title: Temporal and spatial evolution of maternal and neonatal mortality rates in Brazil, 1997-2012.
abstract: OBJECTIVE
  Maternal and neonatal mortality are important public health issues in low-income countries. This study evaluated spatial and temporal maternal and neonatal mortality trends in Brazil between 1997 and 2012.
  
  
  METHODS
  This study employed spatial analysis techniques using death records from the mortality information system. Maternal mortality rates per 100,000 and neonatal mortality rates (early and late) per 1000 live births were calculated by state, region, and period (1997-2000, 2001-2004, 2005-2008, and 2009-2012). Multivariate negative binomial models were used to explain the risk of death.
  
  
  RESULTS
  The mean Brazilian maternal mortality rate was 55.63/100,000 for the entire 1997-2012 period. The rate fell 10% from 1997-2000 (58.92/100,000) to 2001-2004 (52.77/100,000), but later increased 11% during 2009-2012 (58.69/100,000). Early and late neonatal mortality rates fell 33% (to 7.36/1000) and 21% (to 2.29/1000), respectively, during the 1997-2012 period. Every Brazilian region witnessed a drop in neonatal mortality rates. However, maternal mortality increased in the Northeast, North, and Southeast regions.
  
  
  CONCLUSIONS
  Brazil's neonatal mortality rate has improved in recent times, but maternal mortality rates have stagnated, failing to meet the Millennium Development Goals. Public policies and intersectoral efforts may contribute to improvements in these health indicators.
authors.affiliation: Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Rio de Janeiro, RJ, Brazil; Universidade do Estado do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Rio de Janeiro, RJ, Brazil. Electronic address: nadia@lampada.uerj.br.
authors.forename: Nádia Cristina Pinheiro
authors.initials: NC
authors.lastname: Rodrigues
authors.affiliation: Universidade do Estado do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Rio de Janeiro, RJ, Brazil.
authors.forename: Denise Leite Maia
authors.initials: DL
authors.lastname: Monteiro
authors.affiliation: Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Rio de Janeiro, RJ, Brazil.
authors.forename: Andréa Sobral de
authors.initials: AS
authors.lastname: Almeida
authors.affiliation: Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Rio de Janeiro, RJ, Brazil.
authors.forename: Mônica Barros de Lima
authors.initials: MB
authors.lastname: Barros
authors.affiliation: Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Rio de Janeiro, RJ, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Pereira Neto
authors.affiliation: Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Rio de Janeiro, RJ, Brazil.
authors.forename: Gisele
authors.initials: G
authors.lastname: O'Dwyer
authors.affiliation: Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Rio de Janeiro, RJ, Brazil; Instituto Vital Brazil, Centro de Estudo e Pesquisa do Envelhecimento, Niterói, RJ, Brazil.
authors.forename: Mônica Kramer de Noronha
authors.initials: MK
authors.lastname: Andrade
authors.affiliation: Georgia Southern University, Department of Sociology & Anthropology, Statesboro, United States.
authors.forename: Matthew Brian
authors.initials: MB
authors.lastname: Flynn
authors.affiliation: Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Rio de Janeiro, RJ, Brazil.
authors.forename: Valéria Teresa Saraiva
authors.initials: VT
authors.lastname: Lino
mesh_terms: D001938:Brazil / Q000453:epidemiology; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D008428:Maternal Mortality / Q000639:trends*; D011247:Pregnancy; D012306:Risk; D062211:Spatio-Temporal Analysis
keywords: Ecological studies; Estudos ecológicos; Infant mortality; Maternal health; Maternal mortality; Mortalidade; Mortalidade infantil; Mortalidade materna; Mortality; Saúde maternal; Tendências; Trends