Temporal trend of near miss in Brazil

It is considered a case of near miss or extremely severe maternal morbidity, a pregnant woman or a woman who survives severe maternal complications. To identify the temporal trend of maternal near miss in Brazil, from 2010 to 2018. Among 20,891,040 hospitalizations due to obstetric causes, 766,249 cases of near miss were identified, 31,475 women required ICU admission and 1,259 died. There was a predominance of hospitalizations among black women and aged over 35 years. Near miss rates grew by around 13.5% per year. This trend behaved differently depending on the level of development of the studied region, presenting greater positive increase in less developed regions. The main markers of near miss were preeclampsia, severe bleeding and infection. There was a trend of increased risk rates for near miss in Brazil at 9 years. The highest rates were concentrated in the North and Northeast and a predominance of cases among black women and aged over 35 years. The clarification of the temporal trend of near miss can contribute with the establishment of politics that protect women from complications associated with the gestational, obstetric and puerperal periods, reducing maternal morbidity and mortality rates.As gestantes ou puérperas são consideradas casos de near miss quando elas sobrevivem a complicações maternas graves. O objetivo do estudo foi avaliar a tendência temporal do near miss no Brasil, de 2010 a 2018. Estudo ecológico de tendência temporal das regiões brasileiras, utilizou- se dados do SIH/SUS. Selecionadas internações de mulheres de 10 a 49 anos com diagnóstico contemplado no CID-10 e marcadores indicativos de near miss. Dentre 20.891.040 internações por causas obstétricas verificou-se 766.249 casos de near miss, 31.475 mulheres precisaram de admissão em UTI e 1.259 foram a óbito. Observou-se predomínio de casos entre mulheres negras e idade superior a 35 anos. Constatou-se aumento nas taxas de near miss, em torno de 13,5% ao ano. A tendência se comportou diferente a depender do nível de desenvolvimento da região estudada. As principais causas de near miss foram pré-eclâmpsia, hemorragia grave e infecção. Houve tendência de aumento das taxas de near miss, em 9 anos. As maiores taxas se concentraram na região Norte e Nordeste, predomínio dos casos entre mulheres negras e idade superior a 35 anos. A elucidação da tendência temporal do near miss pode contribuir para institucionalização de políticas que reduzem as taxas de morbimortalidade maternas