Spatial patterns of avoidable fetal mortality and social deprivation

Canuto, Indianara Maria de Barros; Macêdo, Vilma Costa de; Frias, Paulo Germano de; Oliveira, Conceição Maria de; Costa, Heitor Victor Veiga da; Portugal, José Luiz; Bonfim, Cristine Vieira do

doi:10.1590/1980-549720210007.supl.1

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…This rate is an indicator that reflects the access and quality of healthcare services and signals the existence of deficiencies in the healthcare provided 11 . This gradient is consistent with the result obtained in a capital in Northeastern Brazil, which also identified an increase in the rates of avoidable fetal mortality in regions marked by the presence of greater social deprivation 28 .…”

Section: Discussionsupporting

confidence: 91%

Intra-urban differentials of fetal mortality in clusters of social vulnerability in São Paulo Municipality, Brazil

Marques

Silva

Moura

et al. 2021

Sci Rep

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This study aimed to analyze the distribution of stillbirths by birth weight, type of death, the trend of Stillbirth Rate (SBR), and avoidable causes of death, according to social vulnerability clusters in São Paulo Municipality, 2007–2017. Social vulnerability clusters were created with the k-means method. The Prais-Winsten generalized linear regression was used in the trend of SBR by < 2500 g, ≥ 2500 g, and total deaths analysis. The Brazilian list of avoidable causes of death was adapted for stillbirths. There was a predominance of antepartum stillbirths (70%). There was an increase in SBR with the growth of social vulnerability from the center to the outskirts of the city. The cluster with the highest vulnerability presented SBR 69% higher than the cluster with the lowest vulnerability. SBR ≥ 2500 g was decreasing in the clusters with the high vulnerability. There was an increase in SBR of avoidable causes of death of the cluster from the lowest to the highest vulnerability. Ill-defined causes of death accounted for 75% of deaths in the highest vulnerability area. Rates of fetal mortality and avoidable causes of death increased with social vulnerability. The trend of reduction of SBR ≥ 2500 g may suggest improvement in prenatal care in areas of higher vulnerability.

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Section: Discussionsupporting

confidence: 91%

Intra-urban differentials of fetal mortality in clusters of social vulnerability in São Paulo Municipality, Brazil

Marques

Silva

Moura

et al. 2021

Sci Rep

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“…Finally, the associations identified in the analyzed area make it possible to assess the services and the socioeconomic development of the region 18,40 . The results reinforce what has already been described in other studies [42][43][44] , suggesting the need for intervention and implementation of health programs and public policies to maintain care for mothers and newborns in municipalities with spatial dependence 46 , with the objective of reversing the negative effects of LBW 16 and mitigating the risk of infant death.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, given the efforts of many countries to reduce mortality, in recent years several studies have analyzed cases of LBW and their association with mortality [13][14][15][16][17] . Besides, thanks to geographic information systems (GIS) and spatial distribution studies, it is possible to analyze and apply geographic analytical methods to spatial data for mapping and identifying clusters and risk areas in health problems [18][19][20] .…”

Section: Introductionmentioning

confidence: 99%

Spatial patterns of mortality in low birth weight infants at term and its determinants in the State of São Paulo, Brazil

Rodríguez

Marins

et al. 2023

Rev. bras. epidemiol.

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Objective: Low birth weight (LBW) is a public health problem strongly associated with infant mortality. This study aimed to identify the spatial distribution of infant mortality in newborns with LBW (750–2,500 g) at term (≥37 weeks of gestation), due to their being small for gestational age, analyzing its association with mother-related determinants, as well as to identify priority areas of mortality in the State of São Paulo, 2010–2019. Methods: Infant mortality rate was analyzed in the division of neonatal mortality and postneonatal mortality of newborns with LBW at term. The empirical Bayesian method smoothed the rates, the univariate Moran index was used to measure the degree of spatial association between the municipalities, and the bivariate Moran index was employed to identify the existence of a spatial association between the rates and the selected determinants. Thematic maps of excess risk and local Moran were prepared to identify spatial clusters, adopting 5% as a significance level. Results: The excess risk map showed that more than 30% of the municipalities had rates above the state rate. High-risk clusters were identified in the southwest, southeast, and east regions, mainly among more developed municipalities. The determinants of adolescent mothers, mothers over 34 years of age, low education, human development index, social vulnerability index, gross domestic product, physicians, and pediatric beds showed a significant association with the rates evaluated. Conclusions: Priority areas and significant determinants associated with reduced mortality in newborns with LBW were identified, suggesting the need for intervention measures to achieve the Sustainable Development Goal.

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“…In addition, the social dynamics of health problems differ spatially (Yourkavitch et al, 2018). A study carried out in different municipalities in the state of Pernambuco, Brazil, showed that variables representing social need are related to foetal mortality (Canuto et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…The presence of clusters at the municipality level in a large part of Pernambuco State found in this study reflects health inequalities. There is a need to identify the barriers access to primary healthcare services and the quality provided there (Canuto et al, 2021). In economically disadvantaged places, spatial differences regarding early neonatal mortality rates are linked to health inequalities and, consequently, also to uneven distribution of, and differentiated access to, healthcare services (Boutayeb et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Spatial patterns of the total mortality over the first 24 hours of life and that due to preventable causes

Silva¹,

Araújo²,

Silva³

et al. 2022

Geospat Health

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This is an ecological study analysing spatial patterns of the total mortality over the first 24 hours of life and that due to preventable causes using data from the mortality information system (SIM) and live birth information system (SINASC) based on the municipalities of Pernambuco State, Brazil. The total mortality rates over the first 24 hours and that due to preventable causes were calculated for each municipality for the decades of 2000 to 2009 and for 2010 to 2019 to enable a comparison of the spatial patterns with spatial scan statistic used to identify clusters. Over the first 24 hours of life, a total of 13,571 deaths were reported, out of which 10,476 (77.2%) were preventable. The total mortality rate over the first 24 hours of life decreased from 5.5 in the 2000- 2009 period to 3.7 per 1000 live births in the following decade: a reduction of 32.7%, while the mortality rate due to preventable causes decreased from 4.4 to 2.8 per 1000 live births, a reduction of 36.7%. In the first decade, spatial exploratory analysis found three mortality rate clusters encompassing 56 municipalities over the first 24 hours of life. With respect to preventable causes over the first 24 hours of life, two mortality rate clusters were identified encompassing 41 municipalities. Risk areas for mortality over the first 24 hours of life were detected through spatial scan statistic. This method, directed towards uncovering the geographical distribution of deaths of very premature infants, can act as a tool for identifying priority areas to guide healthcare interventions.

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Spatial patterns of avoidable fetal mortality and social deprivation

Cited by 6 publications

References 27 publications

Intra-urban differentials of fetal mortality in clusters of social vulnerability in São Paulo Municipality, Brazil

Intra-urban differentials of fetal mortality in clusters of social vulnerability in São Paulo Municipality, Brazil

Spatial patterns of mortality in low birth weight infants at term and its determinants in the State of São Paulo, Brazil

Spatial patterns of the total mortality over the first 24 hours of life and that due to preventable causes

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