Evolução da mortalidade infantil e perinatal no municipio de Campinas/SP no periodo de 1970 a 1995

AUTOR(ES)
DATA DE PUBLICAÇÃO

1998

RESUMO

OBJECTIVE: To describe the evolution of Infant and Perinatal Mortality and their components in Campinas, in the period from 1970 to 1995. POPULATION: Deceased children less than one year old, distributed by age groups (less than one day, from one to six days, from seven to 27 days, and from 28 to 364 days) living in this municipality in their death year, and fetuses whose mothers were living in this same municipality in their death year, both occurring in this or other municipalities. METHODOLOGY: We deal with a population-based longitudinal descriptive study (a secular trend study) which can be considered an ecological study of chronological series comparison. The study starts with the analysis of the quality of data, discussing aspects ranging from their generation (Death and Birth Certificates) to definitions and criteria uti1ized, inc1uding database limitations. It follows with the presentation of the time evolution of Infant and Perinatal Mortality for Campinas, together with comparisons to other places ofvarying areas (countries, regions, capitals, and municipalities). Data were not standardized for comparisons, but emphasis was given on aspects of changes in the presented pattem among the Infant Mortality components, as well as on achievements in the relative reduction of these. deaths, as obtained from linear regression lines on the mortality curves. RESULTS AND CONCLUSION: In that it concems to the quality of data we have observed an under-reporting of infant and fetaI obits, besides a lower coverage in relation to that presented by the Geographica1 and Statistical Brazilian Institute (IBGE). We have al50 verified a bad filling quality of Death Certificates, which genera11y were more adequately filled to Fetal deaths when compared to Infant deaths, specia1ly for the variables gestation . duration, age of mother and occupation of mother. Concerning "Rl-defined Causes" we have observed a major concentration as death approximates the birth time, showing itself considerably greater to Late Fetal deaths, when compared to lrifant obits, over the-entire period from 1980 to 1995. liowever, despite of the worse trend in the quality of data on the cause of death, the magnitude of the "Rl-defined Causes" did not overcome 10% for the In/ant obits (except for PostNeonatal deaths in the period from 1991 to 1995) and 15% for Late Fetal obits (except in the year 1987), in pratica1ly the entire period. In Campinas, the Infant Mortality in the first year of life has presented significant reduction in the last decades (81.1% in the period from 1970 to 19~5). The PostNeonatal component was the leading contributor to this change. However, the Early and Late Neonatal componel}ts- of Infant Mortality did not present 50 deep a reduction. Quantitatively, the reduction in the coeficients of the Infant Mortality components, in these 26 years studied, was 98.0% for PostNeonatal and 56.2% for Neonatal; this, in tum, was compounded of reductions of 75.6% for Late Neonatal and 50.2% for Early Neonatal. The Perinatal Mortality and its components followed, in general, a descending course, presenting a linear reduction of 62.4% in the study period. The component of Fetal Deaths (relative reduction of 74.8%) efIectively determined this behavior of the Perinatal period, because both Fetal Deaths and Perinatal have presented similar pattems, whi1e the Early Neonatal component, with a linear behavior of lower relative reduction (50.2%) simply contributed with a low variation relative to Fetal death rate over the entire period. Similar pattems of decline in the evolution of Infant and PerinataI Mortality rates were observed in São Paulo state, as well as in other regions and capitais in Brazil, in the country as a whole and in other countries. It must be highlighted the privileged situation of Campinas MunicipaJity relative to Brazil as a whole, relative to other regions and capitais in Brazil, and relative to the majority of the analysed municipaJities, ca11ing for attention to the over two decade delay relative to the partem already reached by some other countries (Japan, Sweden, New Zealand, United States, and England), and indicating the potential to improvement directed to lower levels of mortality. In despite of shortage of integral data, which would allow more revealing analyses on the scope of a Social Determination of the Health-Disease Process, we have detected prevalence of inequaJities in the Infant and PerinataI Mortality behavior between Campinas Municipality and some countries of higher social development. However, far from intend defmitive conclusions, this study opens windows to new researches, preferably those specifically aiming to construct intrinsic, clarifying municipal indicators, useful to quantification of existing diferences and rates in the Reproductive Profile of the distinct populational groups. And specially those researches simultaneouly aiming to assess, through sistematic evaluations, the effectiveness of public policies, including the impact of both health services and economic-social changes on the health and life conditions

ASSUNTO(S)

epidemiologia

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