Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
Secretaria Municipal de Saúde Belo Horizonte, Belo Horizonte, Brasil.
Cad Saude Publica. 2024 Aug 26;40(7):e00168223. doi: 10.1590/0102-311XEN168223. eCollection 2024.
To analyze the temporal trend of the late maternal mortality ratio (LMMR) in Brazil and its geographic regions in the period from 2010 to 2019, an ecological time series study was conducted. Data related to late maternal mortality from information systems of the Brazilian Ministry of Health were used. Statistical analysis used Prais-Winsten autoregressive models. A total of 1,470 late maternal deaths were reported in Brazil, resulting in an LMMR of 5 deaths per 100,000 live births. The late maternal mortality records revealed regional disparities, with the lowest index in the North (3.5/100,000 live births) and the highest in the South (8.3/100,000 live births). The LMMR showed an increasing trend in the country, with a general increase in the LMMR in the period and a mean annual percentage variation of 9.79% (95%CI: 4.32; 15.54). The Central-West region led this increase, with a mean annual percentage change of 26.06% (95%CI: 16.36; 36.56), followed by the North and Northeast regions, with 23.5% (95%CI: 13.93; 33.88). About 83% of the reported late maternal deaths were investigated, and 65.6% were corrected by the Maternal Mortality Committees. These findings highlight the relevance of late maternal mortality as an important indicator for maternal health, which is often invisible. The increase in the LMMR result from the improvement in the quality of the registration of these deaths in recent years in Brazil, and especially from the work of investigating deaths. The fragility of reporting with regional disparities points to the need for a more comprehensive approach that promotes equity and prevention of avoidable late maternal mortality.
为分析 2010 至 2019 年期间巴西及各地区晚期孕产妇死亡率（LMMR）的时间趋势，开展了一项生态时间序列研究。研究使用了巴西卫生部信息系统中与晚期孕产妇死亡相关的数据。统计分析采用了普赖斯-温斯坦（Prais-Winsten）自回归模型。巴西共报告了 1470 例晚期孕产妇死亡，导致每 10 万例活产中有 5 例死亡，LMMR 出现上升趋势。晚期孕产妇死亡率记录显示存在地区差异，北部地区的指数最低（每 10 万例活产中有 3.5 例死亡），南部地区的指数最高（每 10 万例活产中有 8.3 例死亡）。LMMR 呈现出全国性的上升趋势，LMMR 在整个时期呈普遍上升趋势，年平均百分比变化为 9.79%（95%CI：4.32；15.54）。中西部地区引领了这一增长，年平均百分比变化率为 26.06%（95%CI：16.36；36.56），其次是北部和东北部地区，分别为 23.5%（95%CI：13.93；33.88）。约 83%的报告晚期孕产妇死亡得到了调查，其中 65.6%的死亡经孕产妇死亡率委员会纠正。这些发现突显了晚期孕产妇死亡作为一个重要的孕产妇健康指标的重要性，因为它往往是无形的。LMMR 的上升归因于近年来巴西对这些死亡的登记质量的提高，尤其是对死亡调查工作的加强。报告存在地区差异表明，需要采取更全面的方法，促进公平，防止可避免的晚期孕产妇死亡。
