Análise epidemiológica dos óbitos maternos no Estado do Maranhão no período de 2017 a 2021

Abstract

Maternal death is defined as: the death of a woman during pregnancy or within 42 days of the end of pregnancy, regardless of the duration or location of the pregnancy, due to any cause related to or aggravated by the pregnancy or measures taken in relation to it, but not due to accidental or incidental causes. They are divided into direct obstetric causes, which are related to complications during pregnancy, childbirth or the puerperium, due to inadequate treatment, bad practices and omissions. And indirect, which are the result of diseases that already existed before pregnancy or a pathology that developed during pregnancy, unrelated to direct obstetric causes, but which were aggravated by the specific physiological conditions of a pregnancy. To characterize the epidemiological and sociodemographic profile of maternal mortality in Maranhão between 2017 and 2021. This is a descriptive, exploratory and cross-sectional epidemiological study, with a quantitative data approach, whose population consists of maternal deaths that occurred in Maranhão between 2017 and 2021. Data was collected using secondary data from the following sources: The Mortality Information System (SIM). Between 2017 and 2021, 520 (100.0%) maternal deaths were reported in the state of Maranhão, with 2021 being the year with the highest number of records (146 - 28.1%). When analyzing mortality by municipality, São Luís accounted for the most (53 - 10.2%), followed by Imperatriz (22 - 4.2%) and Caxias (17 0 3.3%). As for the variables, women aged between 20 and 29 (204 - 39.2%) predominated, followed by those aged between 30 and 39 (197 - 37.9%). As for marital status, the majority of women were single (252 - 48.5%) of the cases (p<0.0001), followed by married women (121 - 23.3%). With regard to schooling (248 - 47.7% 248) had between 8 and 11 years of schooling. When assessing the color/race variable (363 - 69.8% 363) declared themselves to be brown, followed by self-declared white women (70- 13.5%). When investigating the obstetric causes of death (367 - 70.6%) women died from direct causes. When checking the main direct cause, according to the ICD-10 category, the data showed that eclampsia was the main cause of death (83 - 16.0%) followed by gestational hypertension with significant proteinuria (37 - 7.1%) and postpartum hemorrhage (36 - 6.9%) and a large number of deaths with no specified cause (166 - 31.9%). Regarding indirect causes, the largest number of deaths were due to maternal infectious and parasitic diseases (55 - 14.8%) of the cases, followed by other Maternal Diseases, Classified Elsewhere, but Complicating Pregnancy/Partum/Puerperium (57 - 11.0%). Conclusion Maternal mortality continues to be a public health problem in Maranhão, and new strategies need to be implemented to reduce this problem, promoting family planning and quality prenatal care, with a focus on the quality of the service, in order to minimize maternal rates through professional care that is qualified to act at all stages of this process.