Revista Brasileira de Epidemiologia
Print version ISSN 1415-790X
LAURENTI, Ruy; JORGE, Maria Helena Prado de Mello and GOTLIEB, Sabina Léa Davidson. Maternal mortality in Brazilian State Capitals: some characteristics and estimates for an adjustment factor. Rev. bras. epidemiol. [online]. 2004, vol.7, n.4, pp. 449-460. ISSN 1415-790X. http://dx.doi.org/10.1590/S1415-790X2004000400008.
INTRODUCTION: There is criticism as to the heterogeneity and reliability of mortality data in Brazilian Regions. However, official mortality statistics of State Capitals are more accurate and have adequate coverage. Reduction of maternal mortality is one of the world's major goals and it is measured by the Maternal Mortality Ratio. International agencies have been estimating that the Brazilian ratio is very high. An investigation was carried out to know the actual value. OBJECTIVE: The aim was to calculate the maternal mortality ratio for Brazilian Capitals and the Federal District and estimate an adjustment factor for official data. METHODOLOGY: A total of 7,332 deaths that occurred in the first semester of 2002 in women from 10 to 49 years of age living in these areas were investigated, using the RAMOS methodology (household interviews and investigation of medical and hospital records and autopsies.). RESULTS: The maternal mortality ratio calculated was 54.3 per 100,000 live born, ranging between 73.2 in the North State Capitals and 42 per 100,000 live born in the South. The lowest adjustment factors were 1.08 in the North Region, and 1.10 in the Middle West State Capitals. The highest values were 1.76 and 1.83 in the Northeast and South Regions. Considering the set of Brazilian State Capitals, the adjustment factor estimated was equal to 1.4. The maternal mortality ratios observed were lower than WHO, UNICEF and UNFPA values. Direct obstetric maternal deaths accounted for 67.1% of the total, thus indicating that pre-natal and childbirth care must be improved.
Keywords : Maternal mortality; Adjustment factor; RAMOS methodology.