Severe maternal morbidity and factors associated with the occurrence of abortion in Brazil

Abstract Objective To evaluate the reported occurrence of spontaneous and induced abortion, and abortion-associated severe maternal morbidity in Brazil. Methods A secondary analysis of the 2006 Brazilian Demographic Health Survey was conducted. Interview data on women's experience of spontaneous/induced abortion and associated factors were analyzed overall and by geographic region. Multinomial logistic regression was performed to identify factors independently associated with abortion. The risk of associated severe maternal morbidity was estimated. Results The reported lifetime rates of spontaneous and induced abortion were 13.3% and 2.3%, respectively, and were highest in the north (4.3%) and northeast (3.5%). The rate of spontaneous abortion was higher among women aged 40–49 years (odds ratio [OR] 1.15; 95% confidence interval [CI], 1.03–1.30) and among those with 0 or 1 children or delivery (OR 1.97; 95% CI, 1.36–2.85 vs OR 1.98; 95% CI, 1.37–2.86). Induced abortion was not associated with sociodemographic factors. Abortion significantly increased the risk of complications (hemorrhage and infection). Conclusion Spontaneous abortion was significantly associated with parity and maternal age. Abortion in general carried a higher risk of severe maternal complications.