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Published on: July 29, 2020
Spatial distribution of Robson 10-group classification system and poverty in southern and southeastern Brazil
Marisa A A Brunherotti1,2, Marli F Prado3, Edson Z Martinez2
1Postgraduate Program in Health Promotion, Universidade de Franca, São Paulo, Brazil.
Objective:
To assess the spatial distribution of the Robson 10-group classification system (TGCS) and poverty in southeastern and southern regions of Brazil in 2016.
Methods:
An ecologic study based on public data from the Brazilian Information System on Live Births and the Brazilian Institute of Geography and Statistics, including 1 519 289 (53.2%) of all live-born neonates in Brazil between January and December 2016. Statistical analysis used Bayesian modelling with spatial distribution following an autoregressive conditional structure, and Moran index.
Results:
In 2016, the percentage of live-born neonates delivered by cesarean was 58.8% and 60.7% in the southeastern and southern regions, respectively. Robson groups 1 and 3, involving spontaneous labor, were related to regions with higher poverty (Moran index, 0.36 and 0.44, respectively), whereas groups 2 and 5, involving cesarean delivery, were related to poorer regions (Moran index, 0.56 and 0.45, respectively).
Conclusion:
The frequencies of each group of the Robson TGCS were heterogeneously distributed in the geographic space owing to important associations with the proportion of poverty in the different regions. Actions are needed to develop the poorest regions in order to minimize existing disparities.
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