ABSTRACT
OBJECTIVE: The main objective of this study was to explore the relationship between perinatal care and neonatal mortality as a component of the infant mortality. Indicators were selected to analyze some aspects of the quality of perinatal care attendance offered to pregnant women and their newborns. Specific attention was given to the avoidable perinatal deaths in the city of Fortaleza, Ceará. METHODS: Population-based, prospective study on incidence. The study was carried out collecting data of seventeen maternity units and two referral pediatric hospitals of the public health system in Fortaleza, the capital of the State of Ceará. All births, alive or dead, weighting 500 grams or more, along the whole year of 1995, were included in the study. The perinatal deaths' causes were studied according to the modified Wigglesworth classification (1989). RESULTS: Along the whole study period, 40,712 children were born and 1,337 perinatal deaths occurred. Among them 730 occurred during the fetal life and 607 during the first week of life. In spite of the low incidence of low-weight newborns (7.4%), the coefficients of fetal mortality were high (17.9 per thousand), as well as the perinatal mortality (32.8 per thousand) and neonatal mortality (15.1 per thousand). The number of avoidable perinatal deaths related to adequate perinatal care was estimated to be one third of the total deaths studied (458/1,323). CONCLUSIONS: The results indicate that the perinatal assistance in the city of Fortaleza is of low quality, with problems related to the health system organization and to the low quality of the care offered to women during pregnancy, at delivery and to the newborns in the delivery room as well as in neonatal wards.
