Mortality in children under five years old in Brazil: evolution from 2017 to 2020 and the influence of COVID-19 in 2020

Moura, Erly Catarina de; Cortez-Escalante, Juan José; Lima, Rodrigo Tobias de Sousa; Cavalcante, Fabrício Vieira; Alves, Layana Costa; Santos, Leonor Maria Pacheco

doi:10.1016/j.jped.2022.03.004

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“…In 2017, the IMR in Brazil was 13.4:1000 LB, with the South (where the Rio Grande do Sul state is located) and Southeast regions of the country showing rates below the national average (10.1 and 11.3:1000 LB, respectively), while in the North (15.4:1000 LB), Northeast (14.1:1000 LB), and Central-West region (11.7:1000 LB) the means were higher [ 7 ]. The mortality rate declined from 2017 to 2020, and this variation was higher in the early neonatal period (0–6 days after birth) [ 8 ]. In 2020, the mortality rates were 6.5, 2.1, 3.4, and 1.7 per 1000 LB, respectively, for the early neonatal, late neonatal (7–27 days), post-neonatal (28–364 days), and 1–4 years of age periods [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…The mortality rate declined from 2017 to 2020, and this variation was higher in the early neonatal period (0–6 days after birth) [ 8 ]. In 2020, the mortality rates were 6.5, 2.1, 3.4, and 1.7 per 1000 LB, respectively, for the early neonatal, late neonatal (7–27 days), post-neonatal (28–364 days), and 1–4 years of age periods [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10][11].3) 7.5 (6.0-9.2) 5.0 (3.8-6.4) 4.0 (3.0-5.3) 1 6. (1.0-2.5) 1.3 (0.7-2.1) 2.9 (2.0-4.0) 2.3 (1.5-3.3) 7.7 (6.7-8.8) 5.3 (4.5-6.2) 4.1 (3.4-4.9) 2.0 (1.5-2.6) 1.4 (1.0-1.9) 3.0 (2.4-3.7) 2.2 (1.7-2.8) 3rd 36,977 9.6 (8.6-10.6) 7.4 (6.6-8.3) 5.1 (4.4-5.9) 4.1 (3.5-4.8) 1.6 (1.2-2.0) 1.3 (1.0-1.7) 2.9 (2.4-3.5) 2.0 (1.6-2.5) 8.4 (7.7-9.1) 4.9 (4.4-5.5) 4.2 (3.7-4.7) 2.2 (1.8-2.6) 1.7 (1.4-2.0) 3.2 (2.8-3.7) 2.5 (2.1-2.9) 9.9 (8.7-11.2) 8.5 (7.4-9.7) 3.9 (3.1-4.7) 3.3 (2.6-4.1) 4.9 (4.1-5.9) 4.1 (3.3-5.0) ≥ 7 108,239 5.1 (4.7-5.5) 3.4 (3.1-3.8) 2.1 (1.8-2.4) 1.5 (1.3-1.7) 1.0 (0.8-1.2) 0.6 (0.5-0.8) 1.9 (1.6-2.2) 1.3 (1.1-1.5) Type of delivery (N = 141,530) 9.4 (8.8-10.0) 6.2 (5.7-6.7) 5.6 (5.2-6.1) 1.7 (1.5-2.0) 1.4 (1.2-1.6) 3.1 (2.8-3.4) 2.5 (2.2-2.8)…”

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Contextual, maternal, and infant factors in preventable infant deaths: a statewide ecological and cross-sectional study in Rio Grande do SUL, Brazil

Kreutz

Santos

2023

BMC Public Health

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Background Ending preventable deaths of newborns and children under five by 2030 is among the United Nations Sustainable Development Goals. This study aimed to describe infant mortality rate due to preventable causes in Rio Grande do Sul (RS), the Southernmost state in Brazil. With 11,329,605 inhabitants and 141,568 live births in 2017, RS was the fifth most populous state in the country. Method An ecological and cross-sectional statewide study, with data extracted from records of the Mortality Information System, Death Certificates, and Live Birth Certificates for the year 2017. Preventability was estimated by applying the List of Causes of Deaths Preventable through Intervention of SUS (acronym for Sistema Unico de Saude - Brazilian Unified Health System) Intervention. Rates of preventable infant mortality (PIMR), preventable early neonatal mortality (PENMR), preventable late neonatal mortality (PLNMR), and preventable post-neonatal mortality (PPNMR) per 1000 live births (LB) were quantified. Incidence ratios, according to contextual characteristics (human development index of the health region and of the municipality; Gini index of the municipality), maternal characteristics at the time of delivery (age, education, self-reported skin color, presence of a partner, number of antenatal care consultations, and type of delivery), and characteristics of the child at the time of birth (gestational age, weight, and pregnancy type) were calculated. Results In 2017, there were 141,568 live births and 1425 deaths of infants younger than 1 year old, of which 1119 were preventable (PIMR = 7.9:1000 LB). The PENMR, PLNMR, and PPNMR were 4.1:1000 LB; 1.5:1000 LB; and 2.3:1000 LB, respectively. More than 60% of deaths in the first week and 57.5% in the late neonatal period could be reduced through adequate care of the woman during pregnancy. The most frequent preventable neonatal causes were related to prematurity, mainly acute respiratory syndrome, and non-specified bacterial septicemia. In the post-neonatal period, 31.8% of deaths could be prevented through adequate diagnostic and treatment. Conclusions The strategies needed to reduce preventable infant deaths should preferably focus on preventing prematurity, through adequate care of the woman during pregnancy.

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confidence: 99%

Section: Introductionmentioning

confidence: 99%

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