Desigualdade espacial da mortalidade neonatal no Brasil: 2006 a 2010 / The spatial inequality of neonatal mortality in Brazil: 2006 to 2010

O objetivo deste estudo é analisar a distribuição espacial da mortalidade neonatal e sua correlação com os fatores biológicos, socioeconômicos e de atenção à saúde materno-infantil, nos estados brasileiros, no período de 2006 a 2010. Foram construídos mapas temáticos e de correlação (LISA) para verificação de dependência espacial e modelos de regressão linear múltipla. Verificou-se que não há autocorrelação espacial para mortalidade neonatal nos estados brasileiros (I = 0,002; p = 0,48). A maioria das variáveis estava correlacionada (r > 0,3, p < 0,05) com a mortalidade neonatal, formando clusters em estados do Norte e Nordeste, com maiores taxas de mães adolescentes, renda domiciliar per capta baixa, menor realização de consultas de pré-natal e de leitos de UTI Neonatal. O número de leitos de UTI Neonatal manteve efeito independente após a análise de regressão. Conclui-se que as desigualdades regionais das condições de vida e, principalmente, de acesso aos serviços de saúde materno-infantil contribuem para a distribuição desigual da mortalidade neonatal no Brasil.

The objective of this study is to analyze the spatial distribution of neonatal mortality and its correlation with the biological and socioeconomic factors and maternal and child health care in the Brazilian states in the period from 2006 to 2010. Thematic and correlation (LISA) maps were created for verification of spatial dependence as well as multiple linear regression models. It was found that there is no specific spatial correlation for neonatal mortality in the Brazilian states (R = 0.002, p = 0.48). The majority of the variables were correlated (r > 0.3, p < 0.05) with neonatal mortality, forming clusters in the North and Northeast, with higher rates for teenage mothers, low household income per capita, lower prenatal consultations and less Neonatal Intensive Care Unit beds. The number of Neonatal ICU beds maintained an independent effect after regression analysis. The conclusion reached was that regional inequalities in living conditions and especially access to maternal and child health contribute to the unequal distribution of neonatal mortality in Brazil.

A desigualdade espacial do Baixo Peso ao Nascer no Brasil / The spatial inequality of low birth weight in Brazil

O baixo peso ao nascer (BPN) é fator de risco para a morbidade, mortalidade neonatal e infantil. No Brasil os maiores percentuais de baixo peso ao nascer ocorrem em regiões de melhor situação socioeconômica. O objetivo deste artigo é conhecer a distribuição espacial de taxas de baixo peso ao nascer e a correlação com indicadores sociais e de serviço. Desenho: ecológico, tendo os estados brasileiros como unidades de análise. Utilizou-se técnica de análise espacial, dados de 2009 do SINASC, IPEA e IBGE. Taxas maiores de baixo peso ao nascer estão nos estados da região sul/sudeste, Moran Global: 0,267, p = 0,02. Aglomerados do tipo alto-alto na região Sudeste e baixo-baixo em estados da região da Amazônia Legal. A desigualdade espacial do baixo peso ao nascer reflete as condições socioeconômicas dos estados. Regiões mais desenvolvidas detêm maiores taxas de baixo peso ao nascer, portanto, a presença do serviço e sua utilização fazem diminuir a mortalidade infantil e aumentar o BPN.

Low birth weight (LBW) is a risk factor for neonatal and infant morbidity and mortality. In Brazil the highest percentages of low birth weight occur in regions of higher socio-economic status. The scope of this article is to ascertain the spatial distribution of low birth weight rates and the correlation with social and service indicators. The scale is ecological taking all the Brazilian states as units of analysis. The spatial analysis technique is the methodology used together with data from SINASC, IPEA and IBGE for 2009. Higher rates of low birth weight are found in the south/southeastern states (Global Moran: 0.267, p = 0.02). Clusters of the high-high type in the Southeast and of the low-low variety in states in the Amazon region are detected. The spatial inequality of low birth weight reflects the socio-economic conditions of the states. More developed regions have higher rates of low birth weight, therefore, the presence of the service and its use decrease infant mortality and increase LBW.

[The spatial inequality of neonatal mortality in Brazil: 2006 to 2010]. / Desigualdade espacial da mortalidade neonatal no Brasil: 2006 a 2010.

The objective of this study is to analyze the spatial distribution of neonatal mortality and its correlation with the biological and socioeconomic factors and maternal and child health care in the Brazilian states in the period from 2006 to 2010. Thematic and correlation (LISA) maps were created for verification of spatial dependence as well as multiple linear regression models. It was found that there is no specific spatial correlation for neonatal mortality in the Brazilian states (R = 0.002, p = 0.48). The majority of the variables were correlated (r > 0.3, p < 0.05) with neonatal mortality, forming clusters in the North and Northeast, with higher rates for teenage mothers, low household income per capita, lower prenatal consultations and less Neonatal Intensive Care Unit beds. The number of Neonatal ICU beds maintained an independent effect after regression analysis. The conclusion reached was that regional inequalities in living conditions and especially access to maternal and child health contribute to the unequal distribution of neonatal mortality in Brazil.

[The spatial inequality of low birth weight in Brazil]. / A desigualdade espacial do Baixo Peso ao Nascer no Brasil.

Low birth weight (LBW) is a risk factor for neonatal and infant morbidity and mortality. In Brazil the highest percentages of low birth weight occur in regions of higher socio-economic status. The scope of this article is to ascertain the spatial distribution of low birth weight rates and the correlation with social and service indicators. The scale is ecological taking all the Brazilian states as units of analysis. The spatial analysis technique is the methodology used together with data from SINASC, IPEA and IBGE for 2009. Higher rates of low birth weight are found in the south/southeastern states (Global Moran: 0.267, p = 0.02). Clusters of the high-high type in the Southeast and of the low-low variety in states in the Amazon region are detected. The spatial inequality of low birth weight reflects the socio-economic conditions of the states. More developed regions have higher rates of low birth weight, therefore, the presence of the service and its use decrease infant mortality and increase LBW.