Analysis of spatial and temporal patterns of fetal mortality: ecological study, Pernambuco, 2010-2021

OBJECTIVE: To analyze the spatial pattern and time series of fetal mortality in Pernambuco, Brazil, from 2010 to 2021. METHOD: An ecological study was conducted using municipalities as spatial units of analysis and months as temporal units. Data were obtained from the Mortality Information System and the Live Birth Information System. Maps displaying annual fetal mortality rates were constructed. Three classes of time series models were tested, and the model with the lowest mean absolute percentage error on a validation dataset was selected to perform projections. RESULTS: A total of 18,810 fetal deaths were recorded, with a mean monthly fetal mortality rate of 11.3 fetal deaths per 1,000 births. The spatial distribution showed the highest fetal mortality rates in municipalities located in the Sertão, São Francisco, and Agreste regions. The overall mean rate of the series was 13.3 (±1.1) fetal deaths per 1,000 births. A stationary trend was observed, ranging from 8.1 to 14.4 per 1,000 births per month, with outliers in May 2020 (+29%) and November 2020 (-24.1%). CONCLUSION: The spatial distribution of fetal mortality rates revealed variations among municipalities, while the temporal trend remained stationary. These findings can support the monitoring of actions aimed at reducing fetal mortality in the state and inform nursing practices to enhance preventive care and reduce avoidable deaths.