管官方卫生数据无法让我们估算巴西的堕胎人数，但我们能够确定因堕胎而死亡的风险较高的妇女的特征：黑人和土著妇女，教育水平较低，年龄在 14 岁以下和 40 岁以上，居住在北部东北部和中部地区，没有伴侣。
