Fonseca Sandra Costa, Flores Patricia Viana Guimarães, Camargo Kenneth Rochel, Pinheiro Rejane Sobrino, Coeli Claudia Medina
Departamento de Epidemiologia e Bioestatística . Instituto de Saúde Coletiva . Universidade Federal Fluminense . Niterói , RJ , Brasil.
Programa de Pós-Graduação em Saúde Coletiva. Instituto de Estudos em Saúde Coletiva . Universidade Federal do Rio de Janeiro . Rio de Janeiro , RJ , Brasil.
Rev Saude Publica. 2017 Nov 17;51:94. doi: 10.11606/S1518-8787.2017051007013.
Evaluate the interaction between maternal age and education level in neonatal mortality, as well as investigate the temporal evolution of neonatal mortality in each stratum formed by the combination of these two risk factors.
A nonconcurrent cohort study, resulting from a probabilistic relationship between the Mortality Information System and the Live Birth Information System. To investigate the risk of neonatal death we performed a logistic regression, with an odds ratio estimate for the combined variable of maternal education and age, as well as the evaluation of additive and multiplicative interaction. The neonatal mortality rate time series, according to maternal education and age, was estimated by the Joinpoint Regression program.
The neonatal mortality rate in the period was 8.09‰ and it was higher in newborns of mothers with low education levels: 12.7‰ (adolescent mothers) and 12.4‰ (mother 35 years old or older). Low level of education, without the age effect, increased the chance of neonatal death by 25% (OR = 1.25, 95%CI 1.14-1.36). The isolated effect of age on neonatal death was higher for adolescent mothers (OR = 1.39, 95%CI 1.33-1.46) than for mothers aged ≥ 35 years (OR = 1.16, 95%CI 1.09-1.23). In the time-trend analysis, no age group of women with low education levels presented a reduction in the neonatal mortality rate for the period, as opposed to women with intermediate or high levels of education, where the reduction was significant, around 4% annually.
Two more vulnerable groups - adolescents with low levels of education and older women with low levels of education - were identified in relation to the risk of neonatal death and inequality in reducing the mortality rate.
评估产妇年龄与教育水平在新生儿死亡率方面的相互作用，并研究由这两个风险因素组合形成的各阶层中新生儿死亡率的时间演变情况。
一项非同期队列研究，源于死亡率信息系统与活产信息系统之间的概率关系。为调查新生儿死亡风险，我们进行了逻辑回归，对产妇教育程度和年龄的组合变量进行比值比估计，并评估相加和相乘相互作用。根据产妇教育程度和年龄，通过Joinpoint回归程序估计新生儿死亡率时间序列。
该时期新生儿死亡率为8.09‰，教育水平低的母亲所生新生儿的死亡率更高：12.7‰（青少年母亲）和12.4‰（35岁及以上母亲）。教育水平低，在不考虑年龄影响的情况下，新生儿死亡几率增加25%（比值比=1.25，95%置信区间1.14 - 1.36）。年龄对新生儿死亡的单独影响在青少年母亲中（比值比=1.
