Factors associated with neonatal-near miss: birth cohorts in three Brazilian cities - Ribeirão Preto, Pelotas and São Luís, Brazil

Abstract

The aim of this study was to investigate the association of sociodemographic factors, lifestyle, maternal reproductive profile and prenatal and childbirth care with neonatal near miss (NNM) morbidity in four birth cohorts. This study involved four population-based birth cohorts: Ribeirão Preto (RP) and São Luís (SL) (2010), Pelotas 2004 (PEL04) and 2015 (PEL15). NNM was defined when one or more of the following conditions were present: birthweight <1,500 g, 5-minute Apgar score <7, gestational age <32 weeks, and report of congenital malformations. The covariates were obtained with questionnaires applied to the puerperal women. Some particularities between cohorts were identified. In the RP and SL cohorts, factors of the more distal levels (sociodemographic, lifestyle, and reproductive profile) were associated with NNM. On the other hand, proximal factors related to healthcare were more significant for the occurrence of NNM in PEL. Only the absence of prenatal care was associated with NNM in all cohorts: RP (OR=4.27, 95%CI 2.16-8.45), SL (OR=2.32, 95%CI 1.09-4.94), PEL04 (OR=4.79, 95%CI 1.59-14.46), and PEL15 (OR=5.10, 95%CI 2.60-9.97).

Association between neonatal near miss and infant development: the Ribeirão Preto and São Luís birth cohorts (BRISA)

“…Although the present results corroborate those of previous studies that did not find disparities in the frequency of NNM between different regions of Brazil [5], the factors associated with the occurrence of NNM can vary according to region [6,26]. Rocha et al (2022) showed that a low maternal educational level, living without a companion, gestational hypertension, smoking during pregnancy, and cesarean delivery were associated with NNM in RP but not in SL [27]. Thus, the particularities of each location tend to lead to the formation of NNM groups with different characteristics, a fact that would explain different outcomes in the developmental domains.…”

“…Exposure to alcohol and/or tobacco during pregnancy [28][29][30], cesarean delivery [27], high blood pressure [31], and gestational diabetes [32] are generally associated with long-term developmental delays [28]. Furthermore, cesarean delivery has been associated with changes in the intestinal microbiota, which plays an important role in child development and behavior [33][34][35].…”

Fatores De Risco Associados À Mortalidade Infantil No Brasil: Revisão Integrativa

“…Além disso, crianças nascidas de mães que não fizeram pelo menos seis consultas pré-natais tiveram uma probabilidade significativamente maior de óbito perinatal, assim como gestações múltiplas. A presença de malformações congênitas, partos prematuros e baixo peso ao nascer (BPN) também foi associada a um maior risco de óbito perinatal (MOURA et al, 2020;SERRA et al, 2022) De acordo com a pesquisa conduzida por Rocha et al (2022), foi constatado que a cor da pele categorizada como preta ou parda, a ausência de um parceiro, o hábito de fumar durante a gravidez, a ocorrência de hipertensão gestacional e fatores de saúde (especialmente a falta de realização de consultas pré-natais) estão associados a um aumento nas probabilidades de nascimento de muito baixo peso e, consequente, morte perinatal. Para além disso, é crucial implementar estratégias que promovam melhorias nas condições sociais, visando a redução das desigualdades sociais existentes.…”