Hospitalizations for Postpartum Hemorrhage and Maternal Mortality: A Time-Series Study in Espírito Santo, Brazil, From 2010 to 2024

BackgroundThis study aimed to analyze the temporal trend in Sistema Único de Saúde (SUS)-funded hospitalizations with International Classification of Diseases, 10th Revision (ICD-10) category O72 as the principal diagnosis relative to live births and to describe maternal deaths attributed to O72 among residents of Espírito Santo, Brazil, from 2010 to 2024. MethodologyAn ecological time-series study was conducted using publicly available aggregated data from the Hospital Information System of the Brazilian Unified Health System (SIH/SUS), the Mortality Information System (SIM), and the Live Birth Information System (SINASC).Category O72 of the ICD-10 was selected.Hospitalization ratios per 10,000 live births and maternal mortality ratios per 100,000 live births were calculated.The hospitalization trend was estimated using Poisson regression with an offset for live births and covariance estimates robust to heteroskedasticity and autocorrelation.Sensitivity analyses and age standardization were performed. ResultsA total of 601 hospitalizations, seven deaths during these hospitalizations, 25 maternal deaths, and 806,313 live births were recorded.The hospitalization ratio increased from 3.86 to 10.41 per 10,000 live births, reaching a peak of 12.87 in 2018.The estimated annual percentage change was 9.36% (95% confidence interval (CI): 5.22-13.66),with the direction of the trend remaining consistent across sensitivity analyses.The maternal mortality ratio for the study period was 3.10 (95% CI: 2.01-4.58)per 100,000 live births. ConclusionsThe administrative ratio of SUS-funded hospitalizations with a primary diagnosis of postpartum hemorrhage increased overall, particularly during the earlier years, followed by fluctuations.This trend does not necessarily reflect an increase in clinical incidence.The findings provide a state-level descriptive reference for maternal health surveillance and support further investigation of hospitalization patterns and maternal outcomes.