Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil.
Universidade Federal do Espírito Santo, São Matheus, Brasil.
Cad Saude Publica. 2019 Aug 12;35(7):e00072918. doi: 10.1590/0102-311X00072918.
This study aimed to describe fetal, neonatal, and post-neonatal mortality and associated factors in participants of the 2015 Pelotas (Brazil) birth cohort. The child mortality sub-study followed up all deaths in the first year of life. Data were collected on intrauterine fetal deaths (weight ≥ 500g and/or gestational age ≥ 20 weeks), neonatal deaths (< 28 days of life), and post-neonatal deaths (from 28 days to the end of the first year of life). Descriptive analyses using the Pearson chi-square test and a multinomial logistic regression to estimate the risk of fetal, neonatal, and post-neonatal deaths compared to live infants in the cohort (reference group) were performed. Data from 4,329 eligible births were collected, of which 54 died during the fetal period. Of the 4,275 eligible live births, 59 died in the first year of life. An association between fetal, neonatal, and post-neonatal deaths (OR = 15.60, 7.63, and 5.51 respectively) was found, as well as less than six prenatal consultations. Compared to live infants, fetal deaths were more likely to occur in non-white mothers, and neonatal deaths were 14.09 times more likely to occur in a preterm gestational age (< 37 weeks). Compared to live infants, infants that were born in a C-section delivery had 3.71 increased odds of post-neonatal death. Additionally, neonatal deaths were 102.37 times more likely to have a low Apgar score on the fifth minute after birth. These findings show the need for early interventions during pregnancy, ensuring access to adequate prenatal care.
本研究旨在描述 2015 年佩洛塔斯（巴西）出生队列参与者的胎儿、新生儿和婴儿后期死亡及其相关因素。儿童死亡率子研究对生命第一年中的所有死亡进行了随访。数据收集了宫内胎儿死亡（体重≥500 克和/或胎龄≥20 周）、新生儿死亡（<28 天）和婴儿后期死亡（从 28 天到生命第一年结束）。使用 Pearson 卡方检验和多项逻辑回归进行描述性分析，以估计与队列中活产儿（参考组）相比，胎儿、新生儿和婴儿后期死亡的风险。共收集了 4329 名合格出生的婴儿的数据，其中 54 名在胎儿期死亡。在 4275 名合格的活产儿中，有 59 名在生命的第一年死亡。发现胎儿、新生儿和婴儿后期死亡之间存在关联（OR 分别为 15.60、7.63 和 5.51），以及产前检查次数少于 6 次。与活产儿相比，胎儿死亡更可能发生在非白人母亲中，而新生儿死亡更可能发生在早产（<37 周）的情况下，其风险是活产儿的 14.09 倍。与活产儿相比，剖宫产分娩的婴儿有 3.71 倍的可能性在出生后第五分钟出现低 Apgar 评分。这些发现表明需要在怀孕期间进行早期干预，确保获得充足的产前保健。
