Female mortality in reproductive age in the State of Sao Paulo, Brazil, 1991-1995: underlying causes of death and maternal mortality

Objective To describe female mortality in the reproductive age (15 to 49 ye ar old) in the State of S. Paulo, Brazil, from 1991 to 1995, according to t he age and underlying causes of death. Methods Underlying causes of death, according to the International Classifi cation of Diseases, 9(th) Revision, were determined in the program Automate d Classification of Medical Entities (ACME), developed by "Fundacao Seade", which provided us data files and estimated women population by age groups and numbers of live births during the 1991 - 1995 period. Specific rates we re calculated per 100,000 women and maternal mortal-sub-groups. The median of the rates for a five-year-period was calculated to allow the comparison among the leading underlying causes of death. Results "Celular immunity deficiency" increased from 1991 to 1995 in women aged 25 or more which seems to be concomitant to the spreading of the AIDS epidemic among women. Lesions and poisonings were the leading causes of dea th in younger women, but after the age of 35 cardiovascular diseases and ne oplasms became the chief causes. Infectious and parasitic diseases were rat ed in the 7(th) or 8(th) positions in all ages. Accidents and homicides wer e high. Maternal mortality rates ranged from 43.7 to 49.6 per 100,000 live births, their leading causes were presented and discussed. Conclusions Women in the reproductive age were exposed to external factors, chronic diseases and AIDS. The majority of maternal causes of death are pr eventable diseases. There is a lack of adequate and extensive antenatal car e as well as in delivery and postpartum care.