Alves Jakeline Barbara, Gabani Flávia Lopes, Ferrari Rosângela Aparecida Pimenta, Tacla Mauren Teresa Grubisich Mendes, Linck Júnior Arnildo
Universidade Estadual de Londrina, Londrina, PR, Brasil.
Rev Paul Pediatr. 2018 Apr-Jun;36(2):132-140. doi: 10.1590/1984-0462/;2018;36;2;00001. Epub 2018 Jan 8.
To describe the neonatal mortality coefficient attributed to sepsis and other causes, and to report the maternal, neonatal and death characteristics of newborn infants that died in the city of Londrina, Paraná, in Southern Brazil.
This is a cross-sectional study with a time series analysis. Neonatal deaths that contained neonatal sepsis records in any field of the death certificate between the years 2000 and 2013 were studied. The years were grouped into biennia, and cause specific neonatal mortality coefficient was calculated, according to the International Classification of Diseases, 10th revision. Results are expressed as prevalence ratio and 95% confidence interval (95CI%). For bivariate analysis, p<0.05 was considered significant.
Among the 745 deaths, 229 (30.7%) had sepsis, with a neonatal mortality coefficient of 7.5 per one thousand livebirths. Sepsis was involved in 2.3 deaths per 1,000 live births. The main underlying causes were conditions originated in the perinatal period and congenital malformations. Sepsis was associated with pre-eclampsia, urinary tract infection, Apgar in the 1st and 5th minutes, and occurrence of late death. In the descriptive trend analysis, there was an increased proportion of mothers aged 35 years or older and with eight or more schooling years. Prenatal coverage was high, but a little more than half of the mothers attended seven or more medical appointments.
In the 14 years analyzed, the prenatal care was identified as a preventive measure against maternal and fetal disorders and the advanced maternal age was associated with neonatal mortality.
描述败血症及其他原因导致的新生儿死亡系数,并报告巴西南部巴拉那州隆德里纳市新生儿死亡的母亲、新生儿及死亡特征。
这是一项采用时间序列分析的横断面研究。研究了2000年至2013年间死亡证明任何字段中包含新生儿败血症记录的新生儿死亡情况。将年份分为两年一组,并根据国际疾病分类第十版计算特定原因的新生儿死亡系数。结果以患病率比值和95%置信区间(95CI%)表示。对于双变量分析,p<0.05被认为具有统计学意义。
在745例死亡中,229例(30.7%)患有败血症,新生儿死亡系数为每千例活产7.5例。败血症导致每1000例活产中有2.3例死亡。主要潜在原因是围生期起源的疾病和先天性畸形。败血症与子痫前期、尿路感染、第1分钟和第5分钟的阿氏评分以及晚期死亡的发生有关。在描述性趋势分析中,35岁及以上且受教育年限为8年或以上的母亲比例有所增加。产前检查覆盖率很高,但略多于一半的母亲进行了7次或更多次产检。
在分析的14年中,产前护理被确定为预防母婴疾病的措施,高龄产妇与新生儿死亡率相关。