ANALYSIS OF POSTPARTUM HEMORRHAGE IN BRAZIL BETWEEN 2019 AND 2023

Abstract

INTRODUCTION: Postpartum hemorrhage (PPH) is one of the main causes of maternal morbidity and mortality worldwide. Despite efforts to reduce these rates, PPH remains a significant concern, highlighting the need for effective strategies to prevent and manage this obstetric complication.  This study aims to analyze the epidemiological profile of hospitalizations for PPH in Brazil between 2019 and 2023. OBJECTIVE: To determine the epidemiological profile of hospitalizations for postpartum hemorrhage in Brazil from 2019 to 2023. METHODS: This study is a retrospective epidemiological research and descriptive with a quantitative approach, using data from the Information Technology Department of the Unified Health System (DATASUS). 13,411 hospitalizations for PPH were analyzed, collected between 2019 and 2023. The data were organized into tables and graphs and interpreted together with a review of academic literature, using the variables: region, age group, incidence per year, race and type of care. RESULTS AND DISCUSSION: Of the 13,411 hospitalizations for PPH analyzed, the Southeast region had the majority of hospitalizations, with 40.09% (5,377), followed by Northeast, with 29.4% (3,943) and the South region, with 18.36 % (2,463). On the other hand, the North region had the lowest number of hospitalizations, with 6.7% (898). Regarding Brazilian states, São Paulo had the most hospitalizations, with 19.5% (2,620), followed by Minas Gerais, with 13.75% (1,845) and Paraná, with 7.5% (1,006).  Furthermore, the state of Acre had the lowest number of hospitalizations, with only 19 hospitalizations.  Among the states in the Northeast, the highest number of hospitalizations was in Rio Grande do Norte, 7% (949). The age range analyzed was 15 years and 49 years, with the majority of cases of postpartum hemorrhage occurring in the age group between 20 and 24 years, representing 23.8% of hospitalizations for PPH. On the other hand, the age group with the lowest number of cases was between 45 and 49 years old, representing less than 1% of hospitalizations. The occurrence of postpartum hemorrhage in this age group is lower due to the reduced frequency of births. Regarding race, there is a predominance of hospitalizations in brown women, representing 43.9% of cases, followed by white women, with 29.5%. Black, yellow and indigenous women together represented only 6.7% of total hospitalizations. Finally, the nature of care for cases of postpartum hemorrhage (Table 2), demonstrating that 97.7% (13104) were urgent. CONCLUSION: A concentration of hospitalizations for PPH was found in the Southeast and Northeast regions, especially among young women aged 20 to 29. There was a decreasing trend in hospitalization rates throughout the studied period. There was a predominance of hospitalizations among mixed-race women, followed by white women, with a smaller proportion of black, yellow and indigenous women. The majority of hospitalizations occurred on an urgent basis. These findings offer insights for improvements in maternal and obstetric health.