Abstract
to analyze the Early Neonatal Mortality risk factors according to the risk stratification criteria of the Guideline of the Rede Mãe Paranaense Program. a case-control epidemiological study with secondary data from the Mortality and Live Birth Information System in 2014. The crude analysis was performed by the Odds Ratio association measure, followed by the adjusted analysis, considering risk factors as independent variables, and early neonatal death as dependent variable. were considered as maternal risk factors: absence of partner and miscarriages; neonatal: male, low birth weight, prematurity, Apgar less than seven in the fifth minute, presence of congenital anomaly; and care: up to six prenatal appointments. an innovative study of risk factors for early neonatal death from the Guideline's perspective, a technological management tool for maternal and child health, in search of its qualification and greater sensitivity.
Highlights
In Brazil, in 2016, there were 20,176 deaths in the Early Neonatal period, constituting 53.2% of infant deaths, with Early Neonatal Mortality Rate (ENMR) of 6.7 deaths per thousand live births (LB)(1)
Regarding the categorized maternal race/ color, there was no significant difference for early neonatal death (Table 1)
The main determining factors were identified with an adjusted analysis of the risk factors and were related, especially to the characteristics of the newborn, such as: male, low birth weight, prematurity, Apgar less than seven in the fifth minute of life and, presence of congenital anomaly; maternal socioeconomic conditions, influenced by the marital situation; and obstetric history with history of previous miscarriage; as well as related to the conditions of care, such as less than seven visits
Summary
In Brazil, in 2016, there were 20,176 deaths in the Early Neonatal period, constituting 53.2% of infant deaths, with Early Neonatal Mortality Rate (ENMR) of 6.7 deaths per thousand live births (LB)(1). There were 943 deaths in the first week of life, accounting for 54.1% of infant deaths, and ENMR of 5.9 deaths per thousand LB, due to the same related causes[1,2]. In 2013, the United States ENMR was 12.9 deaths per thousand LB, as the highest component of Infant Mortality[3]. In this country, the health system is fragmented[4] and, despite being administered by the private sector, the government spends high monetary values on health. The US states show high ENMR, compared to the other developed countries[5], a fact that may reflect the difficulty of the population to access health services free of costs
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