Skin Color and Maternal Near Miss: Exploring a Demographic and Health Survey in Brazil

Abstract

Keywords► severe maternal morbidity ► maternal near miss ► pregnancy complications ► ethnicity ► maternal and child health AbstractPurpose In 2013, it was estimated that 289,000 maternal deaths occurred worldwide. The maternal mortality ratio has decreased in many countries in the past decades, due to early identification and treatment of obstetric complications, despite the dissimilarities observed in diverse locations and populations. Black women, for instance, have always been more susceptible to the occurrence of maternal mortality and severe morbidity. Therefore, the objective of this study is to assess skin color as a predictive factor for maternal near miss (MNM) in a sample of Brazilian women interviewed in the Brazilian National Demographic and Health Survey (DHS) of 2006.Method A secondary analysis of the DHS database, a population-based crosssectional nationally representative study was conducted. This database is of public domain. The risk of maternal complications according to ethnic group and the associated sociodemographic characteristics were evaluated. For the data analysis, the odds ratios and respective 95% confidence intervals were calculated. Results In the sample interviewed, 59% of women were black or brown (mixed-race). Approximately 23% of women had some complication, and 2% of these women had at least one MNM pragmatic criterion. The MNM rate was 31 per 1,000 live births, and its occurrence was not statistically different among the ethnic groups. The only factors identified that were considered to be associated with the occurrence of MNM were maternal age above 40 and women not currently attending school, but only among white women. Conclusion The 2006 DHS results did not show a higher occurrence of maternal complications, and specifically of MNM associated with black/brown skin color. ResumoObjetivo Estima-se que em 2013 tenham ocorrido 289.000 mortes maternas no mundo. Observou-se uma redução na razão de mortalidade materna em muitos países nas últimas décadas, e isso se deveu à identificação e tratamento precoce das complicações obstétricas, embora de forma não similar entre os diversos locais e

Childbirth outcomes and ethnic disparities in Suriname: a nationwide registry-based study in a middle-income country

“…Ethnic disparities in birth outcomes have modestly been studied compared to other social determinants of health, such as wealth, education, age and place of residence. Several studies in high-income countries have shown that women of African descent experience a two to six times higher risk for severe maternal outcomes compared to Caucasian women (often linked to socio-economic factors) [12][13][14][15][16]. Suriname is particularly of interest as it has multiple ethnic groups without one great majority [17].…”

National health surveys: overview of sampling techniques and data collected using complex designs

“… 12 In Brazil, the DHS goes by the name of the National Demographic and Health Survey ( Pesquisa Nacional de Demografia e Saúde - PNDS). Conducted in 1986, 1996 and 2006, the PNDS enabled assessment of changes in women’s and children’s health, 13 as well as enabling international comparisons. 14 Still with regard to ​​maternal and child health, the Being Born in Brazil - National Survey on Child Delivery and Birth ( Nascer no Brasil - Inquérito Nacional sobre Parto e Nascimento ) was conducted in 2011-2012 with the aim of investigating antenatal care, child delivery, birth and the postpartum period.…”

Inquéritos nacionais de saúde: visão geral sobre técnicas de amostragem e dados coletados por desenhos complexos

“…12 No Brasil, o DHS é denominado de Pesquisa Nacional de Demografia e Saúde (PNDS). Realizada em 1986, 1996 e 2006, a PNDS possibilitou a avaliação das mudanças ocorridas na saúde da mulher e da criança 13 e permitiu comparações internacionais. 14 Ainda na área de saúde materno-infantil, o Nascer no Brasil -Inquérito Nacional sobre Parto e Nascimento -foi realizado em 2011-2012 com o objetivo de investigar o atendimento pré-natal, parto, nascimento e puerpério.…”