Spatial analysis of inequalities in fetal and infant mortality due to avoidable causes

ABSTRACT Objectives: to analyze social inequalities in spatial distribution of fetal and infant mortality by avoidable causes and identify the areas of greater risk of occurrence. Methods: avoidable deaths of fetal and infant residents of Recife/Brazil were studied. The rates of avoidable fetal and infant mortality were calculated for two five-year periods, 2006-2010 and 2011-2015. The scan statistics was used for spatial analysis and related to the social deprivation index. Results: out of the total 2,210 fetal deaths, 80% were preventable. Avoidable fetal mortality rates increased by 8.1% in the five-year periods. Of the 2,846 infant deaths, 74% were avoidable, and the infant mortality rate reduced by 0.13%. Conclusions: in the spatial analysis, were identified clusters with higher risk for deaths. The social deprivation index showed sensibility with areas of worse living conditions.

摘要
研究目的：分析可避免病因导致的胎儿及婴儿死亡空间分布的社会不平等性，并识别死亡发生风险更高的区域。
研究方法：以巴西累西腓市常住居民中因可避免病因死亡的胎儿及婴儿为研究对象，针对2006-2010年、2011-2015年两个五年周期，计算可避免胎儿死亡率与可避免婴儿死亡率。采用空间扫描统计（scan statistics）开展空间分析，并将分析结果与社会剥夺指数（social deprivation index）进行关联。
研究结果：本次研究纳入的2210例胎儿死亡病例中，80%为可避免死亡；两个五年周期内，可避免胎儿死亡率上升8.1%。在2846例婴儿死亡病例中，74%为可避免死亡，婴儿死亡率下降0.13%。
研究结论：空间分析结果显示，存在死亡风险更高的聚集区域；社会剥夺指数可有效反映生活条件较差的区域，具备良好的敏感性。