Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil.
Cad Saude Publica. 2011;27 Suppl 2:S185-97. doi: 10.1590/s0102-311x2011001400007.
Avoidable deaths have been employed as indicators of health care quality. The aim of this study was to identify factors associated with avoidable deaths from birth to four years of age among children from the 2004 Pelotas (Brazil) birth cohort study. From January 1st, 2004, to December 31st, 2005, deaths were monitored on a daily basis and the causes were investigated and classified according to avoidability. After the first year, deaths were monitored through the Mortality Information System. A total of 94 children died during this period. It was possible to classify 92 deaths, 70 of which were preventable. Low family income, fewer prenatal visits and poor-quality prenatal care, preterm birth, low 5-minute Apgar score, and no breastfeeding in the first 24 hours of life were associated with increased risk of death. Prematurity was present in 39 deaths, but only five of these would have been prevented by measures provided during prenatal care. Although limited, compliance with antenatal care program guidelines is still the most important strategy for preventing avoidable deaths in childhood, particularly among the poorest children.
可避免死亡已被用作医疗保健质量的指标。本研究旨在确定与 2004 年佩洛塔斯（巴西）出生队列研究中 4 岁以下儿童可避免死亡相关的因素。从 2004 年 1 月 1 日至 2005 年 12 月 31 日，每天监测死亡情况，并根据可避免性对死因进行调查和分类。在第一年之后，通过死亡率信息系统监测死亡情况。在此期间，共有 94 名儿童死亡。其中 92 例死亡可以分类，其中 70 例是可预防的。家庭收入低、产前检查次数少且质量差、早产、出生后 5 分钟阿普加评分低以及出生后 24 小时内未进行母乳喂养与死亡风险增加有关。39 例死亡与早产有关，但只有 5 例可以通过产前护理提供的措施预防。尽管有限，但遵守产前保健计划指南仍然是预防儿童可避免死亡的最重要策略，特别是对最贫困的儿童。
