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Maia MRG, Ferrari RAP, Cardelli AAM, Higarashi IH, Carvalho MDDB, Pelloso SM. Neonatal near miss in the intensive care unit. Rev Bras Enferm 2020; 73:e20180931. [PMID: 32785506 DOI: 10.1590/0034-7167-2018-0931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 01/10/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze near miss cases among newborns hospitalized in the Intensive Care Unit. METHODS An observational, cross-sectional, retrospective study using the STROBE guideline. Data were collected from 1,101 records of live births (newborns). Statistical analysis used the Epi-Info program 3.3.2 and Chi-square and Fisher's exact tests. RESULTS A total of 162 newborns were hospitalized, of which 63 had at least one criterion of near miss. The variables that remained associated with neonatal near miss were weight <1.750 g, gestational age <33 weeks and Apgar at 5 minutes <7, pragmatic criteria to identify cases of neonatal near miss morbidity. CONCLUSION Prematurity and low birth weight were the factors that contributed most to the near miss outcome among newborns hospitalized in intensive care, a rate two and a half times higher than the number of deaths, according to scientific evidence.
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de Souza S, Duim E, Nampo FK. Determinants of neonatal mortality in the largest international border of Brazil: a case-control study. BMC Public Health 2019; 19:1304. [PMID: 31619198 PMCID: PMC6796356 DOI: 10.1186/s12889-019-7638-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 09/16/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Foz do Iguassu is a Brazilian municipality located in the most populous international border of the country and provides medical care to foreigners. Neonatal mortality in the city is higher than Brazil's average and corresponds to 61% of all deaths in children under five. The current study aimed to identify the determinants of neonatal mortality in Foz do Iguassu. METHODS In this case-control study, we analyzed all neonatal deaths occurred in Foz do Iguassu from 2012 to 2016. Birth and mortality data were extracted from two national governmental databases (SINASC and SIM). We extracted data on (i) maternal sociodemographic characteristics, (ii) pregnancy care, and (iii) newborn characteristics. Multiple logistic regression with the conceptual framework was applied to examine the factors associated with neonatal mortality. RESULTS Most of the deaths occurred in the early neonatal period (65.9%). The factors associated with neonatal death were fetal congenital anomaly (OR 22.49; CI 95% 7.44-67.95; p = < 0.001); low birth weight (OR 17.15; CI 95% 8.56-34.37; p = < 0.001), first minute Apgar score under 7 (OR 15.60; CI 95% 8.23-29.67; p = < 0.001); zero to 3 prenatal appointments (OR 3.34; CI 95% 1.28-8.73; p = 0.014) and prematurity (OR 3.60; CI 95% 1.87-7.11; p = < 0.001). CONCLUSION The high rate of neonatal death in Foz do Iguassu is strongly associated with newborn characteristics and not associated with maternal sociodemographic characteristics. Thus, the health services in the Brazilian side of this international borders should be aware of the quality of the prenatal care and childbirth attention provided.
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Affiliation(s)
- Suzana de Souza
- Latin-American Institute of Life and Nature Sciences, Federal University of Latin-American Integration, 1000 Tarquínio Joslin dos Santos Ave ZIP, Foz do Iguassu, PR 85870-650 Brazil
- Evidence-Based Public Health Research Group, 1000 Tarquínio Joslin dos Santos Ave ZIP, Foz do Iguassu, PR 85870-650 Brazil
| | - Etienne Duim
- School of Public Health, Department of Epidemiology, University of Sao Paulo, 715 Dr. Arnaldo Ave ZIP, São Paulo, SP 01246-000 Brazil
| | - Fernando Kenji Nampo
- Latin-American Institute of Life and Nature Sciences, Federal University of Latin-American Integration, 1000 Tarquínio Joslin dos Santos Ave ZIP, Foz do Iguassu, PR 85870-650 Brazil
- Evidence-Based Public Health Research Group, 1000 Tarquínio Joslin dos Santos Ave ZIP, Foz do Iguassu, PR 85870-650 Brazil
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Veloso FCS, Kassar LDML, Oliveira MJC, Lima THBD, Bueno NB, Gurgel RQ, Kassar SB. Analysis of neonatal mortality risk factors in Brazil: a systematic review and meta‐analysis of observational studies. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2019.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Veloso FCS, Kassar LDML, Oliveira MJC, Lima THBD, Bueno NB, Gurgel RQ, Kassar SB. Analysis of neonatal mortality risk factors in Brazil: a systematic review and meta-analysis of observational studies. J Pediatr (Rio J) 2019; 95:519-530. [PMID: 31028747 DOI: 10.1016/j.jped.2018.12.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/18/2018] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To identify, using a systematic review and meta-analysis of observational studies, which risk factors are significantly associated with neonatal mortality in Brazil, and to build a comprehensive national analysis on neonatal mortality. SOURCES This review included observational studies on neonatal mortality, performed between 2000 and 2018 in Brazilian cities. The MEDLINE, Elsevier, Cochrane, LILACS, SciELO, and OpenGrey databases were used. For the qualitative analysis, the Newcastle-Ottawa Scale was used. For the quantitative analysis, the natural logarithms of the risk measures and their confidence intervals were used, as well as the DerSimonian and Laird method as a random effects model, and the Mantel-Haenszel model for heterogeneity estimation. A confidence level of 95% was considered. SUMMARY OF FINDINGS The qualitative analysis resulted in six studies of low and four studies of intermediate-low bias risk. The following exposure factors were significant: absence of partner, maternal age ≥35 years, male gender, multiple gestation, inadequate and absent prenatal care, presence of complications during pregnancy, congenital malformation in the assessed pregnancy, Apgar<7 at the fifth minute, low and very low birth weight, gestational age≤37 weeks, and caesarean delivery. CONCLUSION The most significant risk factors presented in this study are modifiable, allowing aiming at a real reduction in neonatal deaths, which remain high in the country.
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Affiliation(s)
| | | | - Michelle Jacintha Cavalcante Oliveira
- Universidade Federal de Alagoas (UFAL), Faculdade de Medicina, Maceió, AL, Brazil; Centro Universitário Tiradentes, Curso de Medicina, Maceió, AL, Brazil
| | - Telmo Henrique Barbosa de Lima
- Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL), Curso de Medicina, Maceió, AL, Brazil; Centro Universitário Tiradentes, Curso de Medicina, Maceió, AL, Brazil
| | - Nassib Bezerra Bueno
- Universidade Federal de Alagoas (UFAL), Faculdade de Nutrição, Maceió, AL, Brazil
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Elarrat Canto SV, Leite Araújo MA, Espinosa Miranda A, Paulo Cardoso AR, Freitas de Almeida RL. Fetal and infant mortality of congenital syphilis reported to the Health Information System. PLoS One 2019; 14:e0209906. [PMID: 30608958 PMCID: PMC6319744 DOI: 10.1371/journal.pone.0209906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 12/13/2018] [Indexed: 11/19/2022] Open
Abstract
Background Congenital syphilis (CS) is a major cause of mortality in several countries, especially in Latin America and the Caribbean. This study aimed to analyze fetal and infant mortality of CS reported to the Health Information System in a State in Northeastern Brazil. Methods and results This was a cross-sectional study that analyzed the deaths of CS from 2010 to 2014 through the linkage of the Mortality Information System (SIM) and the Notifiable Diseases Information System (Sinan). The Statistical Package for the Social Sciences (SPSS) version 23.0 was used to calculate the rates of Fetal, Perinatal, Neonatal (early and late), and Postneonatal Mortality. Simple linear regression was performed. Fisher's exact test or Pearson's chi-square test were used for comparison of proportions and Student's t-test was used for comparison of means. Of the 414 cases reported to the SIM as deaths possibly caused by CS, 44 (10.6%) presented CS as the underlying cause. From 2010 to 2014 the Infant Mortality Rate of CS was 16.3 per 100,000 live births (y = 0.65x + 14.33, R2 = 0.2338, p = 0.003). There was an 89.4% underreporting of deaths. Perinatal deaths and fetal deaths of CS accounted for 87.7% and 73.9% of total deaths, respectively. Conclusions The results of the study revealed a significant Fetal and Infant Mortality rate of CS and demonstrated the importance of using the linkage method in studies that involve the analysis of secondary data obtained from mortality and disease reporting systems. The underreporting of CS as a cause of fetal and infant mortality leads to unawareness of the reality of deaths from this disease, hindering the development of public policies aimed at its prevention.
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Affiliation(s)
| | - Maria Alix Leite Araújo
- Collective Health Post Graduation Program, University of Fortaleza, Fortaleza, Ceará, Brazil
| | - Angélica Espinosa Miranda
- Department of Social Medicine, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Ana Rita Paulo Cardoso
- Department of Health Surveillance, Ceará State Secretary of Health, Fortaleza, Ceará, Brazil
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Kropiwiec MV, Franco SC, do Amaral AR. FACTORS ASSOCIATED WITH INFANT MORTALITY IN A BRAZILIAN CITY WITH HIGH HUMAN DEVELOPMENT INDEX. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2017; 35:391-398. [PMID: 28977130 PMCID: PMC5737259 DOI: 10.1590/1984-0462/;2017;35;4;00006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 12/23/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To identify factors associated with infant mortality in a city with good socioeconomic development. METHODS A retrospective cohort study with 7,887 live births in the year of 2012 recorded in the Live Births Information System (SINASC) and associated by linkage with the Mortality Information System (SIM) to identify the deaths in the first year of life. The risk factors were ranked in three levels of determination: distal, intermediate and proximal. The logistic binomial regression models and the multivariate model quantified the impact of the individual variables tested and adjusted the effect of confounding variables. The magnitude of the effect of the explanatory variables was estimated by calculating the crude and adjusted Odds Ratio (OR) and their respective 95% confidence intervals (95%CI), being significant p<0.05. RESULTS There were 61 deaths in the cohort and the infant mortality rate was 7.7 per thousand live births. Teenage mother (adjOR 3.75; 95%CI 1.40-10.02), gestational age <32 weeks (adjOR 12.08; 95%CI 2.30-63.38), weight at birth <1500g (adjOR 8.20; 95%CI 1.52-44.23), Apgar score at 1 and 5 minutes of life <7 (adjOR 4.82; 95%CI 2.01-11.55 and adjOR 6.26; 95%CI 1,93-20,30, respectively) and the presence of congenital malformation (adjOR 21.49; 95%CI 7.72-59.82) were risk factors for infant mortality. CONCLUSIONS The lower relevance of socioeconomic and health care variables and the greater importance of biological factors in determining infant mortality may reflect the protective effect of high economic and social development of the locality.
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Demitto MDO, Gravena AAF, Dell’Agnolo CM, Antunes MB, Pelloso SM. High risk pregnancies and factors associated with neonatal death. Rev Esc Enferm USP 2017; 51:e03208. [DOI: 10.1590/s1980-220x2016127103208] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 12/13/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract OBJECTIVE To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. METHOD This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. RESULTS Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. CONCLUSION Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality.
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Rodríguez-Balderrama I, Ostia-Garza P, Villarreal-Parra R, Tijerina-Guajardo M. Risk factors and the relation of lactic acid to neonatal mortality in the first week of life. MEDICINA UNIVERSITARIA 2016. [DOI: 10.1016/j.rmu.2015.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Gaiva MAM, Fujimori E, Sato APS. MATERNAL AND CHILD RISK FACTORS ASSOCIATED WITH NEONATAL MORTALITY. TEXTO & CONTEXTO ENFERMAGEM 2016. [DOI: 10.1590/0104-07072016002290015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT This was a cross-sectional study that investigated maternal and child factors associated with neonatal mortality. Data was obtained from the Live Births and Mortality Information Systems integrated by linkage. A total of 9,349 live births and 78 deaths in the neonatal period, which occurred in 2010 in Cuiabá-MT were analyzed. Univariate and multivariate analyzes were performed. In the multiple logistic regression, neonatal mortality was associated with: maternal age less than 20 years; prematurity; low birth weight; Apgar score less than seven at 1 and 5 minutes; and presence of congenital anomaly. The results highlight the need to improve the quality of prenatal care in order to prevent low birth weight and prematurity. The association between neonatal death and low Apgar score at 1 and 5 minutes indicates the importance of investments in delivery care.
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Gaiva MAM, Fujimori E, Sato APS. Neonatal mortality in infants with low birth weigh. Rev Esc Enferm USP 2014; 48:778-86. [DOI: 10.1590/s0080-6234201400005000002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 07/19/2014] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the factors associated with neonatal mortality in infant born with low birth weight. Method Cross-sectional study that analyzed data from 771 live births with low birth weight (<2500 g) in the city of Cuiabá, MT, in 2010, of whom 54 died in the neonatal period. We obtained data from the Information System on Live Births and Mortality, by integrated linkage. Results In multiple logistic regression, neonatal mortality was associated with: number of prenatal visits less than 7 (OR=3.80;CI:1,66-8,70); gestational age less than 37 weeks (OR=4.77;CI:1.48-15.38), Apgar score less than 7 at the 1st minute (OR=4.25;CI:1.84-9.81) and the 5th minute (OR=5.72,CI:2.24-14.60) and presence of congenital anomaly (OR=14.39;IC:2.72-76.09). Conclusion Neonatal mortality in infants with low birth weight is associated with avoidable factors through adequate attention to prenatal care, childbirth and infants.
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Santos SLD, Silva ARVD, Campelo V, Rodrigues FT, Ribeiro JF. Utilização do métodolinkage na identificação dos fatores de risco associados à mortalidade infantil: revisão integrativa da literatura. CIENCIA & SAUDE COLETIVA 2014; 19:2095-104. [PMID: 25014289 DOI: 10.1590/1413-81232014197.21532013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/30/2013] [Indexed: 11/22/2022] Open
Abstract
A preocupação mundial em relação à mortalidade infantil ganhou visibilidade com a divulgação no ano 2000 dos Objetivos do Desenvolvimento do Milênio, em que sua redução ganha destaque com a meta de número quatro, que propõe diminuir em dois terços sua taxa para crianças menores de cinco anos, no período entre 1990 e 2015. Reduzir a mortalidade infantil tem sido uma das prioridades das políticas sociais de saúde do governo brasileiro. A identificação de fatores de risco relacionados com a mortalidade infantil pode auxiliar no planejamento de ações para a reestruturação e melhoria da assistência à gestante e aos recém-nascidos, visando à redução da mortalidade infantil. Nesta perspectiva, o presente estudo tem como objetivo analisar a utilização do método de linkage na identificação de fatores de risco associados à mortalidade infantil. Utilizou-se a Revisão Integrativa da Literatura. Foram analisados oito artigos na íntegra publicados entre 2008 e 2013, através dos descritores: mortalidade infantil, fatores de risco e sistemas de informação. O uso da técnica de linkage mostrou-se bastante útil, permitindo a adequada investigação dos fatores mais fortemente relacionados à mortalidade infantil, mostrando sua relevância para o estudo de problemas de saúde pública.
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