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CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(09): 662-668
DOI: 10.1055/s-0041-1735300
Original Articles
Obstetrics/Maternal Mortality

Temporal Evolution of Maternal Mortality: 1980-2019

Evolução temporal da mortalidade materna: 1980-2019
Janete Vettorazzi 
1   Department of Gynecology and Obstetrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
2   Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
,
Edimárlei Gonsales Valério 
1   Department of Gynecology and Obstetrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
2   Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
,
Maria Alexandrina Zanatta 
1   Department of Gynecology and Obstetrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Mariana Hollmann Scheffler 
1   Department of Gynecology and Obstetrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Sergio Hofmeister de Almeida Martins Costa 
1   Department of Gynecology and Obstetrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
2   Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
,
José Geraldo Lopes Ramos 
1   Department of Gynecology and Obstetrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
2   Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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Abstract

Objective To determine the profile of maternal deaths occurred in the period between 2000 and 2019 in the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) and to compare it with maternal deaths between 1980 and 1999 in the same institution.

Methods Retrospective study that analyzed 2,481 medical records of women between 10 and 49 years old who died between 2000 and 2018. The present study was approved by the Ethics Committee (CAAE 78021417600005327).

Results After reviewing 2,481 medical records of women who died in reproductive age, 43 deaths had occurred during pregnancy or in the postpartum period. Of these, 28 were considered maternal deaths. The maternal mortality ratio was 37.6 per 100,000 live births. Regarding causes, 16 deaths (57.1%) were directly associated with pregnancy, 10 (35.1%) were indirectly associated, and 2 (7.1%) were unrelated. The main cause of death was hypertension during pregnancy (31.2%) followed by acute liver steatosis during pregnancy (25%). In the previous study, published in 2003 in the same institution4, the mortality rate was 129 per 100,000 live births, and most deaths were related to direct obstetric causes (62%). The main causes of death in this period were due to hypertensive complications (17.2%), followed by postcesarean infection (16%).

Conclusion Compared with data before the decade of 2000, there was an important reduction in maternal deaths due to infectious causes.

Resumo

Objetivo Determinar o perfil dos óbitos maternos ocorridos no período de 2000 a 2019 no Hospital de Clínicas de Porto Alegre (HCPA) e comparar com os óbitos maternos entre 1980 e 1999 na mesma instituição.

Métodos Estudo retrospectivo que analisou 2.400 prontuários de mulheres entre 10 e 49 anos que morreram entre 2000 e 2019. O presente estudo foi aprovado pelo Comitê de Ética (CAAE 78021417600005327).

Resultados Após revisão de 2.481 prontuários de mulheres que morreram em idade reprodutiva, 43 mortes ocorreram durante a gravidez ou no período pós-parto. Destas, 28 foram considerados óbitos maternos. A taxa de mortalidade materna foi de 37.6 por 100.000 nascidos vivos. Em relação às causas, 16 óbitos (57.1%) estiveram diretamente associados à gravidez, 10 (35.1%) estiveram indiretamente associados e 2 (7.1%) não estiveram relacionados. A principal causa de morte foi hipertensão na gravidez (31.2%) seguida de esteatose hepática aguda da gravidez (25%). No estudo anterior, publicado em 2003 na mesma instituição4, a taxa de mortalidade foi de 129 por 100.000 nascidos vivos, e a maioria dos óbitos estava relacionada a causas obstétricas diretas (62%). As principais causas de óbito neste período foram por complicações hipertensivas (17.2%), seguidas de infecção pós-cesárea (16%).

Conclusão Em comparação com os dados anteriores à década de 2000, houve uma redução importante das mortes maternas por causas infecciosas.

Keywords

maternal mortality - maternal mortality ratio - pregnancy-related death - severe maternal morbidity - pregnancy hypertension - acute fatty liver of pregnancy - postcesarean infection - septic abortion

Palavras-chave

mortalidade materna - razão de mortalidade materna - morte relacionada à gravidez - morbidade materna grave - hipertensão na gravidez - esteatose hepática aguda da gravidez - infecção pós-cesárea - aborto séptico

Contributors

All authors contributed with the project and data interpretation, the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.




Publication History

Received: 17 December 2020

Accepted: 02 August 2021

Article published online:
20 October 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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