Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Rua General Osório 1227, Pelotas, RS, Brazil.
Rev Saude Publica. 2011 Apr;45(2):334-42. doi: 10.1590/s0034-89102011005000013. Epub 2011 Feb 25.
To describe avoidable deaths of children from the 2004 Pelotas Birth Cohort.
The death of 92 children between 2004/2008 from Pelotas Birth Cohort were identified and classified according to the Brazilian List of Avoidable Causes of Mortality of Brazilian Unified Healthcare System. The Mortality Information System (SIM) for the State of Rio Grande do Sul (Southern Brazil) and the city of Pelotas were screened to search for deaths that occurred outside the city, as well as causes of deaths after the 1st year. Causes of infant deaths (<1 year of age) were compared between information from a sub-study and SIM. Mortality coefficients per 1,000 LB and proportional mortality for avoidable causes, including by type of health facility (traditional or Family Health Strategy) were calculated.
The mortality coefficient was 22.2/ 1,000 LB, 82 the deaths occurred in the first year of life (19.4/1,000LB), and these included 37 (45%) in the first week. More than ¾ of the deaths (70/92) were avoidable. In infancy, according to the sub-study, the majority (42/82) could be prevented through adequate care of the woman during pregnancy; according to SIM, the majority could have been prevented through adequate newborn care (32/82). There was no difference in the proportion of avoidable deaths by type of health facility.
The proportion of avoidable deaths is high. The quality of death certificate registries needs improvement so that avoidable deaths can be employed as an indicator to monitor maternal and child health care.
描述 2004 年佩洛塔斯出生队列中儿童的可避免死亡情况。
确定并根据巴西统一医疗保健系统的可避免死因清单对佩洛塔斯出生队列中 2004/2008 年期间的 92 名儿童死亡进行分类。筛选巴西南里奥格兰德州(南里奥格兰德州)的死亡率信息系统(SIM)和佩洛塔斯市的死亡率信息系统,以寻找发生在城市之外的死亡情况以及 1 岁以后的死亡原因。比较了子研究和 SIM 中婴儿死亡(<1 岁)的原因。计算了每 1000LB 的死亡率系数和可避免死因的比例死亡率,包括按医疗机构类型(传统或家庭健康战略)。
死亡率系数为 22.2/1000LB,82 例死亡发生在生命的第一年(19.4/1000LB),其中 37 例(45%)发生在第一周。超过 7/10(70/92)的死亡是可以避免的。在婴儿期,根据子研究,大多数(42/82)可以通过妇女在怀孕期间得到适当的护理来预防;根据 SIM,大多数可以通过适当的新生儿护理来预防(32/82)。不同类型医疗机构的可避免死亡比例没有差异。
可避免死亡的比例很高。需要提高死亡证明登记的质量,以便将可避免的死亡作为监测母婴保健的指标。