Panorama of Two Decades of Maternal Deaths in Brazil: Retrospective Ecological Time Series

<b>Background:</b> Maternal mortality remains a significant public health challenge in Brazil, reflecting persistent social, racial, and regional inequalities. <b>Objectives:</b> This study aimed to analyze trends and characteristics of maternal deaths in Brazil from 2000 to 2020, identifying sociodemographic and clinical risk factors. <b>Methods:</b> A retrospective, population-based study was conducted using secondary data from the Sistema de Informações sobre Mortalidade (SIM) of the Brazilian Ministry of Health. Descriptive and comparative statistical analyses were performed, including chi-square (χ<sup>2</sup>) goodness-of-fit tests and 95% confidence intervals calculated by the Wilson method. Variables were stratified by region, age, race, education, type and period of death, and investigation status. <b>Results:</b> A total of 40,907 maternal deaths were recorded. From 2000 to 2020, Brazil recorded 40,907 maternal deaths. The maternal mortality ratio decreased from approximately 74 deaths per 100,000 live births in 2000 to 57 per 100,000 in 2020, representing a 23% reduction over two decades. Most deaths occurred among young, Brown women with low education levels, particularly in the Southeast and Northeast regions. Direct obstetric causes accounted for two-thirds of cases, and most deaths occurred in hospital settings, mainly during the early puerperium. <b>Conclusions:</b> Despite progress, maternal mortality in Brazil remains above the WHO target and is strongly influenced by social inequities. Strengthening primary care, improving referral networks, expanding postpartum follow-up, and enhancing surveillance systems are essential for preventing avoidable deaths and achieving reproductive justice.

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Publication Details

Journal
Nursing Reports
Published
2025-11-11
DOI
https://doi.org/10.3390/nursrep15110396
Primary Topic
Maternal and Neonatal Healthcare
Type
article
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article

Panorama of Two Decades of Maternal Deaths in Brazil: Retrospective Ecological Time Series

Wágnar Silva Morais Nascimento, Karina Franco Zihlmann, Cindy Ferreira Lima, Beatriz María Bermejo‐Gil et al.
Nursing Reports
Maternal and Neonatal Healthcare
article

Panorama of Two Decades of Maternal Deaths in Brazil: Retrospective Ecological Time Series

Wágnar Silva Morais Nascimento, Karina Franco Zihlmann, Cindy Ferreira Lima, Beatriz María Bermejo‐Gil, Júlia Maria das Neves Carvalho, Patrícia Lima Ferreira Santa Rosa, Letícia López Pedraza, Edson Silva do Nascimento, Anderson Lima Cordeiro da Silva, Janize Silva Maia, Gustavo Gonçalves dos Santos, Cláudia de Azevedo Aguiar, Giovana Aparecida Gonçalves Vidotti, Débora de Souza Santos, Alexandrina Cardoso, Bruno Pereira da Silva, Joaquim Guerra de Oliveira Neto, Ricardo José Oliveira Mouta, C. Reis, Carolliny Rossi de Faria Ichikawa, Leticia de Almeida Dionizio
article en

Abstract

<b>Background:</b> Maternal mortality remains a significant public health challenge in Brazil, reflecting persistent social, racial, and regional inequalities. <b>Objectives:</b> This study aimed to analyze trends and characteristics of maternal deaths in Brazil from 2000 to 2020, identifying sociodemographic and clinical risk factors. <b>Methods:</b> A retrospective, population-based study was conducted using secondary data from the Sistema de Informações sobre Mortalidade (SIM) of the Brazilian Ministry of Health. Descriptive and comparative statistical analyses were performed, including chi-square (χ<sup>2</sup>) goodness-of-fit tests and 95% confidence intervals calculated by the Wilson method. Variables were stratified by region, age, race, education, type and period of death, and investigation status. <b>Results:</b> A total of 40,907 maternal deaths were recorded. From 2000 to 2020, Brazil recorded 40,907 maternal deaths. The maternal mortality ratio decreased from approximately 74 deaths per 100,000 live births in 2000 to 57 per 100,000 in 2020, representing a 23% reduction over two decades. Most deaths occurred among young, Brown women with low education levels, particularly in the Southeast and Northeast regions. Direct obstetric causes accounted for two-thirds of cases, and most deaths occurred in hospital settings, mainly during the early puerperium. <b>Conclusions:</b> Despite progress, maternal mortality in Brazil remains above the WHO target and is strongly influenced by social inequities. Strengthening primary care, improving referral networks, expanding postpartum follow-up, and enhancing surveillance systems are essential for preventing avoidable deaths and achieving reproductive justice.

Nursing ReportsVol. 15(11)
Universidad Complutense de Madrid (ES), Universidade Federal de Mato Grosso do Sul (BR), Universidade Federal do Acre (BR), Universidade de Ribeirão Preto (BR), Universidade de São Paulo (BR), Universidade Estadual de Campinas (UNICAMP) (BR), Universidad de Salamanca (ES), Centro Universitário das Faculdades Metropolitanas Unidas (BR), Universidade Federal do Piauí (BR), Universidade do Estado do Rio de Janeiro (BR), Universidade Federal do Tocantins (BR), Universidade Federal do Triângulo Mineiro (BR), Universidade de Sorocaba (BR), Escola Superior de Enfermagem da Universidade do Porto (PT), Universidade Metropolitana de Santos (BR), Faculdade de Medicina do ABC (BR), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR), Universidade Cruzeiro do Sul (BR), Universidade de Santo Amaro (BR), Escola Superior de Enfermagem de Coimbra (PT), Universidade Federal de São Paulo (BR)
Openalex Percentile: Top 49%
Maternal and Neonatal Healthcare
DOIOpen Access PDFOpenAlex
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