Analysis of the causes of fetal death in Brazil, 2002 to 2017

Analysis of the causes of fetal death in Brazil, 2002 to 2017

Lays Janaina Prazeres Marques (1)(2); Zilda Pereira da Silva(2); Gizelton Pereira de Alencar(2); Marcia Furquim de Almeida(2).
 (1) PhD student in Public Health, (2) Dept. Epidemiology, University of Sao Paulo (USP);

1) Background: Brazil had a population of 207.7 million inhabitants in 2017, the Mortality Information System (MIS),
register all deaths, including fetal deaths of 22nd week of gestation and over. The stillbirths represent 2/3 of perinatal mortality and 90.8% of these were antepartum. This study aimed to investigate the trend of causes of fetal death in Brazil, between 2002 and 2017. 2) Methods: It was used the informations of MIS. The Fetal Mortality Rate (FMR) was calculated by the cause of death per thousand births, using the 10th International Classification of Diseases and Related Health Problems (ICD-10). The Time trends were assessed according to gestational age (<37 and ≥37 weeks) and exponential regression in Excel®. 3) Results: The FMR declined 0.9% per year, from 12.1 (37.417 deaths) in 2002 to 10.4 (30.574) for a thousand births in 2017.The decline in FMR was higher in preterm gestations (5% per year) than that among those with ≥37 weeks (0.8% per year), and this group represented 75% of fetal deaths in 2017. The FMR due to other disorders originating in the perinatal period (P96) presented a fall of 11% per year and the unspecified causes (P95) declined 8.8% per year in pregnancies <37 weeks. These causes of fetal death also showed decline trend in gestations of ≥37 weeks, but with lower decline and there was an increase of maternal factors and complications of pregnancy (P00-P01) in this group. 4) Conclusion: There was an increase in access to prenatal care in the period, contributing to the reduction of fetal mortality. The investigation of fetal deaths may have contributed to a better specification of the causes of death and to the reduction of non-specified mortality rates, but a large proportion of fetal deaths still remain with a non specified cause of death. This is probably due to lack of integration of the information from prenatal care and hospitals in which the delivery occurs.

Ethics statement
The study does not require the approval of the Committee on Ethics in Research with Human Beings because it is a public information obtained through the computerized department of the Brazilian National Health System (DATASUS) at the electronic address http://datasus.saude.gov.br/

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