title: Fetal deaths in Brazil: a systematic review.
abstract: OBJECTIVE
  To review the frequency of and factors associated with fetal death in the Brazilian scientific literature.
  
  
  METHODS
  A systematic review of Brazilian studies on fetal deaths published between 2003 and 2013 was conducted. In total, 27 studies were analyzed; of these, 4 studies addressed the quality of data, 12 were descriptive studies, and 11 studies evaluated the factors associated with fetal death. The databases searched were PubMed and Lilacs, and data extraction and synthesis were independently performed by two or more examiners.
  
  
  RESULTS
  The level of completeness of fetal death certificates was deficient, both in the completion of variables, particularly sociodemographic variables, and in defining the underlying causes of death. Fetal deaths have decreased in Brazil; however, inequalities persist. Analysis of the causes of death indicated maternal morbidities that could be prevented and treated. The main factors associated with fetal deaths were absent or inadequate prenatal care, low education level, maternal morbidity, and adverse reproductive history.
  
  
  CONCLUSIONS
  Prenatal care should prioritize women that are most vulnerable (considering their social environment or their reproductive history and morbidities) with the aim of decreasing the fetal mortality rate in Brazil. Adequate completion of death certificates and investment in the committees that investigate fetal and infant deaths are necessary.
authors.forename: Fernanda Morena dos Santos
authors.initials: FM
authors.lastname: Barbeiro
authors.forename: Sandra Costa
authors.initials: SC
authors.lastname: Fonseca
authors.forename: Mariana Girão
authors.initials: MG
authors.lastname: Tauffer
authors.forename: Mariana de Souza Santos
authors.initials: Mde S
authors.lastname: Ferreira
authors.forename: Fagner Paulo da
authors.initials: FP
authors.lastname: Silva
authors.forename: Patrícia Mendonça
authors.initials: PM
authors.lastname: Ventura
authors.forename: Jesirée Iglesias
authors.initials: JI
authors.lastname: Quadros
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death; D003644:Death Certificates; D005260:Female; D005313:Fetal Death / Q000209:etiology; D046689:Fetal Mortality; D063005:Health Information Systems; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy; D011295:Prenatal Care; D012307:Risk Factors; D012959:Socioeconomic Factors