Maternal mortality and access to obstetric care in Manaus, Amazonas: a population-based observational study (2021–2023)

Abstract

Objective: to analyze maternal deaths in the municipality of Manaus, Amazonas, from 2021 to 2023, through an observational, descriptive, retrospective, population-based study using secondary data from official health information systems. Methods: Observational, descriptive-analytical, retrospective, population-based study that analyzed maternal deaths among residents of Manaus between 2021 and 2023, using secondary data from the Mortality Information System and the Live Birth Information System, available at DATASUS. The analyses were performed using Jamovi software (v.2.3.28). Results: Between 2021 and 2023, 113 maternal deaths were recorded among residents of Manaus, corresponding to an average maternal mortality ratio of 107.4 per 100,000 live births. A significant reduction in the MMR was observed over the period, with the highest value in 2021 (191.7/100,000 live births) and a decline in 2022 (66.3) and 2023 (56.7). The comparative analysis showed a higher concentration of deaths among brown-skinned, unmarried women with 8–11 years of schooling and aged between 30 and 39 years. In the etiological profile, indirect obstetric causes predomination, especially infectious and parasitic diseases that complicated pregnancy, childbirth, and the postpartum period. Conclusions: Despite the reduction in maternal mortality, inequalities in access to obstetric care remain in Manaus, indicating the need to strengthen prenatal care, childbirth assistance, and the organization of the care network, based on clinical protocols and actions guided by equity.