Silva Antônio Augusto Moura da, Leite Alvaro Jorge Madeiro, Lamy Zeni Carvalho, Moreira Maria Elisabeth Lopes, Gurgel Ricardo Queiroz, Cunha Antonio José Ledo Alves da, Leal Maria do Carmo
Centro de Ciências da Saúde, Universidade Federal do Maranhão, São Luis, Brasil.
Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Brasil.
Cad Saude Publica. 2014 Aug;30 Suppl 1:S1-10. doi: 10.1590/0102-311x00129613.
This study used data from the Birth in Brazil survey, a nationwide hospital-based study of 24,197 postpartum women and their newborns, collected between February 2011 and July 2012. A three-stage cluster sampling design (hospitals, days, women) was used consisting of stratification by geographic region, type of municipality (capital or non-capital), and type of hospital financing. Logistic regression was used to identify variables that were potential predictors of neonatal mortality and neonatal near miss indicators. After testing nineteen variables, five were chosen to compose a set of neonatal near miss indicators (birth weight of less than 1,500 g, Apgar score of less than 7 in the 5th minute of life, use of mechanical ventilation, gestational age of less than 32 weeks and congenital malformations). The neonatal near miss rate in the Birth in Brazil survey was 39.2 per thousand live births, three and a half times higher than the neonatal mortality rate (11.1 per thousand). These neonatal near miss indicators were able to identify situations with a high risk of neonatal death.
本研究使用了巴西出生情况调查的数据，这是一项基于医院的全国性研究，对2011年2月至2012年7月期间的24197名产后妇女及其新生儿进行了调查。采用了三阶段整群抽样设计（医院、日期、妇女），包括按地理区域、城市类型（首府或非首府）和医院融资类型进行分层。使用逻辑回归来确定作为新生儿死亡率和新生儿接近死亡指标潜在预测因素的变量。在对19个变量进行测试后，选择了5个变量组成一组新生儿接近死亡指标（出生体重低于1500克、出生后第5分钟阿氏评分低于7分、使用机械通气、胎龄小于32周和先天性畸形）。巴西出生情况调查中的新生儿接近死亡率为每千例活产39.2例，比新生儿死亡率（每千例11.1例）高出三倍半。这些新生儿接近死亡指标能够识别出新生儿死亡风险高的情况。
