Infant mortality due to perinatal causes in Brazil: trends, regional patterns and possible interventions

Abstract

RESULTS:The indirect infant mortality rate estimate for 1995-97 is of 37.5 deaths per thousand live births, about six times higher than in the lowest mortality countries in the world. Perinatal causes account for 57% of all infant deaths, and congenital malformations are responsible for 11.2% of these deaths. Mortality levels are highest in the Northeast and North, and lowest in the South and Southeast; the Center-West falls in between. Since surveys of the North region do not cover rural areas, mortality for this region may be underestimated. CONCLUSIONS:A first priority for the further reduction in infant mortality in Brazil is to improve equality among regions, since the North and Northeast, and particularly rural areas, still show very high death rates. Further reductions in infant mortality will largely depend on decreasing deaths due to perinatal causes. Improvements in the coverage and particularly in the quality of antenatal and delivery care are urgently needed. Another intervention with a potential important impact on infant mortality is the promotion of family planning. Improving birth weight might lead to an 8% reduction in infant mortality but the efficacy of available interventions is low.

A populational based study on the prevalence of neonatal near miss in a city located in the South of Brazil: prevalence and associated factors

“…Although it is reported as inaccuracy in the registration, those considered severe tend to be registered in greater frequency and appear to be the important cause of neonatal death, especially in more developed regions, in which the avoidable deaths have already been controlled. 17,18 Moreover, in Joinville, it is possible to have better registration of this information, due to routinely audits in the SINASC databank and the educational actions carried out annually by the city service on epidemiological surveillance.…”

Impacto das malformações congênitas na mortalidade perinatal e neonatal em uma maternidade-escola do Recife

“…Em 1997, os defeitos cardiovasculares responderam por 39,4% de todas as mortes infantis por malformação, seguindose os defeitos do sistema nervoso (18,8%). 9 A associação das malformações congênitas com a mortalidade perinatal constitui também uma preocupação atual, uma vez que as malformações associam-se com óbitos fetais e durante o primeiro mês de vida. Na verdade, as malformações representam em algumas regiões do mundo a primeira causa de óbitos neonatais, respondendo por 25% das mortes neste período, superando a prematuridade (associada com 20% dos óbitos).…”

Mortalidade hospitalar dos recém-nascidos com peso de nascimento menor ou igual a 1.500 g no município de Fortaleza

“…In the more developed regions of Brazil, the decline in neonatal mortality has taken place slowly, tending towards stability, although levels remain elevated; 1 in the Northeast, this decline has proceeded more slowly, comparatively. 2 it is important to emphasize that mortality rates are related to the three sets of factors: the biological characteristics of the mother, the socioeconomic conditions of the family, and the availability and quality of perinatal medical care. 3 In the state of Ceará, transformation is in the healthcare sector have contributed significantly to a reduction in infant mortality of approximately 50.%.…”