Infant mortality evolution in the metropolitan region of São Paulo (Brazil), 1980-2000

Abstract

OBJECTIVE: To analyze IMR evolution in the São Paulo Metropolitan Area (SPMA) between 1980 and 2000, in terms of spatial, age and, causal differences. METHODS: SPMA municipalities were divided into 5 groups, based on their 1980 IMRs: ³90 lb (Group 1); 70-89 lb (Group 2); 50-69 lb (Group 3); <50 lb (Group 4). Group 5 comprised the municipality of São Paulo itself (IMR=51 lb). The analysis of trends was carried out using exponential regression models. RESULTS: IMR and its components showed a statistically significant decrease (p<0.05), with coefficients of determination between 66 and 98%, indicating goodness of fit of the exponential model to all the time series analyzed. SPMA IMR fell 69.4%, from 55.2 to 16.9 lb, and Groups 1-5 showed reductions of 83.9%, 76.2%, 71.3%, 58.7%, and 68.8%, indicating that the groups with highest IMRs also showed the greatest reductions during the studied period. CONCLUSIONS: IMRs were homogenized at around 18 lb in all municipality groups in the SPMA. One-half of all deaths were concentrated within the first week of life, and were due primarily to conditions originating in the perinatal period, indicating that greater care during the pre- and post-delivery periods will be required if the IMR in the SPMA is to descend to levels compatible with those of developed countries.