Spatial patterns of preventable perinatal mortality in Salvador, Bahia, Brazil

Abstract

OBJECTIVE: To identify the spatial distribution patterns and areas of higher risk of preventableperinatal mortality in the city of Salvador, State of Bahia, Brazil.METHODS: We carried out a spatial aggregated study in 2007, considering the weightingareas (census tracts contiguous sets) of Salvador, of which the center and north present lowlife conditions. Data were obtained from national vital statistics systems and the 2010 Census.Addresses of live births and stillbirths were geocoded by weighting area. The spatial distribution ofthe perinatal mortality rate was analyzed from thematic maps. Spatial dependence was evaluatedby the Global and Local Geary’s and Moran’s Indexes.RESULTS: Crude and smoothed perinatal mortality rates were high in areas situated to the north,west, and in center of Salvador. The smoothed rates in weighting areas ranged from 4.9/1,000 to22.3/1,000 births. Of all perinatal deaths, 92.1% could have been prevented. We identified spatialdependence for preventable perinatal mortality for care in pregnancy, with neighboring areaswith high risk in the north of the city.CONCLUSIONS: The preventability potential of perinatal mortality was high in Salvador, in 2007.The spatial distribution pattern with higher rates in disadvantaged areas of the city suggests theexistence of social inequalities in health. The characteristics of the process of urban developmentof Salvador, which has inadequate prenatal care, possibly influenced the magnitude and spatialdistribution pattern of this mortality