Nascimentos no estado do Paraná : análise de indicadores da saúde da mulher e da criança

Abstract

Introduction: The analysis of birth differential factors for the municipalities of the state of Paraná, Brazil, is a method for the detection of people's needs in geographical spaces and makes possible the planning and the evaluation of specific activities for the mother's and the infant's health. Aims: Current research aims at analyzing the distribution, space auto-co-relationship and factors associated to the heath of females and children in the state of Paraná. Method: All live birth of mothers domiciled in the 399 municipalities of the state of Paraná, Brazil, in 2007, reported in the Live Birth Information System (Sinasc) were analyzed. So that the distribution and special auto-co-relationship could be assessed, Sinasc variables were grouped in social and economical indexes: teenage mother, low schooling, high birth capacity, race/negro; assistential indexes: low pre-natal preparation, caesarian birth and prematurity; resulting indexes: low weight and insufficient breath at the 5th minute. So that associated factors could be analyzed, caesarian birth, low pre-natal preparation and low weight were associated to the Sinasc selected indexes and to the municipal indexes such as aging index, PSF coverage, infant mortality rate and others as a function of the municipality's population. Results: Groups of municipalities with high percentages in social and economical variables were identified, especially in the macro-regions with the worst developmental conditions. Analysis of auto-corelationship showed that social and economical indexes were highly close, especially in the East, Campos Gerais and South macro-regions. In the context of assistance indexes, low pre-natal coverage is very close in the Campos Gerais, Center-south and North macro-regions, whereas caesarian birth was conspicuous in the northwestern micro-region. Resulting indexes showed close relationships spread throughout the state of Paraná. There was a positive association between caesarian birth and aging index in the three municipality groups; association was negative to teenage mother, high birth capacity, low schooling, low pre-natal preparation, infant mortality and mortality by diseases of the circulatory apparatus, especially in size three municipalities. Low pre-natal preparation was positively associated to teenage mother, low schooling, high birth capacity, prematurity and infant mortality rates; it was associated negatively to aging index, PSF coverage and mortality rates caused by diseases of the circulatory apparatus. Low weight at birth was positively associated to prematurity and low RN vitality. Conclusion: Municipality groups could be visually identified with favorable and unfavorable indexes with regard to the health of mother and child. Higher percentages and geographic auto-co-relationships of indexes with birth risks were concentrated in macro-regions with low social and demographic standard, such as East, Campos Gerais and South macro-regions. It may be highlighted that big size municipalities had more favorable indexes, whereas social and economical and assistance indexes in small size municipalities had a higher effect on undesirable results for the mother and the newly born child. The above report helps in the evaluation and planning of health services and highlights the importance of establishing institutional activities according to the characteristics of each region.