Annual trend of neonatal mortality and its underlying causes: population-based study - Sao Paulo State, Brazil, 2004-2013

Autor(es):Mostrar menos -

Guinsburg, Ruth ^[1] ; Sanudo, Adriana ^[1] ; Kiffer, V, Carlos Roberto ; Marinonio, Ana Silvia S. ^[2] ; Costa-Nobre, Daniela T. ^[2] ; Areco, Kelsy N. ^[2] ; Kawakami, Mandira D. ^[2] ; Miyoshi, Milton H. ^[2] ; Bandiera-Paiva, Paulo ^[2] ; Balda, Rita de Cassia X. ^[2] ; Konstantyner, Tulio ^[2] ; Morais, Liliam C. C. ^[3] ; Freitas, V, Rosa M. ; Teixeira, Monica L. P. ^[4] ; Waldvogel, Bernadette ^[4] ; Almeida, Maria Fernanda B. ^[2]

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Paulo, Escola Paulista Med, Rua Vicente Felix 77 Apto 09, BR-01410020 Sao Paulo, SP - Brazil

^[2] Kiffer, Carlos Roberto, V, Univ Fed Sao Paulo, Escola Paulista Med, Rua Vicente Felix 77 Apto 09, BR-01410020 Sao Paulo, SP - Brazil

^[3] Fundacao Sistema Estadual Anal Dados, Sao Paulo - Brazil

^[4] Freitas, Rosa M., V, Fundacao Sistema Estadual Anal Dados, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: BMC PEDIATRICS; v. 21, n. 1 JAN 26 2021.
• Citações Web of Science: 0

Resumo

Background: Population-based studies analyzing neonatal deaths in middle-income countries may contribute to design interventions to achieve the Sustainable Development Goals, established by United Nations. This study goal is to analyze the annual trend of neonatal mortality in Sao Paulo State, Brazil, over a 10-year period and its underlying causes and to identify maternal and neonatal characteristics at birth associated with neonatal mortality. Method: A population-based study of births and deaths from 0 to 27 days between 2004 and 2013 in Sao Paulo State, Brazil, was performed. The annual trend of neonatal mortality rate according to gestational age was analyzed by Poisson or by Negative Binomial Regression models. Basic causes of neonatal death were classified according to ICD-10. Association of maternal demographic variables (block 1), prenatal and delivery care variables (block 2), and neonatal characteristics at birth (block 3) with neonatal mortality was evaluated by Poisson regression analysis adjusted by year of birth. Results: Among 6,056,883 live births in Sao Paulo State during the study period, 48,309 died from 0 to 27 days (neonatal mortality rate: 8.0/1,000 live births). For the whole group and for infants with gestational age 22-27, 28-31, 32-36, 37-41 and >= 42 weeks, reduction of neonatal mortality rate was, respectively, 18 %, 15 %, 38 %, 53 %, 31 %, and 58 %. Median time until 50 % of deaths occurred was 3 days. Main basic causes of death were respiratory disorders (25 %), malformations (20 %), infections (17 %), and perinatal asphyxia (7 %). Variables independently associated with neonatal deaths were maternal schooling, prenatal care, parity, newborn sex, 1st minute Apgar, and malformations. Cesarean delivery, compared to vaginal, was protective against neonatal mortality for infants at 22-31 weeks, but it was a risk factor for those with 32-41 weeks. Conclusions: Despite the significant decrease in neonatal mortality rate over the 10-year period in Sao Paulo State, improved access to qualified health care is needed in order to avoid preventable neonatal deaths and increase survival of infants that need more complex levels of assistance. (AU)

• Processo FAPESP: 17/03748-7 - Tendência secular, evolução espacial e condições maternas e neonatais associadas à mortalidade neonatal precoce e tardia decorrente de distúrbios respiratórios, infecções, anomalias congênitas e asfixia perinatal no estado de São Paulo entre 2002-2015
• Beneficiário: Ruth Guinsburg
• Modalidade de apoio: Auxílio à Pesquisa - Temático