Fim da desigualdade racial evitaria parte das mortes neonatais no Brasil

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Pesquisa investiga as consequências do racismo sofridas por uma gestante em seus filhos

Por Agência Gov | Via Fiocruz

“Uma parte considerável das mortes neonatais, e dos desfechos negativos entre recém-nascidos, poderia ser evitada se as desigualdades raciais não existissem no Brasil”, afirma estudo elaborado pela equipe de pesquisa do Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs/Fiocruz Bahia). Publicada na revista The Lancet Regional Health – Americas , a pesquisa investiga as consequências do racismo sofridas por uma gestante em seus filhos e afirma: na ausência da desigualdade racial, aproximadamente 12% das mortes neonatais – pouco mais de 12 mil mortes de crianças com até 7 dias de vida – poderiam ser evitadas.

Para chegar a essa conclusão, os pesquisadores analisaram ocorrências de quatro desfechos negativos entre recém-nascidos: mortalidade neonatal precoce, prematuridade, baixo peso ao nascer e de crianças nascidas pequenas para a idade gestacional (definidas pela sigla PIG). A pesquisa também estimou que 1,7% dos nascimentos prematuros, 11% dos casos de PIG e 7% dos casos de baixo peso ao nascer também poderia ser prevenidos.

“Pessoas vulnerabilizadas pelo racismo têm condições de vida piores que as de pessoas brancas, resultando em menores níveis de escolaridade e acesso a empregos piores”, afirma Poliana Rebouças, pesquisadora associada do Cidacs e uma das responsáveis pelo estudo. Segundo ela, a consequência disso é que essas pessoas são submetidas a efeitos físicos adversos e a contextos econômicos e sociais desfavoráveis, o que pode afetar o acesso aos serviços de saúde e resultar nessas desigualdades nos resultados de nascimento.

Foto: Divulgação

Racismo e desigualdade

O estudo utilizou bases informacionais do Sistema de Informações sobre Nascidos Vivos (Sinasc) e do Sistema de Informação sobre Mortalidade (SIM), analisando dados de pouco mais de 23 milhões de nascidos entre 2012 e 2019. A identificação racial da pessoa gestante foi utilizada como indicador da presença do racismo, entendendo que as diferenças nos desfechos negativos entre crianças se devem às desigualdades sociais, já que raça é uma categoria socialmente construída.

“Usamos a identificação racial materna como uma indicação do racismo na vida da pessoa, reconhecendo que a relação entre raça/cor e desfechos negativos na vida das crianças se deve às diferenças sociais, não a diferenças biológicas”, reforça Poliana.

A análise também levou em conta o nível de escolaridade materna – tido como um indicador de condições socioeconômicas – para avaliar como o racismo atravessa diferentes grupos socioeconômicos. O resultado revelou que, quanto menor o nível de escolaridade da mãe, maior a chance de desfechos negativos para seus filhos.

Entre gestantes indígenas com menos anos de educação, a análise ajustada ao fator de escolaridade indica o risco de 30% de morte neonatal, 25% de prematuridade, 22% de baixo peso ao nascer e 27% de nascimentos de crianças pequenas para a idade gestacional. A eliminação das desigualdades raciais poderia reduzir em mais de 60% a ocorrência de morte neonatal, baixo peso e PIG entre seus filhos, e diminuir em 28% os nascimentos prematuros.

Entre mulheres pardas e pretas, a redução poderia exceder 40% nos casos de morte neonatal, baixo peso e PIG, e 18% nos nascimentos prematuros.  Ainda assim, a análise mostra que, mesmo entre mulheres de grupos raciais minoritários com maior nível de escolaridade, as desigualdades raciais persistem nos desfechos de saúde de seus filhos.

Os dados revelam ainda que as gestantes mais jovens, com menores níveis de educação e menor frequência às consultas de pré-natal eram majoritariamente declaradas pretas e pardas. Indígenas e gestantes pretas tiveram as maiores proporções de ocorrências dos desfechos negativos analisados.

Recomendações

De acordo com Poliana, esses achados somam-se a outras evidências de como a desigualdade racial afeta a saúde das mulheres. “Se entendermos que esses desfechos ocorrem devido a condições sofridas pelas gestantes – como a falta de acesso a consultas pré-natais – fica claro que a desigualdade racial influencia toda a vida da pessoa, desde antes do nascimento”, explica.

Os efeitos da desigualdade racial observados desde o início da vida demonstram a necessidade de ações para reduzir o impacto do racismo na saúde materna e infantil. Segundo a equipe de pesquisa, é necessário um esforço contínuo e políticas que abordem o racismo institucional para enfrentar os problemas apontados no estudo.

“Mesmo com toda a pressão histórica feita pelos movimentos sociais em torno da luta pela equidade em saúde, ainda falta incentivo às políticas públicas voltadas ao combate da desigualdade”, completa Poliana.

Foto capa: Divulgação

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