Trends in hospitalizations for pregnancy, childbirth and the puerperium in São Paulo Brazil
METHODS: Evaluation of trends in hospitalization of Chapter XV-ICD10. Data were gathered from the Hospital Information System (SIH -SUS) and the Brazilian Institute of Geography and Statistics (IBGE). Admissions for PCP of women aged 15 to 49 years in the period of 2003 to 2012. Historical series and descriptive analysis was performed. Exponential regression was employed to evaluate time trend.
RESULTS: PCP hospitalizations represented an average 61.2% of total admissions (SD: 4.0) and there was a decrease of its hospitalization rate of 5.3% over the period. Delivery showed the highest rate of hospitalization, followed by maternal disorders, abortion, hypertensive disorders in pregnancy, respectively of: 20.2 (SD 0.9); 8.8, (SD 0.4), 4.2 (SD 0.5), 1.3 (SD 0.3) /1,000 women. PCP showed an average of 3 days of hospitalization (SD 0.3). There was an annual reduction trend of hospitalization rate of PCP conditions: more than 5% for hypertensive disorders in pregnancy (y = 1.71 e- 0 .054x R ² 0.60) and placenta previa (y = 0.25 e- 0 .055xR ² 0.60). Abortion complications also declined (y = 5.08 e- 0 .034x R ² 0.81). Only obstructed delivery labour showed an increase of hospitalization rate (y =0.88 e0.0125xR ²0.35).
CONCLUSIONS: The reduction of PCP hospitalization rate may be the result of fertility decline in Sao Paulo City. Abortion is an illegal act in Brazil, although there was a reduction trend of its complications, this was still the third cause of hospitalization of these conditions. The maternal disorders hospitalizations reduction suggests an improvement of prenatal care in this period.