Evidence map›Paper›PMID 41595887›Full record

ArticleInternational journal of environmental research and public health2026

Maternal Mortality Among Black Women in Brazil: A Retrospective Cohort Study.

Gustavo Gonçalves Dos Santos, Anuli Njoku, Reginaldo Roque Mafetoni, Clara Fróes de Oliveira Sanfelice, Ana Izabel Oliveira Nicolau, Patrícia Wottrich Parenti, Cely de Oliveira, Leticia López-Pedraza, Ricardo José Oliveira Mouta, Karina Franco Zihlmann and 10 more

Abstract read
In one paragraph

Article in International journal of environmental research and public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Social Marketing for Health Equity: Promoting Preventive Health Behavior Among Women in Rural Communities.International journal of environmental research and public health · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Gustavo Gonçalves Dos SantosEscola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo 04023-062, SP, Brazil.ORCID 0000-0003-1615-7646
Anuli NjokuDepartment of Public Health, College of Health and Human Services, Southern Connecticut State University (USCS), New Haven, CT 06515, USA.ORCID 0000-0002-9471-5175
Reginaldo Roque MafetoniFaculdade de Enfermagem, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-887, SP, Brazil.ORCID 0000-0003-1574-3627
Clara Fróes de Oliveira SanfeliceFaculdade de Enfermagem, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-887, SP, Brazil.ORCID 0000-0003-1920-3193
Ana Izabel Oliveira NicolauCentro de Ciências da Saúde, Departamento de Enfermagem, Universidade Federal do Ceará (UFC), Fortaleza 60430-160, CE, Brazil.ORCID 0000-0002-6584-0575
Patrícia Wottrich ParentiEscola de Artes, Ciências e Humanidades, Universidade de São Paulo (EACH/USP), São Paulo 03828-000, SP, Brazil.ORCID 0000-0001-9321-7169
Cely de OliveiraCampus Guarujá (UNAERP), Universidade de Ribeirão Preto, São Paulo 11440-003, SP, Brazil.ORCID 0000-0003-3407-799X
Leticia López-PedrazaFacultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid (UCM), 28040 Madrid, MA, Spain.ORCID 0000-0003-3557-375X
Ricardo José Oliveira MoutaFaculdade de Enfermagem, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, RJ, Brazil.ORCID 0000-0002-1284-971X
Karina Franco ZihlmannDepartamento de Saúde, Educação e Sociedade, Universidade Federal de São Paulo-Campus Baixada Santista (UNIFESP/BS), São Paulo 11060-001, SP, Brazil.ORCID 0000-0001-9822-7518
Cindy Ferreira LimaOrganização Pan-Americana da Saúde (OPAS), Secretaria do Estado de Saúde de Minas Gerais, Minas Gerais 31630-903, MG, Brazil.ORCID 0000-0002-4578-2224
Cícero Ricarte Beserra JúniorEstratégia Saúde da Família do Município de Senador Pompeu (ESF), Pompeu 63600-000, CE, Brazil.ORCID 0000-0002-7871-0761
Cláudia de Azevedo AguiarInstituto de Ciências da Saúde, Universidade Federal do Triângulo Mineiro (UFTM/ICS), Uberaba 38025-180, MG, Brazil.ORCID 0000-0002-6946-0465
Cesar Henrique Rodrigues ReisPrograma de Pós-graduação em Enfermagem, Faculdade de Enfermagem, Universidade Federal de Mato Grosso do Sul (UFMS), Três Lagoas 79070-900, MS, Brazil.ORCID 0009-0007-4414-3862
Júlia Maria das Neves CarvalhoUnidade Científico-Pedagógica de Enfermagem de Saúde Materna, Obstétrica e Ginecológica (UCP-ESMOG), Escola Superior de Enfermagem de Coimbra (ESEnfC), 3046-851 Coimbra, Portugal.ORCID 0000-0002-4893-7690
Ana Cristina Ribeiro da Fonseca DiasEscola Superior de Saúde, Universidade dos Açores (UAc/ESS), 9500-315 Ponta Delgada, Portugal.
Maria Luísa Santos BettencourtEscola Superior de Saúde, Universidade dos Açores (UAc/ESS), 9500-315 Ponta Delgada, Portugal.ORCID 0000-0002-1274-7473
Mónica Alexandra Pinho da SilvaEscola Superior de Enfermagem do Porto (ESEP), Universidade do Porto, 4200-072 Porto, Portugal.ORCID 0000-0003-0548-8829
Maria João Jacinto GuerraEscola Superior de Enfermagem do Porto (ESEP), Universidade do Porto, 4200-072 Porto, Portugal.ORCID 0000-0002-2510-5955
Giovana Aparecida Gonçalves VidottiEscola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo 04023-062, SP, Brazil.ORCID 0000-0002-0070-7044

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMaternal mortality in Brazil remains a critical indicator of social and racial inequalities, reflecting structural failures in access to and quality of obstetric care. Black women, particularly those categorized as black or brown, are at a higher risk of dying during pregnancy, childbirth, or the postpartum period. This is the result of the intersection of institutional racism, poverty, and social vulnerabilities. This study aimed to analyze trends and associated factors of maternal mortality among black women in Brazil from 2000 to 2020.

methodsThis is a retrospective cohort analytical study using data from the Brazilian Mortality Information System. The sample included women aged 10 to 49 years whose underlying cause of death was classified under ICD-10 codes O00-O99. Descriptive and bivariate analyses were conducted, as well as Poisson and multinomial logistic regressions to estimate adjusted risk ratios according to skin color, education, region, type, and place of death.

resultsA total of 40,907 maternal deaths were identified, with 59.2% occurring among black women. The maternal mortality ratio was 39% higher among black women compared to white women and more than double among Indigenous women. Low education, residence in the North and Northeast regions, deaths outside hospital settings, and lack of formal investigation were independently associated with increased risk. Direct obstetric causes accounted for most deaths, with hypertensive disorders and puerperal complications being the leading conditions.

conclusionsMaternal mortality among black women in Brazil reveals deep structural inequalities. Urgent public policies that incorporate an intersectional perspective, addressing race, gender, and class, are necessary to reduce disparities and ensure equitable and dignified maternal healthcare.

Indexed as

Black PeopleMaternal MortalityAdolescentAdultBrazilChildFemaleHumansMiddle AgedPregnancyRetrospective StudiesYoung Adulthealth equityhealth inequalitiesmaternal mortalitystructural racismwomen’s health

Identifiers

PMID41595887
PMCPMC12841385

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.