Spatial patterns of avoidable fetal mortality and social deprivation

Area of Science:

• Public Health
• Epidemiology
• Social Determinants of Health

Background:

• Fetal mortality remains a significant public health concern, particularly in regions with socioeconomic disparities.
• Effective public health strategies require accurate identification of areas most affected by social deprivation and its impact on fetal health.

Purpose of the Study:

• To create a social need index for stratifying municipalities.
• To identify priority areas for interventions aimed at reducing fetal mortality.

Main Methods:

• An ecological study was conducted in Pernambuco, Brazil (2010-2017).
• Factor analysis by principal components was employed to develop the social need index.
• Spatial analysis utilized the local empirical Bayesian estimator and Moran's spatial autocorrelation.

Main Results:

• The social deprivation index identified two key factors explaining 77.63% of the variance.
• Preventable fetal mortality rates increased with higher levels of social deprivation, from 8.0 to 10.7 per 1,000 births.
• Municipalities in the São Francisco and Sertão Mesoregions showed high rates of fetal mortality and social deprivation.

Conclusions:

• Spatial analysis pinpointed high-risk areas for fetal mortality.
• The social deprivation index identified key determinants of fetal deaths linked to poor living conditions.
• Priority areas for public policies to mitigate fetal mortality and its determinants were identified.