scholarly journals Maternal mortality according to race/skin color in Mato Grosso do Sul, Brazil, from 2010 to 2015

2017 ◽  
Vol 17 (4) ◽  
pp. 729-737 ◽  
Author(s):  
Renata Palópoli Pícoli ◽  
Luiza Helena de Oliveira Cazola ◽  
Everton Ferreira Lemos

Abstract Objectives: to investigate the epidemiological profile, by race/skin color, of maternal deaths in the state of Mato Grosso do Sul, Brazil. Methods: the present epidemiological study of maternal death distribution by race/skin color was based on data extracted from Brazilian mortality and livebirth information systems from 2010 to 2015. The maternal mortality ratio and the specific maternal mortality ratio were calculated and analyzed according to obstetric variables. Results: the death risk for black (RR = 4.3, CI95%= 2.088.71) and indigenous women (RR = 3.7, CI95% 2.26.23) was approximately fourfold in comparison to the risk for white women. For direct causes of death, the state of Mato Grosso do Sul showed higher levels, 74.1%, as well as for most races/skin colors in the first triennium. The specific maternal mortality ratio was higher among black and indigenous women aged30 to 39 years old (416.7 and 651.8, respectively) per 100,000 live births (p<0.05). Conclusions: higher maternal mortality ratio for indigenous and black women and the predominance of deaths related to direct obstetric causes among race/skin color categories reflect inadequate health care during pregnancy and puerperium.

2014 ◽  
Vol 48 (4) ◽  
pp. 662-670 ◽  
Author(s):  
Ioná Carreno ◽  
Ana Lúcia de Lourenzi Bonilha ◽  
Juvenal Soares Dias da Costa

OBJECTIVE To analyze the temporal evolution of maternal mortality and its spatial distribution.METHODS Ecological study with a sample made up of 845 maternal deaths in women between 10 and 49 years, registered from 1999 to 2008 in the state of Rio Grande do Sul, Southern Brazil. Data were obtained from Information System on Mortality of Ministry of Health. The maternal mortality ratio and the specific maternal mortality ratio were calculated from records, and analyzed by the Poisson regression model. In the spatial distribution, three maps of the state were built with the rates in the geographical macro-regions, in 1999, 2003, and 2008.RESULTS There was an increase of 2.0% in the period of ten years (95%CI 1.00;1.04; p = 0.01), with no significant change in the magnitude of the maternal mortality ratio. The Serra macro-region presented the highest maternal mortality ratio (1.15, 95%CI 1.08;1.21; p < 0.001). Most deaths in Rio Grande do Sul were of white women over 40 years, with a lower level of education. The time of delivery/abortion and postpartum are times of increased maternal risk, with a greater negative impact of direct causes such as hypertension and bleeding.CONCLUSIONS The lack of improvement in maternal mortality ratio indicates that public policies had no impact on women’s reproductive and maternal health. It is needed to qualify the attention to women’s health, especially in the prenatal period, seeking to identify and prevent risk factors, as a strategy of reducing maternal death.


2018 ◽  
Vol 30 (1) ◽  
Author(s):  
Rodrigo Gaspar Díaz Novelo ◽  
Luis Orlando Bobadilla Rosado ◽  
Lizbeth Sabrina Fajardo Ruiz ◽  
Nina Méndez Domínguez ◽  
Salvador Gómez Carro

ResumenIntroducción: La mortalidad materna se considera un indicador significativo de la calidad de los servicios de salud, así, se conoce que aproximadamente un 95% de estas muertes en América Latina y el Caribe son prevenibles.Objetivos: Determinar si la Razón de Muerte Materna (RMM) en Yucatán es mayor a la media nacional durante los años 2013 a 2015.Material y Métodos: Estudio transversal observacional en mujeres embarazadas que fallecieron por causas directas relacionadas con el embarazo durante los años 2013 a 2015 en el estado de Yucatán. Se utilizaron datos del Instituto Nacional de Estadística y Geografía (INEGI).Resultados: En el 2013 se encontró que la RMM en Yucatán fue 38,11% mayor en comparación con la nacional, en el 2014 la RMM en este mismo estado fue 34,68% mayor en comparación con la del país y en el 2015 la RMM fue 21,14% mayor que la mexicana. Las principales causas de muerte en el estado concuerdan con lo expuesto en la bibliografía, siendo éstas los desórdenes hipertensivos y las hemorragias.Conclusiones: La RMM durante los años 2013 a 2015 en el estado de Yucatán fue mayor a la media nacional. Es importante implementar medidas preventivas que permitan reducir esta disparidad en términos de mortalidad materna en el estado de Yucatán.Palabras clave: Muerte Materna, Salud Pública, Prevención Secundaria, Salud MaternaTítulo corto: Análisis de la mortalidad materna en Yucatán. ABSTRACT.Introduction. Maternal Mortality is considered a significant indicator of the quality of the health services in any country. It is known that approximately 95% of these deaths in Latin America and the Caribbean are preventable.Objectives. Our objective is to determine whether or not the Maternal Mortality Ratio (MMR) in Yucatan is higher than the national mean during the years 2013 to 2015.Materials and methods. Transversal-observational study in pregnant women who died from direct causes related to pregnancy during the years 2013 to 2015 in Yucatan. Data from the National Institute of Statistics and Geography (INEGI) were used.Results. In 2013 the MMR in Yucatan was 38,11% higher than the national mean, in 2014 the MMR of this state was 34,68% higher in comparison to the national mean and in 2015 the MMR was 21,14% higher than the national mean. The main causes of dead in the state of Yucatan are in agreement with the national causes which are hypertensive disorders and  hemorrhagic disorders.Conclusions. The MMR during the years 2013 to 2015 in the state of Yucatan was higher than the national average. It is important to implement preventive measures to reduce this disparity in terms of maternal mortality in the state of Yucatán.Keywords: Maternal Mortality, Public Health, Secondary Prevention, Maternal Health. 


Author(s):  
Karayna Fernandes ◽  
Maria Sousa ◽  
José Cecatti

Purpose In 2013, it was estimated that 289,000 maternal deaths occurred worldwide. The maternal mortality ratio has decreased in many countries in the past decades, due to early identification and treatment of obstetric complications, despite the dissimilarities observed in diverse locations and populations. Black women, for instance, have always been more susceptible to the occurrence of maternal mortality and severe morbidity. Therefore, the objective of this study is to assess skin color as a predictive factor for maternal near miss (MNM) in a sample of Brazilian women interviewed in the Brazilian National Demographic and Health Survey (DHS) of 2006. Method A secondary analysis of the DHS database, a population-based cross-sectional nationally representative study was conducted. This database is of public domain. The risk of maternal complications according to ethnic group and the associated sociodemographic characteristics were evaluated. For the data analysis, the odds ratios and respective 95% confidence intervals were calculated. Results In the sample interviewed, 59% of women were black or brown (mixed-race). Approximately 23% of women had some complication, and 2% of these women had at least one MNM pragmatic criterion. The MNM rate was 31 per 1,000 live births, and its occurrence was not statistically different among the ethnic groups. The only factors identified that were considered to be associated with the occurrence of MNM were maternal age above 40 and women not currently attending school, but only among white women. Conclusion The 2006 DHS results did not show a higher occurrence of maternal complications, and specifically of MNM associated with black/brown skin color.


2020 ◽  
Vol 45 (2) ◽  
pp. 340-348
Author(s):  
James Lucas da Costa-Lima ◽  
Earl Celestino de Oliveira Chagas

Abstract—A synopsis of Dicliptera (Acanthaceae) for Brazil is presented. Six species are recognized: Dicliptera ciliaris, D. sexangularis, and D. squarrosa, widely distributed in South America; D. purpurascens, which ranges from the North Region of Brazil (in the state of Acre) to eastern Bolivia; D. gracilirama, a new species from the Atlantic Forest of northeastern Brazil; and D. granchaquenha, a new species recorded in dry and semideciduous forests in Bolivia and western Brazil, in the state of Mato Grosso do Sul. Furthermore, we propose new synonyms and designate lectotypes for eleven names. An identification key to the six accepted Dicliptera species in Brazil is provided.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Mendez-Dominguez ◽  
Karen Santos-Zaldívar ◽  
Salvador Gomez-Carro ◽  
Sudip Datta-Banik ◽  
Genny Carrillo

Abstract Background In Mexico, the COVID-19 pandemic led to preventative measures such as confinement and social interaction limitations that paradoxically may have aggravated healthcare access disparities for pregnant women and accentuated health system weaknesses addressing high-risk patients’ pregnancies. Our objective is to estimate the maternal mortality ratio in 1 year and analyze the clinical course of pregnant women hospitalized due to acute respiratory distress syndrome and COVID-19. Methods A retrospective surveillance study of the national maternal mortality was performed from February 2020–February 2021 in Mexico related to COVID-19 cases in pregnant women, including their outcomes. Comparisons were made between patients who died and those who survived to identify prognostic factors and underlying health conditions distribution. Results Maternal Mortality Ratio increased by 56.8% in the studied period, confirmed COVID-19 was the cause of 22.93% of cases. Additionally, unconfirmed cases represented 4.5% of all maternal deaths. Among hospitalized pregnant women with Acute Respiratory Distress Syndrome consistent with COVID-19, smoking and cardiovascular diseases were more common among patients who faced a fatal outcome. They were also more common in the age group of < 19 or > 38. In addition, pneumonia was associated with asthma and immune impairment, while diabetes and increased BMI increased the odds for death (Odds Ratio 2.30 and 1.70, respectively). Conclusions Maternal Mortality Ratio in Mexico increased over 60% in 1 year during the pandemic; COVID-19 was linked to 25.4% of maternal deaths in the studied period. Lethality among pregnant women with a diagnosis of COVID-19 was 2.8%, and while asthma and immune impairment increased propensity for developing pneumonia, obesity and diabetes increased the odds for in-hospital death. Measures are needed to improve access to coordinated well-organized healthcare to reduce maternal deaths related to COVID-19 and pandemic collateral effects.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12599-e12599
Author(s):  
Hyein Jeon ◽  
Myeong Lee ◽  
Mohammed Jaloudi

e12599 Background: Higher prevalence of triple negative breast cancer (TNBC) in black women with associated poor outcomes due to various disparities is well documented within a single state. We examine multiple states to better understand the state effect on such differences in incidence and prevalence of TNBC in black women. Methods: Female patients of ages 19 years old and above with breast cancer from the Surveillance, Epidemiology and End Results (SEER) Program across 13 states (608 counties) from 2015 (n = 66,444) and 2016 (n = 66,122) were examined. The relationships between the proportion of black and white women and the rate of patients with different tumor subtypes (luminal A, luminal B, HR-HER2+, and triple negative) were examined at the county level using ordinary least-square regression models. In parallel, due to consideration of various state-specific healthcare policies, socio-cultural norms, and socio-economic disparities, multi-level regression models were applied to examine the nested, random effect of each state on TNBC prevalence in each county. Bonferroni correction was applied to reduce the Type I error caused by repeated use of the same variables in multiple tests. Results: The baseline breast cancer rates between black and white women were similar in the population (0.171% for black and 0.168% for white). Consistent to previous studies, we demonstrate a significant positive correlation (p < 0.001) in TNBC in black females in both years. Surprisingly, when accounted for the random effects on states, 38.2% (2015) and 34.3% (2016) increase in incidence of TNBC in black females were seen, suggestive of state-specific disparity affecting race-specific health. In 2015, other subtypes of breast cancer in both black and white females did not result in significant relationship. Interestingly, in 2016, there was a significant relationship seen between the TNBC rate in white females and the white female population rate only after adjusting for the state effect (p = 0.026). This indicates the impact of non-biological factors such as state-wide health policies. Additionally, HR-HER2+ black females had a significant relationship against respective population rate only after adjusting for the state effect as well (p = 0.0394). For luminal A white females, a 15% decrease in incidence was seen after adjusting for state effect (p = 0.0424). Conclusions: This is the first known across-state examination of breast cancer subtypes by race with random effects on state. This study shows the role of state-specific factors affecting incidence in black and white females and potentially indicates the importance of state-level management for breast cancer on health disparities in addition to race-driven effects. Further studies are needed to elucidate comparable differences between states affecting the rates of various subtypes of breast cancer and thus health outcomes.


Zootaxa ◽  
2021 ◽  
Vol 4933 (1) ◽  
pp. 98-112
Author(s):  
CLÁUDIO H. ZAWADZKI ◽  
GABRIELA NARDI ◽  
LUIZ FERNANDO CASERTA TENCATT

The menaced and poorly-known waters of the Bodoquena Plateau revealed a new resident, the stunning Hypostomus froehlichi sp. n., a large-sized armored catfish, which is finally described after more than twenty years since its discovery. The Bodoquena Plateau is drained by the rio Paraguay basin, and is located in the state of Mato Grosso do Sul, Brazil. The new species differs from its congeners on the Bodoquena crystalline waters by having teeth with morphological and numerical variation in adult specimens. There is a continuous range of specimens having about 20 thick and worn teeth to specimens having about 50 thin teeth with intact crowns and lanceolate main cusps. Additional diagnostic characters are: dentaries angled more than 90 degrees, dark blotches, one plate bordering supraoccipital, moderate keel along dorsal series of plates, usually two rows of blotches per interradial membrane on dorsal, pectoral and ventral fins, and by attaining comparatively large size. Hypostomus froehlichi seems to be endemic to the area of the Bodoquena Plateau, in rivers draining to the rio Miranda. The description of the new species reveals a potential conservation flagship species as it is one of the most seen and documented fish by visitors and divers in the clear waters from the touristic, though menaced, Bonito region in Brazil. 


2017 ◽  
Vol 107 (0) ◽  
Author(s):  
Guilherme D. P. Dornelles ◽  
Gustavo Graciolli ◽  
Anderson Odon ◽  
Marcelo O. Bordignon

ABSTRACT We described infracommunities, prevalence and mean intensity of infestation of ecotoparasite flies (Nycteribiidae and Streblidae) on bats in an ecotone area of Cerrado as predominant vegetation, with influence of Atlantic Forest, in the southeast of Mato Grosso do Sul. In 36 sampling nights between April 2015 and August 2016 (23,328 m².h), we captured 17 bat species, of which ten were infested, and 14 species of fly. The most abundant bats were the phyllostomids Artibeus planirostris (Spix, 1823), Glossophaga soricina (Pallas, 1776) and Carollia perspicillata (Linnaeus, 1758) and the most abundant flies were the streblids Trichobius longipes (Rudow, 1871), T. joblingi Wenzel, 1966 and Megistopoda aranea (Coquillett, 1899). Phyllostomus hastatus (Pallas, 1767) was the bat species that presented the highest infestation rate. Platyrrhinus lineatus (É. Geoffroy, 1810) and Desmodus rotundus (É. Geoffroy, 1810) were not infested. Besides that, the frequency of bats that were infested by a single species of fly was higher than the frequency of bats infested for two or more, and it may be a pattern.


Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat

Background: According to the WHO, 80 of maternal deaths in developing countries are due to direct maternal causes such as haemorrhage, hypertensive disorders and sepsis. These deaths are largely preventable. Maternal mortality ratio (MMR) in India is 167/100,000 live births.Methods: This retrospective observational study was conducted at GMERS, Valsad. Data regarding maternal deaths from January 2016 to December 2017 were collected and analyzed with respect to epidemiological parameters. The number of live births in the same period was obtained from the labour ward ragister. Maternal mortality rate and Mean maternal mortality ratio for the study period was calculated.Results: The mean Maternal mortality rate in the study period was 413.3/100,000 births. The maternal mortality ratio (MMR) in India is 167/100,000 live births. More than half of maternal deaths were reported in multiparous patients. More maternal deaths were observed in women from rural areas (67.3%), unbooked patients (73.3%) and illiterate women (65.3%). Thirty six (69.3%) maternal death occurred during postpartum period. Most common delay was first delay (60.0%) followed by second delay (40.0%). Postpartum haemorrhage (28.8%), preeclampsia (17.3%), sepsis (13.46%) were the major direct causes of maternal deaths. Indirect causes accounted for one third of maternal deaths in our study. Anemia, hepatitis and heart disease were responsible for 13.4%, 5.7%, and 1.9% of maternal deaths, respectively.Conclusions: Majority of maternal deaths are observed in patients from rural areas, unbooked, and illiterate patients. Hemorrhage, eclampsia and sepsis are leading causes of maternal deaths. Most of these maternal deaths are preventable if patients are given appropriate treatment at periphery and timely referred to higher centers.


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