mortality Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article

    Increment of Maternal Mortality Among Admissions for Childbirth in Low-risk Pregnant Women in Brazil: Effect of COVID-19 Pandemic?

    Rev Bras Ginecol Obstet. 2022;44(8):740-745

    Summary

    Original Article

    Increment of Maternal Mortality Among Admissions for Childbirth in Low-risk Pregnant Women in Brazil: Effect of COVID-19 Pandemic?

    Rev Bras Ginecol Obstet. 2022;44(8):740-745

    DOI 10.1055/s-0042-1751059

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    Abstract

    Objective

    To assess the possible impact of the COVID-19 pandemic on maternal mortality among admissions for childbirth in 2020 in relation of the last 10 years.

    Methods

    An ecological study with pregnant women who underwent hospital births at the Brazilian unified public health service (SUS, in the Portuguese acronym) in Brazil from 2010 to 2020. The mortality among admissions for childbirth was obtained based on the number of admissions for childbirth with reported death as outcome divided by the total number of admissions. The underlying gestational risk and route of delivery were considered based on the national surveillance system. The average mortality for the period between 2010 and 2019 (baseline) was compared with the rate of deaths in 2020 (1st pandemic year); the rate ratio was interpreted as the risk of death in 2020 in relation to the average of the previous period (RR), with 95% confidence intervals (CIs).

    Results

    In 2020, the 1st year of the COVID-19 pandemic, 1,821,775 pregnant women were hospitalized for childbirth and 651 deaths were reported, which represents 8.7% of the total hospitalizations and 11.3% of maternal deaths between 2010 and 2020. There was an increase in maternal mortality after births in 2020 compared with the average for the period between 2010 and 2019, specially in low-risk pregnancies, both in vaginal (RR = 1.60; 95%CI:1.39–1.85) and cesarean births (RR = 1.18; 95%CI:1.04–1.34).

    Conclusion

    Maternal mortality among admissions for childbirth according to SUS data increased in 2020 compared with the average between 2010 and 2019, with an increment of 40% in low-risk pregnancies. The increase was of 18% after cesarean section and of 60% after vaginal delivery.

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    Increment of Maternal Mortality Among Admissions for Childbirth in Low-risk Pregnant Women in Brazil: Effect of COVID-19 Pandemic?
  • Original Article

    Papanicolaou smear screening: coverage in two home surveys applied in the city of São Paulo in 1987 and 2001-2002

    Rev Bras Ginecol Obstet. 2011;33(5):238-245

    Summary

    Original Article

    Papanicolaou smear screening: coverage in two home surveys applied in the city of São Paulo in 1987 and 2001-2002

    Rev Bras Ginecol Obstet. 2011;33(5):238-245

    DOI 10.1590/S0100-72032011000500006

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    PURPOSE: to compare the coverage of conventional Papanicolaou cytology in women aged 15 to 59 years between two home surveys, related to some personal attributes and to the tendency to die from cervical cancer. METHODS: we analyzed data collected in two home surveys, with complex sampling, in the city of São Paulo, Brazil, over the years from 1987 to 2001 and 2002. The self-reported answers of 968 women in the first inquiry and of 1,125 women in the second inquiry were compared regarding the reply to the question about the execution of the Papanicolaou test "sometimes in a lifetime" in relation to age distribution, black skin, marital status, years of education and tendency to die because cervical cancer during the period from 1980 to 2007. The Fisher exact test was used to compare the sample regarding each item, with the level of significance set at p value >5%. RESULTS: from the first to the second inquiry there was a 24% increase in the execution of conventional Papanicolaou cytology (from 68.8% to 85%). The greatest variations in the increased coverage related to the personal attributes of the women were detected in black skin color, among single women and among women of lower schooling. Regarding the tendency to mortality rates due to cervical cancer, no clear ascending or declining tendency was observed along the 28 years studied (1980 to 2007). CONCLUSION: there was an increase in access to the cytological Papanicolaou test among the most vulnerable women. Since 2001 and 2002, the 85% coverage already reached WHO recommendation, although without a clear trend of decline in mortality due to cervical cancer in the following years, indicating that screening is only part of an effective and organized program for the control of cervical cancer, whose model must guarantee full women's health care.

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    Papanicolaou smear screening: coverage in two home surveys applied in the city of São Paulo in 1987 and 2001-2002
  • Original Article

    Uterus cervix cancer mortality: socio-demographic characteristics of women living in the city of Recife, Pernambuco, Brazil

    Rev Bras Ginecol Obstet. 2008;30(5):248-255

    Summary

    Original Article

    Uterus cervix cancer mortality: socio-demographic characteristics of women living in the city of Recife, Pernambuco, Brazil

    Rev Bras Ginecol Obstet. 2008;30(5):248-255

    DOI 10.1590/S0100-72032008000500007

    Views1

    PURPOSE: to describe the socio-demographic characteristics of deaths caused by uterine cervix cancer in women living in Recife, Pernambuco, Brazil, from 2000 to 2004. METHODS: a transversal populational study, including 323 deaths by uterine cervix cancer, among which 261 were recorded in the Information System about Mortality and 62 were identified after investigation on deaths by cancer at non-specified sites of the uterus. Mortality rate for all the variables was obtained and statistics for central tendency and variance were calculated. The χ2 test was performed to obtain the mortality coefficient concerning the living place and age range of the patients. RESULTS: death among women under 60 (54.7%), black (60.5%), single (67.6%), housewives (71.2%) and the ones living in poor neighborhood (53.3%) preponderated. Most of deaths occurred in hospitals (85.1%) and 90.2% of them occurred inside national health system hospitals. The mortality coefficient varied from 0.3 (among women under 30) to 54.9/100.00 (among women over 80). Significant statistical differences (p<0.05) were evidenced when death linked to age range and sanitary district was compared to characteristics of the female population living in the city. CONCLUSIONS: in Recife, death by cervix cancer are more frequent among adult, black, single, housewives, women living in poor neighborhoods and attended to at national health system hospitals, with differences in death risk among age ranges and living place.

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