Ferrari Rosângela Aparecida Pimenta, Bertolozzi Maria Rita, Dalmas José Carlos, Girotto Edmarlon
Programa de Pós-Graduato da Escola de Enfermagem da Universidade de São Paulo, São Paulo, SP, Brasil.
Departamento de Enfermagem em Saude Coletiva da Escola de Enfermagem da Universidade de São Paulo, São Paulo, SP, Brasil.
Rev Esc Enferm USP. 2013 Jun;47(3):531-8. doi: 10.1590/s0080-623420130000300002.
This is an ecological quantitative study to identify risk factors that determined neonatal death between the years of 2000 to 2009 in Londrina, Paraná, using data from Birth Certificates, Death Certificates and Infant Death Investigation Forms. The variables maternal age, years of education, family income, occupation, marital status, type of delivery, and number of prenatal appointments were not associated to neonatal death. To the contrary, birth weight, gestational age, Apgar score at 1 and 5 minutes, and place of birth were identified as statistically significant variables. More than 73.0% of newborns died within early neonatal period. The predominant basic cause of death was perinatal problems (77.7%), 72.6% of which were preventable, and the majority of which could be reduced with adequate control over pregnancy/birth. These results highlight the need for investments in prevention of premature delivery by improvement of health care in prenatal and birth periods, in an equanimous, accessible and comprehensive manner in all levels of maternal and child health care.
这是一项生态定量研究,利用出生证明、死亡证明和婴儿死亡调查报告的数据,确定2000年至2009年期间巴拉那州隆德里纳市新生儿死亡的风险因素。产妇年龄、受教育年限、家庭收入、职业、婚姻状况、分娩类型和产前检查次数等变量与新生儿死亡无关。相反,出生体重、孕周、1分钟和5分钟时的阿氏评分以及出生地点被确定为具有统计学意义的变量。超过73.0%的新生儿在早期新生儿期死亡。主要的基本死亡原因是围产期问题(77.7%),其中72.6%是可预防的,而且通过对妊娠/分娩进行适当控制,大多数问题是可以减少的。这些结果凸显了需要通过在各级母婴保健中以公平、可及和全面的方式改善产前和分娩期的医疗保健,来投资预防早产。