Early neonatal mortality according to level of hospital complexity in Greater Metropolitan São Paulo, Brazil

The aim of this study was to analyze the profile of newborns, mothers, and early neonatal mortality according to the hospital's complexity and affiliation (or lack thereof) with the Unified National Health System (SUS) in Greater Metropolitan São Paulo, Brazil. The study was based on data for l...

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Bibliographic Details
Published in:Cadernos de saúde pública 2010-01, Vol.26 (1), p.123-134
Main Authors: Silva, Zilda Pereira da, Almeida, Márcia Furquim de, Ortiz, Luís Patrício, Alencar, Gizelton Pereira, Alencar, Airlane Pereira, Schoeps, Daniela, Minuci, Elaine Garcia, Novaes, Hillegonda Maria Dutilh
Format: Article
Language:Portuguese
Subjects:
Adolescent
Adult
Birth Weight
Brazil - epidemiology
Educational Status
Female
Hospitals, Private - statistics & numerical data
Hospitals, Public - statistics & numerical data
Humans
Infant Mortality
Infant, Newborn
Maternal Age
Pregnancy
Urban Population
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Summary:The aim of this study was to analyze the profile of newborns, mothers, and early neonatal mortality according to the hospital's complexity and affiliation (or lack thereof) with the Unified National Health System (SUS) in Greater Metropolitan São Paulo, Brazil. The study was based on data for live births, deaths, and hospital registries. Factor and cluster analysis were used to obtain the typology of hospital complexity and user profile. The SUS treats more high-risk newborns and mothers with low schooling, insufficient prenatal care, and teenage mothers. The probability of early neonatal death was 5.6 live births (65% higher in the SUS), with no significant differences by level of hospital complexity, except those with extremely high (SUS) and medium (non-SUS) complexity. The difference in early neonatal mortality between the two systems was smaller in the group of newborns with birth weight < 1,500g (22%), but the rate was 131% higher in the SUS for newborns > 2,500g. There was a concentration of high-risk births in the SUS, but the difference in early neonatal mortality between SUS and non-SUS hospitals was smaller in this group of newborns. New studies are needed to elucidate the high mortality rate among newborns with birth weight > 2,500g in the SUS.
ISSN:1678-4464
DOI:10.1590/S0102-311X2010000100013