Secretaria de Estado da Saúde. Coordenadoria de Regiões de Saúde/Atenção Básica. São Paulo, SP, Brasil.
Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Medicina Preventiva. São Paulo, SP, Brasil.
Rev Saude Publica. 2020 Dec 14;54:132. doi: 10.11606/s1518-8787.2020054002309. eCollection 2020.
To analyze the trend of early neonatal infant mortality in the state of São Paulo according to preventability and region of residence.
Ecological study with secondary data from 2008 to 2017, obtained from the Sistema de Informação sobre Nascidos Vivos (Sinasc - Live Birth Information System) and the Sistema de Informação sobre Mortalidade (SIM - Mortality Information System). The causes of death were classified according to preventability groups, and the annual percentage changes in the death rates of each preventability group were estimated using the Joinpoint software.
The early neonatal component showed a reduction trend with an annual percentage change of -1.18 (95%CI -1.63 to -0.72), less pronounced than the other age components of infant mortality. In the analysis according to preventability, the causes reducible by attention to the woman during pregnancy and those reducible by attention to the fetus and the newborn presented annual percentage change of -1.03 (95%CI: -1.92 to -0.13) and -2.6 (95%CI: -4.07 to -1.11), respectively. In the causes reducible by attention to women during delivery, no reduction trend was observed. Regional discrepancies occurred in the variation of early neonatal infant mortality rates according to type of preventability.
Mortality up to the 6th day of life presented greater difficulty of reduction when compared with the other age components. The absence of a reduction trend in preventable deaths due to the attention to women during delivery points to possible fragility in the attention to delivery.
根据可预防程度和居住地区分析圣保罗州早期新生儿婴儿死亡率的趋势。
这是一项生态研究,使用了 2008 年至 2017 年的次级数据,这些数据来自 Sistema de Informação sobre Nascidos Vivos(Sinasc-活产信息系统)和 Sistema de Informação sobre Mortalidade(SIM-死亡率信息系统)。死因按可预防类别进行分类,并使用 Joinpoint 软件估计每个可预防类别死亡率的年变化百分比。
早期新生儿部分呈下降趋势,年变化百分比为-1.18(95%CI-1.63 至-0.72),这一趋势弱于婴儿死亡率的其他年龄组成部分。在根据可预防程度进行的分析中,可通过关注孕妇、胎儿和新生儿来减少的原因的年变化百分比分别为-1.03(95%CI:-1.92 至-0.13)和-2.6(95%CI:-4.07 至-1.11)。在可通过分娩时关注妇女来减少的原因中,未观察到下降趋势。根据可预防程度的不同,早期新生儿死亡率的区域差异也有所不同。
与其他年龄组成部分相比,6 天内的死亡率更难降低。由于分娩时对妇女的关注而导致的可预防死亡没有减少趋势,这表明对分娩的关注可能存在脆弱性。