Abstract

HOLCMAN, Marcia Moreira; LATORRE, Maria do Rosário Dias de Oliveira  and  SANTOS, Jair Lício Ferreira. Infant mortality evolution in the metropolitan region of São Paulo (Brazil), 1980-2000. Rev. Saúde Pública [online]. 2004, vol.38, n.2, pp. 180-186. ISSN 0034-8910.  http://dx.doi.org/10.1590/S0034-89102004000200005.

OBJECTIVE: To analyze IMR evolution in the São Paulo Metropolitan Area (SPMA) between 1980 and 2000, in terms of spatial, age and, causal differences. METHODS: SPMA municipalities were divided into 5 groups, based on their 1980 IMRs: ³90‰ lb (Group 1); 70-89‰ lb (Group 2); 50-69‰ lb (Group 3); <50‰ lb (Group 4). Group 5 comprised the municipality of São Paulo itself (IMR=51‰ lb). The analysis of trends was carried out using exponential regression models. RESULTS: IMR and its components showed a statistically significant decrease (p<0.05), with coefficients of determination between 66 and 98%, indicating goodness of fit of the exponential model to all the time series analyzed. SPMA IMR fell 69.4%, from 55.2 to 16.9‰ lb, and Groups 1-5 showed reductions of 83.9%, 76.2%, 71.3%, 58.7%, and 68.8%, indicating that the groups with highest IMRs also showed the greatest reductions during the studied period. CONCLUSIONS: IMRs were homogenized at around 18‰ lb in all municipality groups in the SPMA. One-half of all deaths were concentrated within the first week of life, and were due primarily to conditions originating in the perinatal period, indicating that greater care during the pre- and post-delivery periods will be required if the IMR in the SPMA is to descend to levels compatible with those of developed countries.

Keywords : Infant mortality [trends]; Mortality rate; Death certificates; Cause of death; Neonatal mortality (public health); Residence characteristics.