Clusters of preterm live births and respiratory distress syndrome-associated neonatal deaths: spatial distribution and cooccurrence patterns

Author(s):Show less -

Scavacini Marinonio, Ana Silvia ; Costa-Nobre, Daniela Testoni ; Miyoshi, Milton Harumi ; Xavier Balda, Rita de Cassia ; Nema Areco, Kelsy Catherina ; Konstantyner, Tulio ; Kawakami, Mandira Daripa ; Sanudo, Adriana ; Bandiera-Paiva, Paulo ; Vieira de Freitas, Rosa Maria ; Correia Morais, Lilian Cristina ; Teixeira, Monica La Porte ; Waldvogel, Bernadette Cunha ; Branco de Almeida, Maria Fernanda ; Guinsburg, Ruth ; Veiga Kiffer, Carlos Roberto

• Document type: Journal article
• Source: BMC PUBLIC HEALTH; v. 22, n. 1, p. 10-pg., 2022-06-20.

Abstract

Background Prematurity and respiratory distress syndrome (RDS) are strongly associated. RDS continues to be an important contributor to neonatal mortality in low- and middle-income countries. This study aimed to identify clusters of preterm live births and RDS-associated neonatal deaths, and their cooccurrence pattern in Sao Paulo State, Brazil, between 2004 and 2015. Methods Population-based study of all live births with gestational age >= 22 weeks, birthweight >= 400 g, without congenital anomalies from mothers living in Sao Paulo State, Brazil, during 2004-2015. RDS-associated neonatal mortality was defined as deaths < 28 days with ICD-10 codes P22.0 or P28.0. RDS-associated neonatal mortality and preterm live births rates per municipality were submitted to first- and second-order spatial analysis before and after smoothing using local Bayes estimates. Spearman test was applied to identify the correlation pattern between both rates. Results Six hundred forty-five thousand two hundred seventy-six preterm live births and 11,078 RDS-associated neonatal deaths in Sao Paulo State, Brazil, during the study period were analyzed. After smoothing, a non-random spatial distribution of preterm live births rate (I = 0.78; p = 0.001) and RDS-associated neonatal mortality rate (I = 0.73; p = 0.001) was identified. LISA maps confirmed clusters for both, with a negative correlation (r = -0.24; p = 0.0000). Clusters of high RDS-associated neonatal mortality rates overlapping with clusters of low preterm live births rates were detected. Conclusions Asymmetric cluster distribution of preterm live births and RDS-associated neonatal deaths may be helpful to indicate areas for perinatal healthcare improvement. (AU)

• FAPESP's process: 17/03748-7 - Secular trends, spatial evolution, and maternal & neonatal conditions associated to early and late neonatal deaths caused by respiratory distress, perinatal asphyxia, infections, and congenital anomalies, in São Paulo State, Brazil, between 2002 and 2015
• Grantee: Ruth Guinsburg
• Support Opportunities: Research Projects - Thematic Grants