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Epidemiological profile, spatial patterns and preventability of fetal mortality in Pernambuco

Abstract

Objective

To describe the epidemiological characteristics, preventability and spatial distribution of fetal deaths.

Methods

Ecological study conducted in the state of Pernambuco between 2010 and 2017 with the health regions as the unit of analysis. Data from Mortality and Live Birth Information Systems were used. The classification of the preventability of deaths followed the criteria of the Brazilian List of causes of preventable deaths by interventions of the National Health Service. Descriptive statistics and the chi-square test were used for comparisons of proportions. Maps with the spatial distribution of fetal mortality and of preventable and ill-defined causes were prepared

Results

There were 12,337 fetal deaths, of which 8,927 (72.3%) from preventable causes. The variables mother’s age, number of dead children, type of pregnancy, type of delivery and birth weight were related to preventability of death. The fetal mortality rate for the state of Pernambuco was 10.9 per 1,000 births, ranging from 10.1 to 16.6, with a higher rate of 16.6 in region XI. The rate of fetal mortality from preventable causes was 7.9, with a minimum of 6.7 and a maximum of 13.2 in region XI. The rate for ill-defined causes was 2.3 per 1,000 births, and the highest rate was 6.2 in region IX.

Conclusion

The results of the study showed the characterization of fetal deaths, mostly preventable, and contributed to understand the chain of factors involved in the occurrence of deaths. Priority health regions for actions to reduce fetal deaths were identified by mapping the mortality rates.

Fetal mortality; Vital statistics; Spatial analysis; Public health nursing; Parturition; Birth weight

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