Determinants of neonatal mortality in the largest international border of Brazil: a case-control study

Abstract

Background Foz do Iguassu is a Brazilian municipality located in the most populous international border of the country and provides medical care to foreigners. Neonatal mortality in the city is higher than Brazil’s average and corresponds to 61% of all deaths in children under five. The current study aimed to identify the determinants of neonatal mortality in Foz do Iguassu. Methods In this case-control study, we analyzed all neonatal deaths occurred in Foz do Iguassu from 2012 to 2016. Birth and mortality data were extracted from two national governmental databases (SINASC and SIM). We extracted data on (i) maternal sociodemographic characteristics, (ii) pregnancy care, and (iii) newborn characteristics. Multiple logistic regression with the conceptual framework was applied to examine the factors associated with neonatal mortality. Results Most of the deaths occurred in the early neonatal period (65.9%). The factors associated with neonatal death were fetal congenital anomaly (OR 22.49; CI 95% 7.44–67.95; p = < 0.001); low birth weight (OR 17.15; CI 95% 8.56–34.37; p = < 0.001), first minute Apgar score under 7 (OR 15.60; CI 95% 8.23–29.67; p = < 0.001); zero to 3 prenatal appointments (OR 3.34; CI 95% 1.28–8.73; p = 0.014) and prematurity (OR 3.60; CI 95% 1.87–7.11; p = < 0.001). Conclusion The high rate of neonatal death in Foz do Iguassu is strongly associated with newborn characteristics and not associated with maternal sociodemographic characteristics. Thus, the health services in the Brazilian side of this international borders should be aware of the quality of the prenatal care and childbirth attention provided.

Neonatal mortality: morbidity pattern and risk factors in a resource-limited centre in North Central Nigeria

“…In a study by Debelew GT, et al carried out in North Gondar Zone in Northwest Ethiopia, low birth weight, lack of formal education in mothers (a reflection of low social class), neonatal illnesses, and maternal illnesses were found to be associated with neonatal death 33 . The present study did not consider maternal illness as a risk factor for neonatal mortality and other studies also have not found maternal illnesses to be a risk factor for neonatal mortality 34,35 .…”

Neonatal Mortality is Modulated by Gestational Age, Birthweight and Fetal Heart Rate Abnormalities in the Low Resource Setting in Tanzania – a Five Year Review 2015-2019

“…First, we did not example the contribution of antenatal factors, which have been found in other studies to contribute to NM. 10,11,13,14 In this regard it is notable that a maternal referral was associated with a 1.7 fold increased likelihood of death. Second, the report represents a single center, and the ndings may not be generalizable to other regions of Tanzania, or other low resource countries.…”

“…There are data to indicate that NM is strongly in uenced by GA and/or birth weight (BW) as well as variables during labor and the delivery room. [10][11][12][13][14][15][16][17][18] Moreover many of the prior studies have not examined NM as a function of time. This is relevant to KCMC, since a premature care bundle was introduced in that institution in 2015 and completed in 2017.…”

Spatial Analysis of Antenatal Care and Low Birth Weight against Neonatal Mortality Rate in Aceh Province, Indonesia

“…Similarly, the four-time ANC was the lowest at 64% in Pidie, but the highest (96%) in Banda Aceh. When examining neonatal mortality rate against four-time ANC at the district level, it shows the negative correlation, indicating the higher percent of antenatal care, the lower neonatal mortality rate, but it was not statistically significant, rs ( 21 ) = − 0.35, P =0.09. Descriptive thematic map demonstrates variations in neonatal mortality rate and ANC across the districts in Aceh province.…”