Ethnic diferences in maternal near miss
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restricted access
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Article
Date
2017
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Springer
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Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Departamento de Ginecologia e Obstetrícia. Campinas, SP, Brasil.
Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Departamento de Ginecologia e Obstetrícia. Campinas, SP, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
Universidade de Brasília. Faculdade de Ciências da Saúde. Departamento de Saúde Coletiva. Brasília, DF, Brasil.
Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Departamento de Ginecologia e Obstetrícia. Campinas, SP, Brasil.
Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Departamento de Ginecologia e Obstetrícia. Campinas, SP, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
Universidade de Brasília. Faculdade de Ciências da Saúde. Departamento de Saúde Coletiva. Brasília, DF, Brasil.
Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Departamento de Ginecologia e Obstetrícia. Campinas, SP, Brasil.
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Abstract
Abstract
Purpose: To evaluate the association between ethnic diferences and the occurrence of maternal near miss (MNM) in the Amazon and Northeast regions of Brazil. Methods: This is a secondary analysis of a national crosssectional study focused on the assessment of care to pregnancy, childbirth, and infants under 1 year of age. Ethnicity was classifed as white, black or indigenous. Ethnic distribution by state and region, the proportion of severe maternal complications and related procedures, and the prevalence of MNM and its criteria were calculated for the ethnic groups. Risks for MNM were estimated per sociodemographic characteristics and healthcare received by ethnic group, using prevalence ratios adjusted by all predictors and by the sampling method. Results: 76% of the 16.783 women were black, 20% white and 3.5% indigenous. Around 36% reported any complication related to pregnancy and the most frequent were hemorrhage (27–31%), and infection (7.1–9.0%). The MNM ratio was higher among indigenous (53.1) and black (28.4) than in white women (25.7). For black women, the risks of MNM were lower for private prenatal care and hospital admission for conditions other than hypertension, while higher for cesarean section and peregrination. For indigenous, the risks of MNM were lower for private prenatal care, and higher for a longer time to reach the hospital. For white women, only the low number of prenatal visits increased the risk of MNM. Conclusions: The occurrence of MNM was higher for indigenous and black than for white women.
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Keywords in Portuguese
Região Nordeste, Região Amazônica, Desigualdades em Saúde, Gravidez, Parto e Puerpério
Keywords
Brazil, Ethnic groups, Maternal health, Morbidity, Near miss, healthcare
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Keywords in French
DeCS
Brasil, Índios Sul-Americanos, Saúde de Populações Indígenas, Ecossistema Amazônico, Epidemiologia, Saúde da Criança, Saúde da Mulher, Estudos Epidemiológicos, Saúde Materna, Disparidades nos Níveis de Saúde, Saúde Reprodutiva
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FERNANDES, Karayna Gil et al. Ethnic diferences in maternal near miss. Archives of Gynecology and Obstetrics, v. 296, n. 6, p. 1063-1070, 16 Sept. 2017.
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0932-0067
DOI
10.1007/s00404-017-4530-6