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[Magnitude and tendencies of maternal-infant mortality].


 In 1985 reported maternal mortality rates (MMR) in Mexico were 6.5/10,000, while the National Institute of Peritology has reported MMR of 10/1000. The major causes of MM are toxemia, hemorrhaging and infections. Indirect causes of MMR result in 1/1000 deaths. This relationship is inverted in tertiary care where indirect causes of MMR and those causes of death not related to the obstetric event outnumber the direct ones. This is due to careful monitoring, good deliveries and puerperium care. In order to analyze perinatal mortality it is necessary to separate it from fetal and neonatal mortality. Fetal mortality rates have shown an inverse relationship with medical interventions during prenatal care and delivery. According to the Mexican Fertility Survey, neonatal mortality dropped between 1940-76. There is a direct correlation between prenatal control and neonatal deaths. Prematurity and low birth weight continue to remain the principal reasons for neonatal deaths-independent of or associated to a specific pathology- followed by neonatal infections and malformations. Solutions to these problems include community participation, maintenance of health equipment in government institutions, and support from policy-makers and administrators. 3 strategies are proposed to lower these problems: 1) health education with special reference to reproductive health; 2) active and intense participation at primary health care levels to help prevent and detect maternal and child health care problems; and 3) a registration and information system that monitors the diagnosis, community needs, quality of services rendered and knowledge of the impact these interventions have in the health sector.
