tetano
Editor, Senior Moderator
Rev Bras Epidemiol
. 2025 Jul 21:28:e250037.
doi: 10.1590/1980-549720250037. eCollection 2025. Maternal and late mortality trends, emphasizing the H1N1 and COVID-19 pandemics, in the state of Rio de Janeiro, Brazil, from 2009 to 2021
[Article in English, Portuguese]
Ana Lucia de Melo Bellizzi[SUP] 1 2 [/SUP], Angela Maria Cascão[SUP] 2 [/SUP], Alexandre Dos Santos Brito[SUP] 3 [/SUP], Sandra Costa Fonseca[SUP] 4 [/SUP], Pauline Lorena Kale[SUP] 3 [/SUP]
Affiliations
Objective: Trends in maternal mortality (MMR) and late maternal mortality ratios (LMMR) were estimated, in periods with and without H1N1 and COVID-19 pandemics, in Rio de Janeiro, Brazil, from 2009 to 2021.
Methods: Ecological study of temporal trends. Data was obtained from the Mortality and Live Birth Information Systems. The annual MMR and LMMR per 100,000 live births (LB) were calculated and the trends were estimated using the joinpoint regression model.
Results: In 2009, the MMR was 103.1, reaching 152.4/100,000 LB in 2021, with an annual reduction of 3.3% (95% confidence interval - 95%CI -5.5; -1.7) until 2019 and an increase of 51.2% (95%CI 23.5; 64.5) in 2020/21. Excluding the years of the COVID-19 pandemic, it was observed that an annual decline of 3.3% and, with the concomitant exclusion of the years of the H1N1 pandemic, stability. The LMMR were 8.3 (2009) and 22.2 (2021) per 100,000 LB, with an annual growth of 28.2% (95%CI 11.8; 47.8) until 2011, remaining stationary from 2011 to 2015, followed by an increase of 11.7% until 2021; with the exclusion of the final biennium, the trend is upward (3.8%) and also with the exclusion of the initial biennium, the trend became downward (7%) until 2014 and upward (8.2%) from then on.
Conclusion: There was a change in trend with the separate or joint incorporation of pandemic biennia: without pandemics, maternal mortality would be stationary, despite actions to prevent maternal deaths, and late maternal mortality, would be descending until 2014 and then ascending, crediting itself in part, to improving death investigation.
. 2025 Jul 21:28:e250037.
doi: 10.1590/1980-549720250037. eCollection 2025. Maternal and late mortality trends, emphasizing the H1N1 and COVID-19 pandemics, in the state of Rio de Janeiro, Brazil, from 2009 to 2021
[Article in English, Portuguese]
Ana Lucia de Melo Bellizzi[SUP] 1 2 [/SUP], Angela Maria Cascão[SUP] 2 [/SUP], Alexandre Dos Santos Brito[SUP] 3 [/SUP], Sandra Costa Fonseca[SUP] 4 [/SUP], Pauline Lorena Kale[SUP] 3 [/SUP]
Affiliations
- PMID: 40699054
- DOI: 10.1590/1980-549720250037
Objective: Trends in maternal mortality (MMR) and late maternal mortality ratios (LMMR) were estimated, in periods with and without H1N1 and COVID-19 pandemics, in Rio de Janeiro, Brazil, from 2009 to 2021.
Methods: Ecological study of temporal trends. Data was obtained from the Mortality and Live Birth Information Systems. The annual MMR and LMMR per 100,000 live births (LB) were calculated and the trends were estimated using the joinpoint regression model.
Results: In 2009, the MMR was 103.1, reaching 152.4/100,000 LB in 2021, with an annual reduction of 3.3% (95% confidence interval - 95%CI -5.5; -1.7) until 2019 and an increase of 51.2% (95%CI 23.5; 64.5) in 2020/21. Excluding the years of the COVID-19 pandemic, it was observed that an annual decline of 3.3% and, with the concomitant exclusion of the years of the H1N1 pandemic, stability. The LMMR were 8.3 (2009) and 22.2 (2021) per 100,000 LB, with an annual growth of 28.2% (95%CI 11.8; 47.8) until 2011, remaining stationary from 2011 to 2015, followed by an increase of 11.7% until 2021; with the exclusion of the final biennium, the trend is upward (3.8%) and also with the exclusion of the initial biennium, the trend became downward (7%) until 2014 and upward (8.2%) from then on.
Conclusion: There was a change in trend with the separate or joint incorporation of pandemic biennia: without pandemics, maternal mortality would be stationary, despite actions to prevent maternal deaths, and late maternal mortality, would be descending until 2014 and then ascending, crediting itself in part, to improving death investigation.