Mortalidade perinatal e avaliação da assistência ao pré-natal, ao parto e ao recém-nascido em Belo Horizonte, Minas Gerais

Abstract

The perinatal mortality nowadays has got relevance due to the greatest participation of theearly neonatal component on child mortality as well as by technological advances on obstetricand neonatal assistance that benefit the perinatal survival even in high risk situations. Theperinatal mortality rate is an important indicator for the mother health and neonatalconditions. It reflects the available assistance quality. This study objective was analyze theperintal mortality and to evaluate the pregnant and newborn child health assistance from theperinatal death investigations. It was studied the perinatal deaths of residents in BeloHorizonte recorded on the Information System about Mortality between 2003 and 2007, andinvestigated by the death prevention Committee BH Vida. The investigation criteria adoptedby Committee were the weight of stillbirth and newborn children, at birth over or equal to1.500g, excluding those ones with serious congenital malformation. The data source was theInformation System about Mortality and the investigation form of death preventionCommittee BH Vida. The included variables refer to the death cause, the mother profile, thedeath prevention also the pregnant and newborn assistance process. The data was analyzed bythe analytical and descriptive statistic. The assistance was evaluated during the prenatal,delivery and also to the newborn children, basing on simple recommendation recognized byscientific evidences. The mortality special distribution was analyzed second to the HealthVulnerability Index of prefecture de Belo Horizonte. To the prevention analyze theWigglesworth Classification was adopted. The studied deaths where 2.710. From those figure728 where investigated by Committee, and it corresponds to 93% of the death according theinvestigation criteria. The highest mortality rates were registered with low weight andpremature children. As for the mother characteristics, the highest rates were observed amongthe women at equal or over the age of 35 years, no school and multiple type of pregnancy.The main deaths causes were concentrated on the perinatal disease chapter. The mostimportant ones were associated with maternal factores, pregnancy complication, intrauterineasphyxia and the non specified fetus death. The death investigation identified a highpercentual of avoidable cases and with failure on the perinatal assistance process. Thosefailures were more evident on the prenatal and the delivery attention. The spatial analyzeshowed that the mortality rates were increasing with the risk elevated of the mother residencearea. The perinatal mortality evaluation in Belo Horizonte city, under the view of healthservice attention, the social inequality and avoidance, allowed better understanding of thesituation. This may also contribute to the preventive action planning.