Levels and determinants of early neonatal mortality in Natal, northeastern Brazil: results of a surveillance and case-control study.
Int J Epidemiol
; 20(2): 467-73, 1991 Jun.
Article
em En
| MEDLINE
| ID: mdl-1917251
ABSTRACT
PIP: To facilitate health service planning, a surveillance and case-control study were conducted of births in 3 hospitals and 2 maternity clinics in the city of Natal in northeastern Brazil. The surveillance study revealed 285 early neonatal deaths among the 111,171 singleton live births recorded in the study institutions from September 1984-February 1986, for a rate of 25.5/1000. 75% of these early neonatal deaths involved premature infants. The mortality rates were 591/1000 for preterm small-for-gestational age infants and 318/1000 for preterm appropriate-for-gestational age infants, while this rate was 50/1000 for term low-birthweight infants and only 8.6/1000 for term normal birthweights infants. The case-control study indicated that the maternal risk factors of body weight under 50 kg and single parent status significantly increased the likelihood of early neonatal mortality, while maternal age, parity, prior reproductive loss, and socioeconomic status did not have a significant effect on this outcome. Pregnancy-related factors that substantially increased the risk of early neonatal death included smoking, bleeding during the first or second trimester, toxemia, less than 5 prenatal care visits, and congenital malformations. These pregnancy-related risks exerted a more substantial effect than maternal characteristics, suggesting the feasibility of a strategy focused on preventing preterm births through prenatal care rather than a high-risk approach of screening women prior to pregnancy.
Palavras-chave
Americas; Biology; Birth Weight; Body Weight; Brazil; Case Control Studies; Comparative Studies; Delivery Of Health Care; Demographic Factors; Developing Countries; Diseases; Health; Health Services; Incidence; Infant Mortality; Latin America; Low Birth Weight; Maternal Health Services; Maternal-child Health Services; Measurement; Mortality; Mortality Determinants; Neonatal Mortality--prevention and control; Physiology; Population; Population Dynamics; Pregnancy Complications; Prenatal Care; Primary Health Care; Research Methodology; Risk Factors; South America; Studies
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Mortalidade Infantil
/
Vigilância da População
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Female
/
Humans
/
Newborn
/
Pregnancy
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Int J Epidemiol
Ano de publicação:
1991
Tipo de documento:
Article
País de publicação:
Reino Unido