Neonatal near miss and the occurrence of negative outcomes in the first year of life: data from a national survey, Nascer no Brasil (Born in Brazil), 2011-2012

Abstract

Objectives: estimate the strength of association between neonatal near miss and the nega-tive outcomes in the child’s first year of life. Methods: a prospective cohort study on neonatal survivors originating from a national survey “Nascer no Brasil (Born in Brazil), 2011-2012.” Main exposure: neonatal near miss (NNM). Negative outcomes: breastfeeding, hospitalization, and post neonatal death (tele-phone interview). For each outcome, the odds ratio (OR) were estimated by univariate (p<0.2) and multivariate (p<0.05) logistic regression models. Results: among 15,675 children 3.3% were neonatal near miss. Neonatal near miss was associated, after adjusting, to: weaning (OR=1.8); hospitalization after hospital discharge (OR=2.2); remained hospitalized (OR=65.6) and post neonatal death (OR=52.4) The increased OR after adjusting revealed negative confounding, such as “remained hospitalized since childbirth” (ORcrude=21.1 and ORadjusted=65.6). Conclusions: although neonatal near miss reflects a good quality of health care, avoiding neonatal death, these survivors have higher risk of negative outcomes in the first year of life.

Neonatal near miss and mortality and associated factors: cohort study of births in the city of Rio de Janeiro, RJ, Brazil

“…19 Although survivors of the neonatal period, NNM cases present higher mortality up to five incomplete years, especially in the post-neonatal period, 19 permanence of hospitalization for delivery, hospitalization after discharge from delivery, and weaning in the first year of life, evidencing conditions of vulnerability and the need for social assistance and support for their families. 30 Besides confirming the effect of low birth weight, prematurity, and asphyxia on neonatal death, this study identified that socioeconomic vulnerability markers -low education level and brown or black skin colors -were associated with neonatal death and NNM. Absent or inadequate prenatal care were strongly associated with both outcomes, being stronger for neonatal death.…”

Use of noninvasive mechanical ventilation weaning protocol in neonatal intensive care units in Brazil: a descriptive study

“…Neonatal intensive care units (NICUs) are intended for hospital care of patients between 0 and 28 days of life, 1 and neonatal hospitalization is mainly related to lower gestational age (GA), low birth weight, and need for oxygen therapy or ventilatory support, which are associated with higher neonatal morbidity and mortality. 2 - 4 …”