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Fetal deaths in Brazil: What changed in the last decade and what can we learn from the current situation?

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Mariana Brasileiro, Renato T. Souza, Thayna B. Griggio, Matias C. Vieira, Paulo F. Oliveira, Cleide M. Silva, Marcos A.B. Dias, Dharmintra Pasupathy, José G. Cecatti

Original languageEnglish
Pages (from-to)254-262
Number of pages9
JournalInternational Journal of Gynecology and Obstetrics
Volume159
Issue number1
DOIs
Accepted/In press2022
PublishedOct 2022

Bibliographical note

Funding Information: We would like to thank the remaining members of the Perinatal Brazil study group: Debora F. Leite, Giovanna Cecília, Joelle Moreira, Sherly Metelus, Jussara Mayrink, Henrique Ferreira, Gabriela Alves, Francisco Edson de Lucena Feitosa, Ayane Sousa Oliveira, and Larissa Braga Costa. In addition, we would like to thank Miss Isadora Bousquet Gimenes for the technical support with the figure editing services. The present study was funded by the Medical Research Council (MRC) UK (Confidence in Concept Award—MQABARR). RTS received funding from the HRP Alliance, part of the UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a co-sponsored program executed by WHO, to complete his studies. This article represents the views of the named authors only and does not represent the views of WHO. Publisher Copyright: © 2022 International Federation of Gynecology and Obstetrics

King's Authors

Abstract

Objective: To determine fetal death rates (FDRs) according to maternal characteristics in Brazil. Methods: A serial cross-sectional analysis was conducted based on vital statistics of the Brazilian population from 2007 to 2019. FDRs were estimated according to maternal and pregnancy characteristics. Annual percent change (APC) of FDR was assessed by joinpoint regression model. Causes of death were compared between the ante−/intrapartum periods. Results: A significant reduction in FDR occurred in Brazil during 2007–2019 (11.1 and 10.43 in 2007 and 2019, respectively; APC –0.44). Only the northern region showed an increase in FDR. In 2019, the northeast and southeast had the highest and lowest FDRs, respectively (11.4 and 7.8/1000 live births). In adolescents, FDR increased from 2007 to 2016 (APC 1.75). In 2019, missing information was significantly high for maternal skin color (99.7%), schooling (17.0%), and age (7.0%) in fetal death registries. The most common causes of fetal death in the ante−/intrapartum periods were fetus and newborn affected by maternal conditions. Conclusion: A reduction in FDR has been achieved in Brazil over the last decade. However, there is an unmet need for decreasing social and regional disparities. A better system to attribute causes of death is needed to identifying priorities in maternal-fetal health care.

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