Incidência do Near Miss Materno entre as mulheres atendidas no Sistema Público de Saúde do Brasil no ano de 2019

Abstract

Introduction: For every maternal death in Latin America, there are 15 cases of Maternal Near Miss (MNM), which is defined by women who almost died, but survived serious health complications in the puerperal pregnancy period, being considered a serious public health problem. Objective: To estimate the Incidence of Near Miss Materno according to the sociodemographic characteristics of the women assisted in the Public Health Services Network in Brazil. Methods: Cross-sectional, retrospective and population-based study, based on data provided online, in a unique way and not identified by the Hospital Information System - SIH / SUS. Inclusion Criteria: women between 10 and 49 years old, with Main Diagnosis of Hospitalization in chapter XV of ICD-10, group “O” and / or the field “Procedures Performed” that were filled in with a procedure code from the unified table of SUS procedures related to the pregnancy-puerperal period in 2019. The selection of cases of NMM was made based on the criteria for identification of NMM adopted by Nakamura et al. (2013) through a WHO criteria proxy. Death cases were excluded and those that met the adopted criteria were selected. Results: Of the 4,304,910 hospitalizations of women aged between 10 and 49 years, 57% (2,441,044) were admitted with the main diagnosis of obstetric causes and, of these, about 0.3% (823) died. 73.525 situations indicating maternal near miss (SINMM) were identified, producing an incidence rate of 30 per 1000 hospitalizations. The highest incidence rate of SINMM occurred among women aged between 40 and 49 years (49 per 1000), who declared themselves black (32 per 1000) and resided in the Northern Region of Brazil (34 per 1000). The main conditions related to SINMM were Hypovolemic Shock (26.4%), Sepsis (25.6%), Puerperium Complications (15.6%) and Eclâmpsia (9.3%). Conclusion: Through this study it was not possible to compare the incidence rate of SINMM in Brazil, however, it raises concerns since, this possible sentinel event has an impact on public policies and deviates from the goals agreed in the Millennium Development Goals.