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Space-time trends in fetal mortality in Brazil, 1996-2021.

João Batista Francalino da Rocha1, Italla Maria Pinheiro Bezerra2, Elyecleyde Katiane da Silva Oliveira3

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This summary is machine-generated.

Fetal mortality in Brazil decreased significantly from 1996-2021, despite a pandemic-related slowdown. Regional disparities persist, with higher rates in the North, Northeast, and Central-West.

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Area of Science:

  • Public Health
  • Epidemiology
  • Demography

Background:

  • Fetal mortality remains a significant public health concern globally.
  • Understanding space-time trends is crucial for targeted interventions.
  • Brazil has faced challenges in reducing fetal mortality rates.

Purpose of the Study:

  • To analyze the space-time trends of fetal mortality in Brazil between 1996 and 2021.
  • To assess the impact of the COVID-19 pandemic on fetal mortality trends.
  • To identify regional disparities in fetal mortality across Brazil.

Main Methods:

  • Ecological time series study utilizing secondary data from Brazil's Mortality Information System (SIM).
  • Analysis of fetal deaths at gestational age ≥ 20 weeks from 1996-2021, including pre-pandemic and pandemic periods.
  • Joinpoint regression analysis to calculate Percentage Change (PC), Annual Percentage Change (APC), and Average Annual Percentage Change (AAPC) for fetal mortality rates (FMR).

Main Results:

  • Fetal deaths accounted for 1.14% of births and 58% of perinatal deaths; 93% were antepartum.
  • Overall FMR decreased by 20-41% across evaluated gestational ages (≥20, ≥22, ≥28 weeks), with AAPC ranging from -1.00 to -1.89.
  • The COVID-19 pandemic showed a slowdown in reduction and an increase in FMR, but did not interrupt the overall downward trend.

Conclusions:

  • Fetal mortality in Brazil exhibits a long-term downward trend nationally and regionally, with a stationary trend in the Central-West region.
  • While the COVID-19 pandemic temporarily impacted FMR, the overall reduction trend persisted.
  • Significant regional inequalities in FMR and reduction rates were observed, particularly in the North, Northeast, and Central-West regions.