NEONATAL MORBIDITY NEAR MISS IN TERTIARY HOSPITALS IN A CAPITAL OF NORTHEAST BRAZIL

• Published in: Revista Paulista de Pediatria 2019-01, Vol.37 (3), p.275-282
• Main Authors: Brasil, Danyelle Rodrigues Pinheiro de Araujo, Vilela, Mirella Bezerra Rodrigues, França, Karla Eveline Ximenes de, Sarinho, Silvia Wanick
• Format: Article
• Language: eng ; por
• Subjects: Assistência; Atenção à saúde; Morbidade; Mortalidade neonatal precoce; Near miss; Original; Recém-nascido
• ISSN: 0103-0582; 1984-0462; 1984-0462
• DOI: 10.1590/1984-0462/;2019;37;3;00011

ABSTRACT Objective: To characterize near miss neonatal morbidity in tertiary hospitals in a capital city of Northeast Brazil based on Health Information Systems, and to identify differences regarding indicators of near miss cases, allowing the surveillance of newborns with risk of death. Methods: A cross-sectional study carried out in hospitals with neonatal intensive care unit, whose neonatal near miss cases in 2012 were identified from a deterministic linkage between the Mortality Information System and the Live Birth Information System. The biological variables of children, variables related to maternal characteristics and indicators of near miss were calculated by type of service and hospital. Biological variables of children, variables related to maternal characteristics and near miss indicators were calculated by service type and hospital and then compared by ratio difference test, parametric and non-parametric tests for measures of central tendency. Results: Of 24,254 live births, 2,098 cases of neonatal morbidity near miss were identified, most of them concentrated in the public hospitals (89.9%). The combination of birth weight and gestational age had the largest number of cases in both segments, public (43.5%) and private (46%). Variations in neonatal near miss indicators were observed between hospitals, which suggests assistance problems. Conclusions: The concept of neonatal near miss, its applicability with data from Health Information Systems, and its indicators are a preliminary tool to monitor hospital care for newborns by signaling health services that require in-depth evaluation and investments for quality improvement. RESUMO Objetivo: Caracterizar a morbidade neonatal near miss em hospitais terciários de uma capital do Nordeste do Brasil, por meio dos Sistemas de Informação em Saúde, e identificar diferenças quanto aos indicadores de near miss que possibilitem a vigilância dos recém-nascidos com risco de morte. Métodos: Estudo transversal realizado em hospitais com unidade de terapia intensiva neonatal cuja população foram os casos de near miss neonatal nascidos em 2012, identificados mediante o linkage determinístico entre os bancos de dados do Sistema de Informações sobre Mortalidade e do Sistema de Informações sobre Nascidos Vivos. As variáveis biológicas das crianças, as referentes às características maternas e os indicadores de near miss foram calculados por tipo de serviço e por hospital e comparados por meio de testes de diferença