Temporal and spatial evolution of maternal and neonatal mortality rates in Brazil, 1997–2012

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. Conclusion 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.