Maternal mortality in Brazil: spatio-temporal analysis between 2000 and 2019Abstract
Objectives: to analyze the spatio-temporal distribution of maternal mortality in Brazil from 2000 to 2019.
Methods: an ecological, longitudinal study of space-time analysis of maternal deaths in Brazil from 2000 to 2019, using the 450 health regions as the spatial unit. Data available from Datasus were used. Analyses were conducted using Satscan v9.7 software, considering the discrete Poisson probability model.
Results: five clusters of high maternal mortality were identified, predominantly in the North and Midwest regions, as well as in the state of Rio de Janeiro and parts of the Northeast. Five low-risk clusters were identified, mainly along the northeastern coast and in states in the South and Southeast. Temporal analysis revealed a low-risk cluster from 2000 to 2007 (RR=0.92; p<0.001), indicating significant advances in maternal health during this period.
Conclusions: the North region of the country showed high MMR values, concentrating high-risk clusters in the spatiotemporal analysis, with high MMR between 2000 and 2009, showing a correlation of maternal mortality with the country’s socioeconomic inequalities.
Key words:
Maternal mortality; Spatio-temporal analysis; Global health strategies
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Risk cluster = MMR higher than expected (relative risk >1); Protection cluster = MMR lower than expected (relative risk <1); MMR = Maternal Mortality Ratio.
MMR= Maternal Mortality Ratio; RR= Relative risk Cluster period in which there was statistical difference between observed and expected MMR. Protection cluster observed (Observed MMR was lower than expected (RR<1). Observed =Number of observed cases of maternal mortality each year. Expected =Trend line representing the number of expected cases based on the probabilistic method of temporal scanning (15).