Zanini Roselaine Ruviaro, Moraes Anaelena Bragança de, Giugliani Elsa Regina Justo, Riboldi João
Departamento de Estatística, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, Brasil.
Cad Saude Publica. 2009 May;25(5):1035-45. doi: 10.1590/s0102-311x2009000500010.
The aim of this study was to analyze the trend in infant mortality rates in the State of Rio Grande do Sul, Brazil, from 1994 to 2004, in a longitudinal ecological study, by means of panel data analysis and multilevel linear regression (two levels: microregion and time) to estimate factors associated with infant mortality. The infant mortality rate decreased from 19.2 per thousand (1994) to 13.7 per thousand (2004) live births, and the principal causes of death in the last five years were perinatal conditions (54.1%). Approximately 47% of the variation in mortality occurred in the microregions, and a 10% increase in coverage by the Family Health Program was associated with a 1 per thousand reduction in infant mortality. A 10% increase in the poverty rate was associated with a 2.1 per thousand increase in infant deaths. Infant mortality was positively associated with the proportion of low birthweight newborns and the number of hospital beds per thousand inhabitants and negatively associated with the cesarean rate and number of hospitals per 100 thousand inhabitants. The findings suggest that individual and community variables display significant effects on the reduction of infant mortality rates.
本研究旨在通过面板数据分析和多级线性回归（两个层次：微观区域和时间），在一项纵向生态研究中分析1994年至2004年巴西南里奥格兰德州婴儿死亡率的趋势，以估计与婴儿死亡率相关的因素。婴儿死亡率从每千例活产19.2例（1994年）降至每千例活产13.7例（2004年），过去五年的主要死亡原因是围产期状况（54.1%）。约47%的死亡率差异发生在微观区域，家庭健康计划覆盖率提高10%与婴儿死亡率每千例降低1例相关。贫困率提高10%与婴儿死亡数每千例增加2.1例相关。婴儿死亡率与低体重新生儿比例和每千名居民的医院床位数呈正相关，与剖宫产率和每十万居民的医院数量呈负相关。研究结果表明，个体和社区变量对降低婴儿死亡率具有显著影响。
