Mortalidade neonatal precoce e tardia: causas evitáveis e tendências nas regiões brasileiras

Prezotto, Kelly Holanda; Bortolato-Major, Carina; Moreira, Ricardo Castanho; Oliveira, Rosana Rosseto de; Melo, Emiliana Cristina; Silva, Flávia Teixeira Ribeiro da; Abreu, Isabella Schroeder; Fernandes, Carlos Alexandre Molena

doi:10.37689/acta-ape/2023ao02322

Cited by 5 publications

(1 citation statement)

References 27 publications

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“…[16][17][18][19] Most published research about neonatal mortality in Latin America focuses on biological determinants and quantitative analyses. [20][21][22] Studies in Brazil and Perú have highlighted the relationship between racial, socioeconomic, and structural factors and neonatal mortality. [23][24][25] None of these studies have focused on Indigenous populations.…”

Section: How This Study Might Affect Research Practice or Policymentioning

confidence: 99%

A biosocial analysis of perinatal and late neonatal mortality among Indigenous Maya Kaqchikel communities in Tecpán, Guatemala: a mixed-methods study

Venzor Strader,

Sotz,

Gilbert

et al. 2024

BMJ Glob Health

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IntroductionNeonatal mortality is a global public health challenge. Guatemala has the fifth highest neonatal mortality rate in Latin America, and Indigenous communities are particularly impacted. This study aims to understand factors driving neonatal mortality rates among Maya Kaqchikel communities.MethodsWe used sequential explanatory mixed methods. The quantitative phase was a secondary analysis of 2014–2016 data from the Global Maternal and Newborn Health Registry from Chimaltenango, Guatemala. Multivariate logistic regression models identified factors associated with perinatal and late neonatal mortality. A number of 33 in-depth interviews were conducted with mothers, traditional Maya midwives and local healthcare professionals to explain quantitative findings.ResultsOf 33 759 observations, 351 were lost to follow-up. There were 32 559 live births, 670 stillbirths (20/1000 births), 1265 (38/1000 births) perinatal deaths and 409 (12/1000 live births) late neonatal deaths. Factors identified to have statistically significant associations with a higher risk of perinatal or late neonatal mortality include lack of maternal education, maternal height <140 cm, maternal age under 20 or above 35, attending less than four antenatal visits, delivering without a skilled attendant, delivering at a health facility, preterm birth, congenital anomalies and presence of other obstetrical complications. Qualitative participants linked severe mental and emotional distress and inadequate maternal nutrition to heightened neonatal vulnerability. They also highlighted that mistrust in the healthcare system—fueled by language barriers and healthcare workers’ use of coercive authority—delayed hospital presentations. They provided examples of cooperative relationships between traditional midwives and healthcare staff that resulted in positive outcomes.ConclusionStructural social forces influence neonatal vulnerability in rural Guatemala. When coupled with healthcare system shortcomings, these forces increase mistrust and mortality. Collaborative relationships among healthcare staff, traditional midwives and families may disrupt this cycle.

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Section: How This Study Might Affect Research Practice or Policymentioning

confidence: 99%

A biosocial analysis of perinatal and late neonatal mortality among Indigenous Maya Kaqchikel communities in Tecpán, Guatemala: a mixed-methods study

Venzor Strader,

Sotz,

Gilbert

et al. 2024

BMJ Glob Health

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Trends and inequalities in neonatal mortality rate in Bangladesh: Evidence from cross‐sectional surveys

Dey,

Kundu,

Ajayi

et al. 2024

Health Science Reports

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Background and AimsGiven the significance of addressing neonatal mortality in pursuing the 2030 Sustainable Development Goal on child health, research focus on this area is crucial. Despite the persistent high rates of neonatal mortality rate (NMR) in Bangladesh, there remains a notable lack of robust evidence addressing inequalities in NMR in the country. Therefore, this study aims to fill the knowledge gap by comprehensively investigating inequalities in NMR in Bangladesh.MethodsThe Bangladesh Demographic and Health Survey (BDHS) data from 2000 to 2017 were analyzed. The equity stratifiers used to measure the inequalities were wealth status, mother's education, place of residence, and subnational region. Difference (D) and population attributable fraction (PAF) were absolute measures, whereas population attributable risk (PAR) and ratio (R) were relative measures of inequality. Statistical significance was considered by estimating 95% confidence intervals (CIs) for each estimate.ResultsA declining trend in NMR was found in Bangladesh, from 50.2 in 2000 to 31.9 deaths per 1000 live births in 2017. This study detected significant wealth‐driven (PAF: −20.6, 95% CI: −24.9, −16.3; PAR: −6.6, 95% CI: −7.9, −5.2), education‐related (PAF: −11.6, 95% CI: −13.4, −9.7; PAR: −3.7, 95% CI: −4.3, −3.1), and regional (PAF: −20.6, 95% CI: −27.0, −14.3; PAR: −6.6, 95% CI: −8.6, −4.6) disparities in NMR in all survey points. We also found a significant urban–rural inequality from 2000 to 2014, except in 2017. Both absolute and relative inequalities in NMR were observed; however, these inequalities decreased over time.ConclusionSignificant variations in NMR across subgroups in Bangladesh highlight the need for comprehensive, and targeted interventions. Empowering women through improved access to economic resources and education may help address disparities in NMR in Bangladesh. Future research and policies should focus on developing strategies to address these disparities and promote equitable health outcomes for all newborns.

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Fatores associados à mortalidade neonatal precoce

Silva,

Pereira,

Bulhões

et al. 2023

Cuad. Ed. Desar.

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A taxa de mortalidade neonatal reflete as condições de saúde de uma população. No Brasil, a elevada taxa revela que há um problema de saúde pública, especialmente na região Norte e Nordeste. Objetivo: Investigar os fatores associados ao óbito neonatal precoce no estado de Pernambuco. Método: Estudo descritivo, transversal e quantitativo. A população foi composta por todos os óbitos neonatais ocorridos no estado de Pernambuco no ano de 2017. Os dados foram coletados a partir do banco de dados do projeto mestre, oriundos do Sistema de Informação de Mortalidade cedidos pela Secretaria de Saúde de Pernambuco. Realizou-se análise descritiva com o auxílio do programa PSPP; para a análise dos fatores associados, aplicou-se o teste Qui-quadrado ou o Exato de Fisher. Resultados: Foram analisados 1151 óbitos, que mostraram associação da mortalidade neonatal precoce com idade e escolaridade materna, residência na região metropolitana, tipo de gravidez e parto, filhos anteriores, sexo do recém-nascido, peso ao nascer, prematuridade e local de ocorrência do óbito. Conclusão: Ser filho de mãe adolescente, com menos de 8 anos de estudo, residente na região metropolitana, nascido de parto vaginal, primogênito, do sexo feminino, prematuro e com baixo peso ao nascer apresenta maior risco de óbito na primeira semana de vida.

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Mortalidade neonatal precoce e tardia: causas evitáveis e tendências nas regiões brasileiras

Cited by 5 publications

References 27 publications

A biosocial analysis of perinatal and late neonatal mortality among Indigenous Maya Kaqchikel communities in Tecpán, Guatemala: a mixed-methods study

A biosocial analysis of perinatal and late neonatal mortality among Indigenous Maya Kaqchikel communities in Tecpán, Guatemala: a mixed-methods study

Trends and inequalities in neonatal mortality rate in Bangladesh: Evidence from cross‐sectional surveys

Fatores associados à mortalidade neonatal precoce

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