Morbimortalidade materna no Estado da Bahia: diferenciais segundo a raça/cor da pele

Abstract

Introduction: According to the World Health Organization, maternal morbidity is understood as the occurrence of complications during pregnancy, childbirth, or puerperium that if untreated can complicate and lead to death. Maternal mortality, in turn, is defined as the death of women of childbearing age (15 - 49 years) during pregnancy or within 42 days after delivery. Objective: To analyze maternal mortality in the state of Bahia in 2010, according to differences in race/sk in color. Methods: Descriptive and ecological study of multiple groups, of the maternal mortality in the 49 most populous cities in Bahia in 2010, according to race / skin color. Secondary data available in Health information systems (SIS), the mortality information system (MIS); Information System on Live Births (SINASC); Hospital information system (HIS) of the department of the SUS (SUS Date) and socioeconomic data from the Brazilian Institute of Geography and Statistics (IBGE) were used. To analyze the association between the independent and dependent variables, we used the logistic regression model of Poisson through of software STATA version 10 and R version 2.15.2. In spatial data was used ARCGIS application 10.0 Results: In 2010, Bahia, 209 444 hosp italizations of women of childbearing age were recorded. In the 49 municipalities with the highest population density 118,773 admissions occurred. Of these, 57,173 (48.1%) occurred in the black population, 6,938 (5.8%) in the white population; 54,551 (45.9%) without race / skin color information. The total number of maternal deaths in MIS aged 15- 49 years accounted for 154 deaths, with 85 of these deaths occurred in the 49 municipalities (55.2%). The Maternal Mortality Ratio (MMR) in Bahia was 72.5 / 100,000 live births (LB) as in the cities studied was 71.9 / 100,000 (LB). In the bivariate and multivariate analyzes of association was observed that the number of maternal deaths was positively associated with the proportion of black population, since, as the proportion of blacks increased 5%, the risk of maternal death increased to 25.2 % (p <0.0278) and 26.6% (p <0.0366), respectively. In the bivariate analysis of HDI and Gini index also associated, but were not statistically significant. The multivariate analysis showed that there was increased risk of death even when adjusted for variable water rate (WR), and this result was statistically significant. Conclusion: The analyzed data revealed higher incidence and prevalence of maternal mortality in the black population. Underreporting related to completing the race / skin color variable records hinders a more precise analysis of morbidity and mortality and represents a gap due to the effectiveness of health interventions for vulnerable groups of women. The red uction of maternal morbidity and mortality should be a universal and emergency commitment. Investments in humanization and universalization of quality maternal health care constitute a significant affirmative action against exclusion and social injustice.