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Early neonatal mortality in cohort of birth Ribeirão Preto the year 2010

Grant number: 12/10523-8
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): August 01, 2012
Effective date (End): July 31, 2013
Field of knowledge:Health Sciences - Medicine
Principal Investigator:Viviane Cunha Cardoso
Grantee:Natacha Bíscaro Junqueira
Home Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
Associated research grant:08/53593-0 - Etiological factors of preterm birth and consequences of perinatal factors in child health: birth cohorts in two Brazilian cities (BRISA project), AP.TEM

Abstract

Introduction: Classically, infant mortality is considered one of the best indicators of living standards and welfare of a population. Brazil still has alarming levels and ethically unacceptable infant mortality, despite declining rates in the last ten years. From the 90s, in the country, neonatal deaths have become the main component of mortality in the first year of life, due to global interventions that favor the decrease of post-neonatal infant mortality and increased complexity of biological,socioeconomic and health care determinants of mortality in the first days of life. Objectives: Calculate the early neonatal mortality in the birth cohort 2010 in Ribeirão Preto / SP, and discuss its association with biological risk factors, socioeconomic and health care. Compare the results obtained in Ribeirão Preto, in the period studied, with the birth cohorts of 1978 and 1994. Methods: Observational, prospective cohort, part of the project themed "Brazilian Ribeirão Preto and São Luís Birth Cohort (BRISA), which evaluated 7443 pairs of mothers and their newborns in hospital birth in 2010. The mothers answered a standardized questionnaire about sociodemographic questions, of health, nutrition, physical activity and prenatal care. Information was obtained from medical records about childbirth and newborns. For this study will be sought records of deaths between 2010-2011, by the SIM e SINASC. The dependent variable is early neonatal mortality, and the independents are birth weight and gestational age. The confounding variables are sociodemographic (maternal age at delivery, marital status, education, and maternal skin color) and clinical (sex of newborns, IUGR, congenital malformations, type of delivery, ICU stay, twin pregnancy, background gestational maternal and newborn LBW, previous pregnancies, births and abortions, prenatal care, maternal diagnosis of infectious or chronic diseases before or during pregnancy, smoking, alcohol or other drug use. The U test of Mann-Whitney and Student t test will be used to compare continuous variables and the Shapiro-Wilks Lillefors to the normal distribution. The effect of potential confounders on the association with the pre-established results will be explored by stratification and multiple logistic regression models. Will be held an analysis of subgroups stratified by birth weight and gestational age, and a sensitivity analysis to explore, for example, the lifetime of the dies. P-value <0.05 wil be considered as an indicator of statistical significance. For the calculations will be used Stata version 9.0.