Fetal Deaths in Brazil: Historical Series Descriptive Analysis 1996–2012
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Objective We seek to comprehensively assess stillbirths in Brazil, to compare the Brazilian findings with global trends and to identify the limitations of the fetal death record system. Method We studied fetal deaths in Brazil between 1996 and 2012 within the following five regions of the country: the North, Northeast, Southeast, South, and Central-West, through an analysis of data obtained from the Unified Health System’s (SUS) Informatics Department. The rates of stillbirth in Brazil and in these regions were calculated in relation to the maternal and gestational age and education, birth weight, type of pregnancy, delivery type, weight ranges and cause of death. Results There were 579,661 recorded fetal deaths and a decrease of 22.9 % in the stillbirth rate. In 2012, the overall rate was 10.0/1000 births; the North and Northeast regions had the highest rates (10.3 and 12.1, respectively) and the South region had the lowest rate (7.7/1000 births). Two-thirds of the deaths occurred in pregnancies of 28 or more weeks. Low education was an important risk factor, with rates of 24.3/1000 birth in women with no formal education and 4.7/1000 birth in women with 12 or more years of study in 2012. More than 40 % of the causes of deaths were nonspecific. Conclusions Despite the gradual decline in stillbirth rates, Brazil still has stillbirth rates that are nearly two times higher than those found in developed countries. There are inequalities between country regions portrayed by the significant variation in mortality rates specified by cause.
KeywordsFetal death Stillbirth Epidemiological surveillance Control methods
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- 2.CLAP, OPAS, OMS. (2011). Estrategias para el abordaje de la salud materna y perinatal en el próximo decenio: Una visión desde la salud pública. Punta del Este: Centro Latinoamericano de Perinatología–Salud de la Mujer y Reproductiva CLAP/SMR.Google Scholar
- 5.The Partnership for Maternal NaCH. (2011). Make Stillbirths Count: The Partnership for Maternal, Newborn and Child Health. Available from: http://portal.pmnch.org/.
- 6.WHO. (2011). National, regional, and worldwide estimates of stillbirth rates in 2009 with trends since 1995. World Health Organization.Google Scholar
- 10.Maranhão, A. G. K., Vasconcelos, A. M. N., Aly, C. M. C., Neto, D. L. R., Porto, D. L., Oliveira, H., et al. (2010) As the Brazilians die: Characterization and geographic distribution of deaths in Brazil, 2000, 2005 and 2009. In: Health Brazil 2010: An analysis of the health and selected evidence of impact health surveillance actions. Brasilia: Ministério da Saúde do Brasil.Google Scholar
- 11.MacDorman, M. F., Kirmeyer, S, & Statistics D. V. (2009). The challenge of fetal mortality. NCHS data brief centers for disease control and prevention—National Center for Health Statistics.Google Scholar
- 14.RCOG. (2010). Late Intrauterine Fetal Death and Stillbirth. NHS Evidence, 55.Google Scholar
- 15.Lee, E. J., Gambatese, M., Begier, E., Soto, A., Das, T., & Madsen, A. (2014). Understanding perinatal death: A systematic analysis of New York City Fetal and neonatal death vital record data and implications for improvement, 2007–2011. Maternal and Child Health Journal, 18, 1945–1954.CrossRefPubMedGoogle Scholar
- 16.Lorenzi, D. R. S. D., Tanaka, A. C. A., Bozzetti, M. C., Riba, S. F. E., & Weissheimer, L. (2009). The stillbirthas perinatal health indicator. Caderno de Saúde Pública, 17(1), 141–146.Google Scholar
- 19.Brasil. (2009). Surveillance manual child and fetal death and committee to prevent of child and fetal death. Brasilia: Ministério da Saúde.Google Scholar
- 21.Brasil. BRAZIL: General information about the different regions. Public Domain Portal. Available from: http://www.dominiopublico.gov.br/pesquisa/DetalheObraForm.do?select_action=&co_obra=84372.
- 23.Victora, C. G., Aquino, E. M. L., Leal, M. C., Monteiro, C. A., Barros, F. C., & Szwarcwald, C. L. (2011). Health in Brazil 2—Health of mothers and children in Brazil: Progress and challenges. Available at www.thelancet.com.
- 27.Zeitlin, J., Mortensen, L., Cuttini, M., Lack, N., Nijhuis, J., Haidinger, G., et al. (2015). Declines in stillbirth and neonatal mortality rates in Europe between 2004 and 2010: results from the Euro-Peristat project. Journal of Epidemiology and Community Health. doi: 10.1136/jech-2015-207013
- 29.IBGE. (2010). Civil register statistics 1010. Rio de Janeiro: Instituto Brasileiro de Geografia e Estatística.Google Scholar
- 30.Beauclair, R., Petro, G., & Myer, L. (2014). The association between timing of initiation of antenatal care and stillbirths: A retrospective cohort study of pregnant women in Cape Town, South Africa. BMC Pregnancy and Childbirth, 14(204). http://www.biomedcentral.com/1471-2393/14/204.
- 31.Mcclure, E. M., Pasha, O., Goudar, S. S., Chomba, E., Garces, A., Tshefu, A., et al. (2011). Epidemiology of stillbirth in low-middle income countries: A global network study. Acta Obstetricia et Gynecologica Scandinavica, 90(12), 1379–1385. doi: 10.1111/j.1600-0412.2011.01275.CrossRefPubMedPubMedCentralGoogle Scholar
- 34.Asare, M., & Laar, A. S. (2016). Accessing the prevalence of stillbirth rate and associated factors among women who delivered in a rural hospital: A retrospective cross-sectional analysis. International Journal of Health Sciences and Research, 6(1), 341–347.Google Scholar
- 35.Bernardes, A. C. F., Silva, R. A., Coimbra, L. C., Alves, M. T. S. S. B., Queiroz, R. C. S., Batista, R. F. L., et al. (2014). Inadequate prenatal care utilization and associated factors in São Luís, Brazil. BMC Pregnancy and Childbirth. Available at http://www.biomedcentral.com. doi: 10.1186/1471-2393-14-266.
- 37.Brasil. (2012). Health Brazil 2011: an analysis of the situation health and surveillance of women’s health. Brasília: Ministério da Saúde, pp 373–394.Google Scholar
- 38.Lawn, J. E., Blencowe, H., Pattinson, R., Cousens, S., Kumar, R., Ibiebele, I., et al. (2011). Stillbirths: Where? When? Why? How to make the data count? Lancet 377: 1448–1463. http://www.thelancet.com.
- 46.Pattinson, R., Kerber, K., Waiswa, P., Day, L. T., Mussell, F., Asiruddin, S., et al. (2009). Perinatal mortality audit: Counting, accountability, and overcoming challenges in scaling up in low- and middle-income countries. International Journal of Gynecology and Obstetrics, 107, S113–S122.CrossRefPubMedGoogle Scholar