Keywords
Hospitalization
Mortality
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Abstract
Objective: To describe and compare the profile of hospitalizations and maternal mortality due to postpartum hemorrhage (PPH) among the states of Brazil's Northern region, from 2019 to 2023. Methods: Ecological, retrospective time series study using data collected from the Department of Informatics of the Unified Health System (DATASUS), Mortality Information System (SIM), Hospital Information System of SUS (SIH/SUS), and the resident population. Maternal deaths due to PPH (ICD-10: O72) were analyzed. Mortality (MoC) and hospital admission (HAC) coefficients were calculated, along with descriptive and inferential analyses (p<0.05). Results: A total of 726 hospitalizations and 76 deaths were recorded, with higher concentrations in the states of Pará and Amazonas. Rondônia had the highest average HAC (3.04; 95%CI: 1.18–4.89), and Roraima presented the highest average MoC (0.42; 95%CI: -0.23–1.07). Most cases occurred among brown-skinned, single women, with 8 to 11 years of schooling, aged between 20 and 29 years, emergency care attendance, and death records mainly in hospital units. Conclusion: Despite the reduction in HAC and MoC, state-level inequalities that affect obstetric care persist. Integrated policies are essential to prevent and manage PPH, reducing disparities in the Northern region.
References
BRASIL. (2016). Redes de atenção: a Rede Cegonha. Disponível em: https://portaldeboaspraticas.iff.fiocruz.br/wp-content/uploads/2018/01/Redes-deA-rede-cegonha.pdf. Acessado em: 12 de junho de 2025.
COSTA RC, et al. Hemorragia pós-parto e a mortalidade materna: perfil epidemiológico. Revista Ibero-Americana de Humanidades, Ciências e Educação, 2023; 9(10): 6820–6833.
COSTA SD, et al. Mortalidade Materna por Hemorragia no Brasil / Maternal Mortality from Hemorrhage in Brazil. Brazilian Journal of Health Review, 2021; 4(2): 4333–4342.
DE FIGUEIREDO JÚNIOR AM, et al. O acesso aos serviços de saúde da população ribeirinha: um olhar sobre as dificuldades enfrentadas. Revista Eletrônica Acervo Científico, 2020; 13: e4680.
EVENSEN A, et al. Postpartum Hemorrhage: Prevention and Treatment. United States: American family physician, 2017; 95(7): 442–449.
FEDUNIW S, et al. Epidemiology, prevention and management of early postpartum hemorrhage — a systematic review. Ginekologia Polska, 2020; 91(1): 38–44.
FREITAS PS, et al. Análise da hemorragia pós-parto no brasil entre 2019 e 2023. Brazilian Journal of Implantology and Health Sciences, 2024; 6(4): 1079–1093.
GONZAGA CM, et al. Disparities in female breast cancer mortality rates between urban centers and rural areas of Brazil: ecological time-series study. Netherlands: Breast (Edinburgh, Scotland), 2014; 23(2) 180–187.
GROBMAN WA, et al. Racial and ethnic disparities in maternal morbidity and obstetric care. United States: Obstetrics and gynecology, 2015; 125(6): 1460–1467.
GUIMARÃES RM, MOREIRA MR. Mortes maternas como desafio para a assistência obstétrica em tempos da Covid-19 no Brasil. Revista Brasileira de Saúde Materno Infantil, 2024; 24: e20230078.
HUANG CR, et al. Incidence and risk factors for postpartum hemorrhage after vaginal delivery: A systematic review and meta-analysis. Australia: The journal of obstetrics and gynaecology research, 2023; 49(7): 1663–1676.
IBGE – Instituto Brasileiro de Geografia e Estatística. Censo Demográfico 2022: População por cor ou raça. Disponível em: https://www.ibge.gov.br/. Acessado em: 10 de junho de 2025.
LEAL MD, et al. Saúde reprodutiva, materna, neonatal e infantil nos 30 anos do Sistema Único de Saúde (SUS). Ciência & Saúde Coletiva, 2018; 23(6): 1915–1928.
LIMA CR, et al. Análise epidemiológica da mortalidade materna no Brasil. Brazilian Journal of Development, 2023; 9(8): 24241–24258.
MATOS SM, et al. Perfil epidemiológico dos óbitos maternos por hemorragia pós-parto no Brasil entre 2000 e 2023. Research, Society and Development, 2025; 14(3): e3814348444.
ONO SOUSA IA, et al. Mortalidade materna por hemorragia pós-parto nas regiões norte e nordeste: um estudo ecológico de série temporal. Revista CPAQV - Centro de Pesquisas Avançadas em Qualidade de Vida, 2024; 16(2).
SANTOS MC, et al. Perfil epidemiológico da mortalidade materna por hemorragia pós-parto no brasil no período de 2018 a 2022. Revista Ibero-Americana de Humanidades, Ciências e Educação, 2025; 11(1): 1115–1123.
SAY L, et al. Global causes of maternal death: a WHO systematic analysis. England: The Lancet. Global health, 2014; 2(6): e323-333.
SHELDON WR, et al. Postpartum haemorrhage management, risks, and maternal outcomes: findings from the World Health Organization Multicountry Survey on Maternal and Newborn Health. England: BJOG : an international journal of obstetrics and gynaecology, 2014; 121 Suppl 1: 5–13.
SILVA AD, et al. Racial disparities and maternal mortality in Brazil: findings from a national database. Revista de Saúde Pública, 2024; 58(1): 25.
SILVA LT, et al. Análise do perfil epidemiológico de internações por hemorragia pós-parto no brasil de 2018 a 2023. Brazilian Journal of Implantology and Health Sciences, 2025; 7(2): 2339–2351.
SOARES LR, et al. Mortalidade por câncer de mama feminino no Brasil de acordo com a cor. Revista Brasileira de Ginecologia e Obstetrícia, 2015; 37(8): 388–392.
SOUZA JP, et al. Maternal near miss and maternal death in the World Health Organization’s 2005 global survey on maternal and perinatal health. Switzerland: Bulletin of the World Health Organization, 2010; 88(2): 113–119.
WATKINS EJ, STEM K. Postpartum hemorrhage. JAAPA, 2020; 33(4): 29–33.
YUNAS I, et al. Causes of and risk factors for postpartum haemorrhage: a systematic review and meta-analysis. England: Lancet (London, England), 2025; 40(10488): 1468–1480.