Neonatal near miss and mortality: factors associated with life-threatening conditions in newborns at six public maternity hospitals in Southeast Brazil

We aimed to evaluate factors associated with cases of neonatal near miss and neonatal deaths at six public maternity hospitals in São Paulo and Rio de Janeiro States, Brazil, in 2011. A prospective hospital-based birth cohort investigated these outcomes among live births with life-threatening condit...

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Bibliographic Details
Published in:Cadernos de saúde pública 2017-01, Vol.33 (4), p.e00179115-e00179115
Main Authors: Kale, Pauline Lorena, Mello-Jorge, Maria Helena Prado de, Silva, Kátia Silveira da, Fonseca, Sandra Costa
Format: Article
Language:English
Subjects:
Adult
Brazil - epidemiology
Complicações na Gravidez
Cuidado Pré-Natal
Female
Gestational Age
Hospitals, Maternity
Humans
Infant
Infant Mortality
Infant, Low Birth Weight
Infant, Newborn
Live Birth - epidemiology
Male
Mortalidade Infantil
Near Miss, Healthcare - statistics & numerical data
Perinatal Death
Pregnancy
Prematuro
Prenatal Care
Prospective Studies
PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Recém-Nascido de Baixo Peso
Risk Factors
Socioeconomic Factors
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Summary:We aimed to evaluate factors associated with cases of neonatal near miss and neonatal deaths at six public maternity hospitals in São Paulo and Rio de Janeiro States, Brazil, in 2011. A prospective hospital-based birth cohort investigated these outcomes among live births with life-threatening conditions. Associations were tested using multinomial logistic regression models with hierarchical levels. High rates of near miss were observed for maternal syphilis (52.2‰ live births) and lack of prenatal care (80.8‰ live births). Maternal black skin color (OR = 1.9; 95%CI: 1.2-3.2), hemorrhage (OR = 2.2; 95%CI: 1.3-3.9), hypertension (OR = 3.0; 95%CI: 2.0-4.4), syphilis (OR = 3.3; 95%CI: 1.5-7.2), lack of prenatal care (OR = 5.6; 95%CI: 2.6-11.7), cesarean section and hospital, were associated with near miss; while hemorrhage (OR = 4.6; 95%CI: 1,8-11.3), lack of prenatal care (OR = 17.4; 95%CI: 6.5-46.8) and hospital, with death. Improvements in access to qualified care for pregnant women and newborns are necessary to reduce neonatal life-threatening conditions.
ISSN:0102-311X
1678-4464
1678-4464
0102-311X
DOI:10.1590/0102-311X00179115