Live Birth Information System Research Articles

Factors associated with hospitalization and neonatal mortality in a cohort of newborns from the Unified Health System in São Paulo.

Newborn care is an important factor associated with hospitalization and neonatal mortality. To analyze factors associated with hospitalization and neonatal mortality of newborns (NBs) admitted to the Unified Health System (SUS), São Paulo, 2012. A cohort of NBs from the SUS was obtained by linking data: SUS Hospital Information System, Live Birth Information System, Mortality Information System and National Health Facility Registry. Poisson and Cox regression were performed. 16.5% (9,127) of the NBs were hospitalized, 4.7% (2,613) were admitted to a Neonatal Intensive Care Unit (NICU) and 11.8% (6,514) to a Neonatal Intermediate Care Unit (NIMCU). Maternal age ≥ 35 years (RR = 1.1, IC95% 1.1 - 1.2), inadequate prenatal care (RR = 1.2, IC95% 1.1 - 1.3), hospitalization for obstetric complications (RR = 1.1, IC95% 1.1 - 1.2), prematurity (≤ 32 weeks: RR = 1.6, IC95% 1.5 - 1.8; 32 to 36 weeks: RR = 1.7, IC95% 1.6 - 1,7), low weight (< 1,500 g: RR = 2.4, IC95% 2.1 - 2.6; 1,500 to 2,499 g: RR = 2.6, IC95% 2.5 - 2.7), APGAR 5º < 7 (RR = 1.9, IC95% 1.7 - 2.0), Cesarean section (RR = 1.1, IC95% 1.1 - 1.2) and Congenital Malformation (RR = 1.4, IC95% 1.3 - 1,5) were associated with the hospitalization of newborns. Neonatal mortality was associated with infants under 1,500 g (RR = 9.1, IC95% 6.3 - 13.1), very premature (RR = 2.6, IC95% 1.9 - 3.5), low APGAR (RR = 5.5, IC95% 4.6 - 6.7). Inadequate prenatal care, prematurity and low weight were risk factors for hospitalization and neonatal mortality.

EFFECT OF FOLIC ACID FORTIFICATION ON THE PREVALENCE OF NEURAL TUBE CLOSING DEFECTS IN GOIÁS

Introduction: Neural Tube Closure Defects classify the most common congenital anomalies of the central nervous system and constitute the main preventable congenital malformation through nutritional strategies. Although its mechanism of action is little known, it is known that folic acid is an important cofactor in the synthesis of amino acids and nucleic acids, therefore, the lack of this nutrient can prevent the correct cellular mitosis interfering already in the early stages of development embryonic. Objective: To evaluate the effect of dietary fortification of wheat and corn flour with folic acid on the prevalence of Neural Tube Closure Defects in Goias. Methods: A cross-sectional study was designed to compare the prevalence of neural tube closure defects at two stages: before (2000 to 2004) and after (2005 to 2013) the introduction of mandatory supplementation of folic acid wheat and maize flour. (June 2004). Secondary data provided by the Live Birth Information System (SINASC) and Mortality Information System (SIM) for mothers living in the state of Goias were used. Results: In the period studied (2000 to 2013), there were a total of 1,269,393 live births and 11,350 dead births, with a total of 519 cases of Neural Tube Closure Defects, resulting in a prevalence of 0.41 / 1000 births. The evaluation of the evolution of the time series of the Neural Tube Closing Defects in Goias over the study period allows us to conclude that there was a trend of increasing prevalence in the pre-fortification period (2000 to 2004), followed by a downward trend in the period post-fortification period (2005-2013) for live births, stillbirths and all births. From 2000 to 2004, the period prior to folic acid food fortification, the total prevalence of Neural Tube Closing Defects (considering all births) was 0.42 / 1000 births, while in the period after food fortification, 2005 to 2013, the prevalence dropped to 0.40 / 1000 live births. The results show a general trend of increasing prevalence of Neural Tube Closing Defects in the pre-fortification period (2000-2004) and reduction of prevalence in the post-fortification period (2005-2013), both when considering born alive, born dead and all births. Regarding the assessment of the effect of fortification on the prevalence of Neural Tube Closing Defects, a significant reduction of 42.6% in dead born (from 14 to 8/1000) was found, this may indicate a beneficial effect of fortification from Wheat and corn flour with folic acid in Goias. Conclusion: The results obtained in this study provided important information about the temporal evolution of the Neural Tube Closing Defects in Goias using the records available in DATASUS.

Presumption of sexual abuse in children and adolescents: vulnerability of pregnancy before 14 years.

to investigate the presumption of sexual abuse through the records of live births with mothers up to 13 years of age. this is a quantitative study, with an ecological design, carried out in Maceió, with data from the Brazilian Live Birth Information System from 2009 to 2017, based on Law 12,015/2009, on sexual crimes against the vulnerable, applying the presumption of violence in children under 14 years old. nine hundred fifty-three births of children with mothers aged 10 to 13 years were recorded; 1.3% were reported as victims of sexual abuse; 20.3% declared to be married or living in a stable relationship. Records were concentrated in 04 neighborhoods, Guaxuma, Benedito Bentes, Tabuleiro do Martins, and Jacintinho. there was a prevalence of pregnancy and marriage in girls under 14 years of age and scarcity of reporting presumed sexual abuse by health professionals.

Maternal characteristics and the risk of neonatal mortality in Brazil between 2006 and 2016

Neonatal deaths account for more than 60% of infant deaths and are a major concern in Brazil. The reduction of the occurrence of these events appears to be more challenging than post-neonatal deaths, as such a reduction depends more on factors related to the pregnancy and childbirth than sanitary and health conditions. The aim of the present study was to evaluate the influence of maternal factors (schooling, marital status, and age) on the risk of neonatal mortality in Brazil between 2006 and 2016. Data were collected from the Brazilian Institute of Geography and Statistics as well as two information systems of the public health-care system: Mortality Information System and Live Birth Information System. The total valid sample size was 28,362,359 children. Visualization and classification methods were performed. The results revealed a considerably higher risk of neonatal deaths when the mothers were unmarried, had a low level of schooling, and were outside the 20-34-year-old age group. Different demographic profiles in Brazil exert an influence on neonatal health. The identification of the risk factors of neonatal mortality can assist in ensuring pregnancy, delivery, and a neonatal period of greater quality.

Relationship of databases of live births and infant deaths for analysis of congenital malformations

Abstract Objectives: to describe the prevalence of congenital malformations in live births in Recife, based on the relationship of birth and infant death data. Methods: a cross-sectional study with data from the Live Birth Information System (Sinasc) and Mortality (MIS) of residents in Recife-PE between 2013 and 2015. The deterministic linkage of deaths and live births (LB) with malformation and the prevalence rate were calculated. Results: 545 (95.1%) deaths and live births were matched. According to the Sinasc, the prevalence of congenital malformations was 10.4 per 1,000 LB. After the linkage, the rate was 12.4. Malformations of the musculoskeletal system (42.1%) among live births were high-lighted, as well as malformations of the circulatory system (35.3%) found in infant deaths. Conclusions: linkage increased the prevalence of congenital malformations in the studied cohort. This demonstrates the potential of this strategy for the monitoring of congenital malformations, which can be used to monitor infant death.

Increasing prevalence, time trend and seasonality of gastroschisis in S\xe3o Paulo state, Brazil, 2005\u20132016

To estimate the gastroschisis seasonality and trend of prevalence in recent years, stratified by maternal age and geographical clusters of São Paulo state, a population–based study was designed. We used data from the Live Births Information System (SINASC) in São Paulo state, Brazil, from 2005 to 2016. Trends of prevalence were evaluated for the specific subgroups using the Prais–Winsten regression model, and the Durbin–Watson test was used, to estimate the regression coefficient, the annual percent change (APC), and 95% confidence interval (CI). We observed 1576 cases of gastroschisis among 7,317,657 live births (LB), a prevalence of 2.154 (95% CI: 2.047–2.260) per 10,000 LB which included, 50.6% males, 67.4% Caucasians, 53.4% preterm births, and 80.9% caesarean births. The prevalence of gastroschisis significantly increased by 2.6% (95% CI: 0.0–5.2) per year, and this trend was higher in mothers aged 30–34 years (APC: 10.2, 95% CI: 1.4–19.4) than in mothers of other age groups. Between 2011 and 2016, we identified the existence of seasonality based on the date of conception in the middle months of the year (p = 0.002). This is the first and largest population–based study summarizing current epidemiology and identifying trend of prevalence of gastroschisis in São Paulo state.

Impact evaluation of Zika epidemic on congenital anomalies registration in Brazil: An interrupted time series analysis

This study aimed to assess the impact of the Zika epidemic on the registration of birth defects in Brazil. We used an interrupted time series analysis design to identify changes in the trends in the registration of congenital anomalies. We obtained monthly data from Brazilian Live Birth Information System and used two outcome definitions: 1) rate of congenital malformation of the brain and eye (likely to be affected by Zika and its complications) 2) rate of congenital malformation not related to the brain or eye unlikely to be causally affected by Zika. The period between maternal infection with Zika and diagnosis of congenital abnormality attributable to the infection is around six months. We therefore used September 2015 as the interruption point in the time series, six months following March 2015 when cases of Zika started to increase. For the purposes of this analysis, we considered the period from January 2010 to September 2015 to be “pre-Zika event,” and the period from just after September 2015 to December 2017 to be “post-Zika event.” We found that immediately after the interruption point, there was a great increase in the notification rate of congenital anomalies of 14.9/10,000 live births in the brain and eye group and of 5.2/10,000 live births in the group not related with brain or eye malformations. This increase in reporting was in all regions of the country (except in the South) and especially in the Northeast. In the period “post-Zika event”, unlike the brain and eye group which showed a monthly decrease, the group without brain or eye malformations showed a slow but significant increase (relative to the pre-Zika trend) of 0.2/10,000 live births. These findings suggest an overall improvement in the registration of birth malformations, including malformations that were not attributed to Zika, during and after the Zika epidemic.

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

ABSTRACTObjective: 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.

Trend of incompleteness of vital statistics in the neonatal period, State of Rio de Janeiro, Brazil, 1999-2014.

to analyze the incompleteness of variables retrieved from the Live Birth Information System (SINASC) and the Mortality Information System (SIM), in the State of Rio de Janeiro, in the time series 1999 to 2014. this was a time series study of SINASC and SIM; the Romero & Cunha score was used to analyze incompleteness; Joinpoint regression was used to analyze temporal trend; in 2014, deaths were evaluated separately according to investigation. regarding SINASC variables, in 1999 marital status (37.40%), number of stillborn children (31.30%), and race/skin color (24.63%) had the highest incompleteness percentages; in 2014, no variable exceeded 5% incompleteness, except occupation; regarding SIM variables, in 1999 five variables exceeded 20%, and missing data for previous stillborn children was over 60%; in 2014, only one variable exceeded 20% incompleteness; investigated deaths had better completeness. both systems were found to have improved; the quality of SINASC completeness remained superior to that of SIM.

Temporal trend of adolescent pregnancy in Brasil.

To analyze the temporal trend and factors associated with adolescent pregnancy during ten years in Brasil. Data were extracted from the Live Births Information System, of the Brazilian Health System and included information regarding live births from adolescent mothers from 2006 to 2015. The overall proportion of gestation in adolescence and the specific proportions according to the characteristics analyzed were calculated using the standardized reporting coefficients and the simple linear regression method. The study was approved by the ethics committee of the University of Southern Santa Catarina (UNISUL). The general proportion of Live Births from adolescent mothers varied from 21.4% in 2006 to 18.1% in 2015. This reduction occurred because of the negative variation observed among mothers aged 15 to 19 years. The indigenous group was the only that did not present a reduction. There was an increase in the proportion of adolescents with between four and seven years of formal education and in the proportion of adolescents living with partners. There was a reduction in all Brazilian Regions and in large part of the Federation Units. The analysis of the temporal trend identifies a reduction in the proportion of live births among adolescent mothers in Brasil. However, there is a growing trend among some specific groups.

Obstetric profile of perinatal deaths on a capital of the Northeast of Brazil

Abstract Objectives: to analyze the obstetric and sociodemographic profile on perinatal deaths in Teresina the capital of Piauí, from data obtained from the Sistema de Informação de Mortalidade e Sistema de Informação de Nascidos Vivos (Brazilian Mortality Information System and Livebirth Information System). Methods: this is a retrospective cohort on perinatal deaths of mothers whose babies were born and resided in Teresina between 2010 and 2014. The analyzed variables were age and the mother´s schooling, gestational age, type of pregnancy (singleton or multiple), route of delivery (vaginal or cesarean), place of death (in and out hospital), time of death in relation to the delivery (prior, during or after), and birth weight. Results: the perinatal mortality coefficient (PMC) varied from 17.5 to 19.3 per 1,000 births. We found similarities in the sociodemographic profile and in the obstetric fetal and non-fetal deaths, both with a great incidence on 20 to 27 years-old mothers, vaginal delivery and singleton pregnancy. Low birth weight was positively related to early neonatal deaths. Conclusions: perinatal mortality presented a statistical correlation in gestational age, birth weight, and type of delivery. The PMC in our study was higher than other Brazilian capitals.

Tendência temporal e características dos nascidos vivos com malformações congênitas: estudo ecológico

Objetivo: descrever as características dos nascidos vivos com malformação congênita, analisar os fatores associados e a tendência temporal no município de Recife, Pernambuco, no período de 2001 a 2015. Métodos: estudo ecológico de série temporal com dados do Sistema de Informações sobre Nascidos Vivos (SINASC). Será calculada a taxa de variação para os anos estudados. A regressão logística múltipla irá analisar as variáveis independentes associadas significantemente às malformações congênitas. A força de associação entre a variável dependente e as variáveis independentes será verificada pela odds ratio. Resultados: espera-se identificar aumento na proporção de nascidos vivos com malformação congênita na série analisada e os fatores associados com as malformações. Conclusões: os resultados desse estudo podem contribuir com as ações de prevenção e o planejamento dos cuidados e da atenção e aos recém-nascidos com malformações congênitas.

Mortalidade neonatal no Brasil no período de 2004 a 2014

Objetivo: Estimar as taxas de mortalidade neonatal no Brasil entre os anos de 2004 a 2014 e sua variação ao longo dos anos. Estimar as taxas de mortalidade neonatal por regiões brasileiras e sua variação entre as regiões brasileiras ao longo do período citado. Métodos: Trata-se de um Estudo ecológico realizado com dados secundários extraídos no departamento de informática do Sistema Único de Saúde (DATASUS), no Sistema de Informação de Mortalidade (SIM) e no Sistema de Informação de Nascidos Vivos (SINASC). O período do estudo se deu de 2004 a 2014, as variáveis estudadas foram o número de nascidos vivos e o número de óbitos de crianças de 0 a 27 dias. Resultados: As taxas de mortalidade neonatal variaram ao longo dos anos entre o máximo de 11,86 no ano de 2004 e o mínimo de 8,97 no ano de 2014. Isso reflete uma tendência decrescente para o Brasil ao longo dos anos. A região Sul tem uma mínima obtida de 7,56 no ano de 2014. A região Nordeste variou de 13,80 em 2004 a 10,31 no ano de 2014. Conclusão: A partir do quadro epidemiológico brasileiro, a diminuição da mortalidade neonatal ainda é um desafio para os serviços de saúde, a sociedade e o governo. Para reduzir essas taxas é fundamental a intervenção nos diversos fatores que afetam a mortalidade neonatal.

Evolution of socioeconomic inequalities in conducting prenatal consultations among Brazilian parturient women: analysis of the period 2000-2015.

to analyze evolution as to conducting seven or more prenatal consultations with pregnant women in Brazil, in the period 2000-2015 according to maternal education level and race/skin color of the newborn baby. this was a time series study based on Live Births Information System (SINASC) data; relative and absolute inequalities were investigated, adjusted for maternal age and gestational week in which childbirth occurred. we analyzed approximately 48 million births; the proportion of seven or more prenatal consultations increased nationally (from 46.0% to 66.9%) in all groups analyzed; the relative difference between the extremes of education level ranged from 3.0 to 2.0, while the absolute difference ranged from 53.1 to 47.7 percentage points; the adjusted ratio between White/Black race/skin color was 1.4 in 2000 and 1.2 in 2015. the proportion of pregnant women having seven or more prenatal consultations has increased in Brazil, although inequalities are still found.

Profile of congenital anomalies among live births in the municipality of Tangará da Serra, Mato Grosso, Brazil, 2006-2016.

to describe congenital anomalies (CA) among live births of mothers resident in Tangará da Serra, MT, Brazil, during the period 2006-2016. this was a descriptive study, using Brazilian Live Birth Information System (SINASC) data. out of 15,689 births, 77 were registered with CA (prevalence of 4.9/1,000); there was an 80.7% increase of recorded CA in 2016, accounting for 10.3/1,000 live births, including five cases of microcephaly; CA prevalence was higher among children born to women aged over 35 years (prevalence ratio [PR] =1.91; confidence interval [95%CI] 1.01;3.60), preterm (PR=2.22; 95%CI 1.26;3.92) and low birth weight infants (PR=3.21; 95%CI 1.86;5.54). low CA prevalence was found, possibly related to under-recording at birth; the increase observed in 2016 may be related to the Zika epidemic causing microcephaly, as well as greater attention by health professionals in relation to CA during this public health emergency.

Twin Pregnancy in Brazil: A Profile Analysis Exploring Population Information from the National Birth E-Registry on Live Births.

Birth records as SINASC (Brazilian Live Birth Information System) are highlighted in uncommon conditions such as twin pregnancy whose prevalence rarely exceeds 2 to 3% of the total number of births. The objective of this study was to assess the prevalence of twin pregnancies in Brazil and their maternal and perinatal characteristics using data from the national birth e-Registry. All births in Brazil from 2011 to 2014 were assessed. Prevalence of twin pregnancies per region was assessed and correlated with the Human Development Index (HDI). Sociodemographic and obstetric factors and main perinatal outcomes were assessed for the first and second twin, in comparison to singletons, and the second twin compared to the first twin, with PR and 95%CI. A multiple logistic regression analysis was conducted to identify factors independently associated with a low 5-minute Apgar score in twin pregnancies. Twin pregnancy occurred in 1.13% in Brazil, with a higher prevalence in regions with a higher HDI. It was associated with a complete higher level of education (22.9% versus 16.3% for singles) and maternal age > 35 years (17.5% versus 11.4% for singles). Preterm birth <32 weeks (prevalence ratio-PR 12.13 [11.93 – 12.33]), low birth weight (PR 17.8 [17.6-18.0] for the first and PR 20.1 [19.8-20.3] for the second twin), and low Apgar score (PR 2.9 [2.8-3.0] for the first and PR 2.7 [2.6-2.8] for the second twin) were the most important perinatal outcomes associated with twin pregnancies. A 5-minute Apgar score < 7 among twins was associated with inadequate prenatal care, extreme preterm birth, vaginal delivery, intrapartum cesarean, and combined delivery. Twin pregnancy in Brazil is associated with worse perinatal outcomes, especially for the second twin.

Spatio-temporal trends in the risk of adolescent pregnancy in Minas Gerais, Brazil, 2000-2015.

To investigate, through a spatio-temporal analysis, the association between the percentages of live births of adolescent mothers (LBAM) and the human development index (HDI), including the three components: income, education and longevity. The percentage of LBAM was obtained from the Brazilian Live Births Information System for the state of Minas Gerais, Brazil in the period 2000-2015 and the HDI data and its components were obtained from United Nations Development Program's (UNDP) Human Development Reports. A generalized additive model (GAM) was used to estimate the relative risk of LBAM in relation to the HDI and to identify spatial clusters of the geographical distribution of LBAM, the Moran global and local index was used. There is an association between the HDI and its components with LBAM. The high values of relative risk are spatially concentrated in the northern part of the state of Minas Gerais. The graphs indicated a nonlinear relationship between LBAM over the years. There is a strong spatial dependence of LBAM in Minas Gerais, which suggests that a geographical location plays a fundamental role in understanding it. The regional disparity confirmed in this study is inherent in the process of human development, it is important for planning actions aimed at the development of these regions in order to minimize existing disparities.

Early neonatal mortality and risk factors: a case-control study in Paraná State

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.

Óbitos neonatais de recém-nascidos de baixo peso ao nascer

Analisar as principais características dos recém-nascidos de baixo peso ao nascer que foram a óbito em Cuiabá, Mato Grosso. Estudo a partir de uma coorte composta de nascidos vivos com peso ao nascer de 500-2499 gramas que evoluíram ao óbito antes de completarem 28 dias de vida. Os dados foram obtidos do Sistema de Informação sobre Nascidos Vivos e Sistema de Informação sobre Mortalidade. Dos 3.404 recém-nascidos estudados, 238 evoluíram para o óbito (7,0%). Prevaleceram osóbitos entre os do sexo masculino, com peso entre 500-999 gramas, Apgar &lt; 7 no primeiro e no quinto minuto e com presença de anomalia congênita (p&lt;0,001); com mães com idade menor que 20 anos (p=0,033); que realizaram de uma a seis consultas no pré-natal (p=&lt;0,001). Os resultados mostraram que os óbitos neonatais se relacionaram com a qualidade da atenção obstétrica e neonatal, por se tratarem majoritariamente de mortes evitáveis.

Precise Assessment on Birth Information at the Civil Registry and Live Births Information System in Minas Gerais, Brazil

Abstract Objective: to assess the precision on birth information at the Civil Registry and Sistema de Informações Sobre Nascidos Vivos (Sinasc) (Live Births Information System) in Minas Gerais with the purpose to analyze the most recent fecundity level and pattern on women and to assess the hypotheses on the fertility component for populational projections adopted by the Instituto Brasileiro de Geografia e Estatística (IBGE) (Brazilian Institute of Geography and Statistics) in the 2013 review. Methods: the estimation level of under registration at the Civil Registry and Sinasc was based on the comparison of number of births registered by these sources with the number of births obtained from an independent source, estimated by the Brass P/F technique with adaptation. Results: in 2010, the coverage on the Civil Registry and Sinasc was 96.0% and 95.0%, respectively. In the period of 2003 to 2015, both sources point to the same trend. From 2011, the total number of births was practically the same. The corrected Total Fertility Rate and The Specific Fertility Rates had a very similar level and pattern in the period of 2010 to 2015. Discrepancies in the fertility hypotheses were observed from the IBGE. Conclusions: from 2010, the births registered in both data sources were considered as good statistical quality in Minas Gerais and the hypotheses of the fertility level and pattern in the IBGE projections need to be revised.