Binational Analysis of Maternal Mortality Between Brazil and Portugal in 2020–2023: A Population-Based Epidemiological Study.

Background/Objectives: Maternal mortality remains an important indicator of health inequities, reflecting social, regional, and racial inequalities, as well as the responsiveness of health systems. This study aimed to analyze and compare maternal mortality between Brazil and Portugal from 2020 to 20...

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Published in:Nursing Reports Vol. 16; no. 6; pp. 185 - 206
Main Authors: Gonçalves dos Santos, Gustavo, Silva, Mónica Alexandra Pinho da, Guerra, Maria João Jacinto, das Neves Carvalho, Júlia Maria, da Fonseca Dias, Ana Cristina Ribeiro, Bettencourt, Maria Luísa Santos, Oliveira, Cely de, Feichas Renó, Bruna, Tramontina Cerqueira, Eneida, Rocha de Almeida Farias, Katucha
Format: research tables/charts Journal Article
Published: MDPI Jun2026
Online Access:View this record in EBSCOhost
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      dt: Jun2026
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        atl: Binational Analysis of Maternal Mortality Between Brazil and Portugal in 2020–2023: A Population-Based Epidemiological Study.
      aug:
        au:
          Gonçalves dos Santos, Gustavo
          Silva, Mónica Alexandra Pinho da
          Guerra, Maria João Jacinto
          das Neves Carvalho, Júlia Maria
          da Fonseca Dias, Ana Cristina Ribeiro
          Bettencourt, Maria Luísa Santos
          Oliveira, Cely de
          Feichas Renó, Bruna
          Tramontina Cerqueira, Eneida
          Rocha de Almeida Farias, Katucha
        affil: Programa de Pós-Graduação em Enfermagem, Universidade Guarulhos (UnG), Guarulhos 07023-070, SP, Brazil
      sug:
        subj:
          Maternal Mortality Epidemiology
          Maternal Mortality Epidemiology
          Health Inequities Evaluation
          Health Systems Agencies
          COVID-19 Complications
          Maternal Mortality Trends
          Maternal Mortality Trends
          Sociodemographic Factors Evaluation
          Brazil
          Portugal
          Human
          Female
          Adolescence
          Adult
          Middle Age
          Aged
          Descriptive Statistics
          Nonexperimental Studies
          Poisson Distribution
          Confidence Intervals
          Incidence
          Pearson's Correlation Coefficient
          Chi Square Test
          Sensitivity and Specificity
          Data Analysis Software
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
      ab: Background/Objectives: Maternal mortality remains an important indicator of health inequities, reflecting social, regional, and racial inequalities, as well as the responsiveness of health systems. This study aimed to analyze and compare maternal mortality between Brazil and Portugal from 2020 to 2023. Methods: This is a binational ecological and observational study based on secondary data from official records of live births and maternal deaths in both countries. Maternal mortality rates were calculated per 100,000 live births and stratified by sociodemographic and regional variables. Poisson regression models offset by the logarithm of live births were used to estimate adjusted incidence ratios (IRR) and 95% confidence intervals. Analyses were conducted using R and Stata software. Results: Brazil presented rates between 55 and 62 per 100,000 live births, while Portugal maintained lower values, ranging from 8 to 20 per 100,000. In Brazil, higher risks were observed among Black and Indigenous women, residents of the North and Northeast regions, and in age groups above 30 years. Direct and indirect causes showed similar proportions, with an increase in indirect causes during the pandemic. In Portugal, mortality showed low magnitude, but annual fluctuation was attributed to the small number of events and the limitation of microdata. Conclusions: The study highlights strong structural and racial inequalities in Brazilian maternal mortality, contrasting with the lower magnitude and greater stability observed in Portugal. This reinforces the need for intersectoral actions, strengthening the obstetric network, and continuous surveillance to reduce preventable deaths and promote equity in maternal care.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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