Risk factors for neonatal death in Recife: a case-control study

Abstract

OBJECTIVE: Neonatal mortality is the main cause of infant mortality in the city of Recife. The objective of the present study was to determine the major risk factors for neonatal death in Recife in 1995. METHODS: This is a case control study. Information was obtained from the mortality and live birth databases after validation of the data set, between January and December 1995. A sample of 456 cases and 2,280 controls was obtained after using the linkage technique between the two data sets. The difference in proportion was analyzed by the chi square test. The odds ratio was calculated as a risk measure, with a 95% confidence interval. The logistic regression technique was used to adjust potential confounding factors. RESULTS: 212 deaths (46.6%) occurred in the first 24 hours of life. We found that 358 (79.7%) of the cases presented low birth weight, with a 46-fold higher risk of death (CI =33.8-59.0 P<0.001) than those weighing >/= 2,500g. The major risk factors observed in the logistic regression analyses of the measure, listed in descending order, were: birth weight < 1,500g (OR= 49.6 CI= 22.6-108.7 P<0.001), 5-minute Apgar score < 7 (OR = 44.1 CI= 25.1-77.2 P<0.001), birth weight between 1,500 and 2,500g (OR= 8.2 CI= 4.8-14.0 P<0.001), gestational age < 37 weeks (OR= 4.3 CI= 2.6-7.1 P<0.001). CONCLUSIONS: Among the studied variables, birth weight, gestational age, and Apgar score should be considered the main risk factors for the surveillance of neonatal death.