Study of fetal and neonatal mortality in Botucatu City, São Paulo State, Brazil, 2008 to 2012

• Grant number: 13/08504-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: July 01, 2013
• End date: June 30, 2014
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Cátia Regina Branco da Fonseca
• Grantee: Larissa Midori Noda
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Infant and fetal mortality has still been a challenge for health services and a major concern for Public Health. In Brazil, these rates have been considered as incompatible with the country development conditions. Reduction in infant mortality rates has also been part of the Millennium Development Goals, a commitment made by countries, including Brazil, members of the Organization of United Nations. Therefore, adequate measures concerning access mainly to health services and good quality care are considered positive actions towards reduction in infant mortality, especially neonatal mortality. With appropriate prenatal follow-up and care assistance during gestation and delivery, some death causes could be reduced or even prevented by means of early diagnosis and intervention. Based on these considerations, the need of efforts to prevent fetal and neonatal mortality is evident. Also, these events should be carefully evaluated through improved research for better understanding of this important problem for Public Health. From this theoretical basis and the reality of natimortality and early and late neonatal mortality rates in the municipality of Botucatu (SP), a descriptive and cross-sectional study is suggested. The objectives of this study are as follows: evaluation of the relationship between these events and maternal and infant health assistance in the municipality of Botucatu (SP), in the period from 2008 to 2012; data description of early and late neonatal mortality as well as fetal deaths and their distribution according to the Health Unit in which the prenatal follow-up was performed and to the mother´s residential location. Moreover, it also analyzes the association of socio demographic variables, prenatal, delivery and newborn health care assistance with those deaths; classification of neonatal and fetal deaths according to their prevention based on criteria from the Ministry of Health, and determination of possible drawbacks of maternal-infant health care. The method consists of secondary data collection on all fetal and neonatal deaths occurred in the municipality based on the Information System of Mortality, distributed according to the following 3 groups: I: fetal deaths occurred as of full 22th week of gestation, or fetus at or over 500 grams, or height as of 25 centimeters. II: early neonatal deaths, from zero to 6th full day old. III: late neonatal deaths, deaths between 7th and 27th full day old. Quality indicators will be used to evaluate prenatal, delivery and newborn care. They are of utmost importance in the occurrence of these deaths, and therefore, will enable local service managers to identify possible actions to reduce or prevent these events. (AU)