Monteiro Renata Alves, Schmitz Bethsáida de Abreu Soares
Secretaria de Atenção à Saúde, Ministério da Saúde, Esplanada dos Ministérios, Brasília, DF 70058-900, Brazil.
Cad Saude Publica. 2007 Apr;23(4):767-74. doi: 10.1590/s0102-311x2007000400004.
This study examined the trend in the infant mortality rate in the Federal District of Brazil (or Greater Metropolitan Brasilia, the national capital) from 1990 to 2000, analyzing the rate according to 5 administrative areas stratified by mean family income, from 1996 to 2000. An ecological time-series study was conducted using the Information Systems on Live Births and Mortality, produced by the Brazilian Ministry of Health. The infant mortality rate (IMR) decreased by 45.2% from 1990 to 2000, from 26.3 per 1000 live births to 14.4, or a mean annual reduction of 5.34% (R(2) = 0.9397; p < 0.0001). During this period there was a higher proportion of neonatal deaths. However, a higher percentage change occurred in the post-neonatal period (-59.0%, R(2) = 0.8452, p < 0.0001). Investigation of the IMR in the various areas of the Federal District showed a reduction in differences among the regions with respect to the component rates; however, substantial disparities persisted in relation to the income variable. The results suggest the need for effective interventions in the determinants of neonatal and post-neonatal mortality in order to improve maternal and infant health in all socioeconomic groups in the Federal District.
本研究调查了1990年至2000年巴西联邦区（即巴西首都巴西利亚大都市区）的婴儿死亡率趋势，并分析了1996年至2000年按家庭平均收入分层的5个行政区的婴儿死亡率。利用巴西卫生部编制的出生和死亡信息系统进行了一项生态时间序列研究。1990年至2000年，婴儿死亡率从每1000例活产26.3例降至14.4例，下降了45.2%，平均每年下降5.34%（R² = 0.9397；p < 0.0001）。在此期间，新生儿死亡比例较高。然而，新生儿后期的百分比变化更大（-59.0%，R² = 0.8452，p < 0.0001）。对联邦区各地区婴儿死亡率的调查显示，各地区在构成率方面的差异有所减少；然而，在收入变量方面仍存在巨大差距。结果表明，有必要对新生儿和新生儿后期死亡率的决定因素采取有效干预措施，以改善联邦区所有社会经济群体的母婴健康状况。
