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| Author(s): |
Elisa Maria da Silva Brito
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR) |
| Defense date: | 2001-06-08 |
| Examining board members: |
Ana Cristina D'Andretta Tanaka;
Maria do Rosário Dias de Oliveira Latorre;
Hillegonda Maria Dutilh Novaes;
Gulnar Azevedo e Silva;
Victor Wunsch Filho
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| Advisor: | Ana Cristina D'Andretta Tanaka |
| Abstract | |
The present study is a two-stage case-control study to determine the independent effect of predictive factors for early neonatal mortality (ENM) in maternities in the city of Sorocaba, São Paulo. During the first stage, a logistic regression model with 1995 data from the birth certificates of 11,121 newborns (NB) and of 107 early neonatal deaths was constructed. Deaths due to congenital malformations were excluded. The following parameters were associated with early neonatal mortality: Apgar, birth weight, gestational age, sex and level of education. During the second stage a case-control study with 70 cases (early neonatal deaths) and 280 controls (live newborns) based on data from medical records was performed. The logistic regression model showed an association between Apgar, birth weight, abnormal event during birth, abnormal event during labor and early neonatal mortality. The results showed how relative the predictive value of the Apgar and birth weight are, corroborated by the fact that a NB with a normal Apgar and weight and an abnormal event during labor and upon birth presented a 79.4% chance of dying. Among NBs with a normal gestational age, 80% (16 out of 19 cases) of abnormal events during labor and 84% (23 of 25 cases) of those that occurred at birth could have been avoided. The performance (ENM) of all hospitals, with the exception of one, was compatible with the risk of the population assisted. (AU) | |