Características biológicas e evitabilidade de óbitos perinatais em uma localidade na cidade do Rio de Janeiro, 1999 a 2003

Abstract

Objectives: to analyze perinatal deaths in a public maternity hospital, located in the city of Rio de Janeiro, Brazil, according to biological characteristics, basic causes, avoidability and birth weight-specific mortality rates. Methods: the coorte study was performed from 1999 to 2003 in the maternity Leila Diniz, Hospital Municipal Raphael de Paula Souza, assisting 50% of the births in the geographic/administrative area 4 (Jacarepaguá and Barra da Tijuca). Perinatal deaths in cases where birth weight was equal or superior to 500 g were included. A standardized tool - Perinatal Investigation Report - and medical records were used to collect data. Death causes were investigated and the Wigglesworth's Classification was applied to assess deaths' avoidability. Results: there were 512 perinatal deaths (377 stillborns and 135 early neonatal deaths). Neonatal deaths tended to occur in the first three days of life. Twenty-four percent of the perinatal deaths occurred in newborns smaller than expected in relation to gestational age. The principal causes of death were maternal morbidities (hypertension and syphilis) and placental complications. According to Wigglesworth's Classification, 50% of the deaths were avoidable. Conclusions: the number of avoidable deaths was high, mainly stillbirths, and referred to conditions related to prenatal care.