Early Neonatal Near Miss in a University Hospital: Comparative Cross-Sectional Study

Abstract

Objective: To compare 2012 and 2016 data on early neonatal near miss indicators from Health Information Systems at a university hospital. Methods: This is a cross-sectional study conducted in 2012 and 2016. We considered early neonatal near misses the live births that presented one of the following risk conditions at birth: gestational age <33 weeks, birth weight <1,750g or 5-minute Apgar score <7, or Neonatal Intensive Care Unit (NICU) admission, and were alive until the 7th day of life. Data were collected from the Live Birth Information System, Hospital Information System, and Mortality Information System. We calculated the early neonatal mortality rate, neonatal near miss rate, severe neonatal outcome rate, early neonatal survival index, and early neonatal mortality index, compared by year of birth. Results: In 2012, 304 early neonatal near misses were registered, with a higher proportion of cases with very low birth weight and mothers who had zero to three prenatal visits. In 2016, the number of cases was 243, with a predominance of more NICU admissions. The incidence of early neonatal deaths and early neonatal near misses was higher in 2012 than in 2016. Conclusions: Neonatal near miss indicators identified difference between years. The cases were more severe in 2012 and there were more NICU admissions in 2016.

Factors associated with neonatal near miss in a Midwest capital in Brazil

“…As for the selection of criteria for the identification of cases of neonatal near miss adopted in this research, the main pragmatic entry criterion was gestational age <32 weeks, which was also identified by studies conducted in Maceió-AL 6 and in the South region of Ghana, Africa. 16 On the other hand, a research developed in Recife-PE, 17 identified low birth weight as the main isolated pragmatic entry criterion. It is noteworthy that both gestational age and low birth weight are factors associated with neonatal death.…”

Fatores associados ao near miss neonatal em uma capital do Centro-Oeste do Brasil

“…Quanto à seleção dos critérios para a identificação dos casos de near miss neonatal adotados nesta pesquisa, o principal critério pragmático de entrada foi a idade gestacional <32 semanas, que também foi identificado pelos estudos realizados em Maceió-AL 6 e na região Sul de Gana, África. 16 Por sua vez, pesquisa desenvolvida em Recife-PE, 17 pragmático isolado de entrada, o baixo peso ao nascer. Ressalta-se que tanto a idade gestacional como o baixo peso ao nascer são fatores associados ao óbito neonatal.…”

“…Esses critérios foram validados 10,11 e tem 97% de sensibilidade, 92,6% de especificidade 9,10 e 97% de acurácia, 10,12 além de apresentarem os pontos de coorte mais adequados com base na literatura perinatal. 12 A partir das definições de critérios pragmáticos de NMN na literatura, este estudo testou a validade dos seguintes critérios no período neonatal (0 a 27 dias): peso de nascimento <1.500g, presença de anomalia congênita, idade gestacional (IG) menor que 32 semanas e Apgar<7 no quinto minuto, identificando especificidade de 97,70% [IC95%=97,55-97,84], sensibilidade de 80,07% [IC95%=75, 17] e uma acurácia de 97,57% [IC95%=97,41-97,71], apresentando uma alta sensibilidade e especificidade, assim como em estudos anteriores. Esse processo de validação usou os óbitos neonatais como padrão-ouro.…”

Morbilidad neonatal extrema y sus desenlaces en un hospital de alta complejidad en el 2013

“…Resaltan que el modelo está orientado a predecir muertes neonatales, sin tener en cuenta la calidad de la atención, por lo que requiere complementarse si se va a utilizar con este fin (33,34). En concordancia, una revisión previa por la Dra.…”