Silva Maria Luiza Melo da, Oliveira Natan Nascimento de, Ferdin Andreia, Galdino Maria José Quina, Melo Emiliana Cristina, Oliveira Rosana Rosseto de
Universidade Estadual de Maringá - Maringá (PR), Brazil.
Universidade Estadual do Norte do Paraná - Bandeirantes (PR), Brazil.
Rev Bras Epidemiol. 2025 May 9;28:e250023. doi: 10.1590/1980-549720250023. eCollection 2025.
To analyze the spatial distribution of neonatal near miss and socioeconomic and healthcare indicators in the state of Paraná.
Ecological, cross-sectional study of neonatal near miss rates in municipalities in the state of Paraná, from 2020 to 2022, obtained through data from the Live Birth Information System (SINASC) and the Mortality Information System (SIM), connected through deterministic linkage. The spatial distribution of neonatal near miss rates, socioeconomic indicators (maternal age and race/ethnicity), and healthcare indicators (type of delivery and number of prenatal consultations) were performed. Global and Local Moran's Index were used for spatial analysis.
The neonatal near miss rate in Paraná was 28.46 per thousand live births. Health regions (HR) 4th HR - Irati, 3rd HR - Ponta Grossa, 6th HR - União da Vitória, and 17th HR - Londrina stood out with high rates of neonatal near miss. Concerning the indicators, significant rates were evident among women of black, yellow, and indigenous race/color, as well as inadequacies in prenatal.
The results highlight priorities in the Eastern and Northern macro-regions, where high-high clusters indicate an urgent need to assess access and quality of care. Additionally, there is a need to investigate neonatal near miss in Black, Yellow, and Indigenous women, as well as low prenatal adherence or coverage.
分析巴拉那州新生儿危殆情况的空间分布以及社会经济和医疗保健指标。
对巴拉那州各市2020年至2022年的新生儿危殆率进行生态横断面研究，数据通过活产信息系统（SINASC）和死亡信息系统（SIM）获取，并通过确定性链接进行关联。对新生儿危殆率、社会经济指标（产妇年龄和种族/族裔）以及医疗保健指标（分娩类型和产前检查次数）进行空间分布分析。使用全局和局部莫兰指数进行空间分析。
巴拉那州的新生儿危殆率为每千例活产28.46例。第4个卫生区域——伊拉蒂、第3个卫生区域——庞塔格罗萨、第6个卫生区域——维多利亚联盟和第17个卫生区域——隆德里纳的新生儿危殆率较高。关于各项指标，黑人、黄种人和原住民种族/肤色的女性以及产前检查不足的情况发生率显著。
结果突出了东部和北部宏观区域的优先事项，其中高高聚集表明迫切需要评估医疗服务的可及性和质量。此外，有必要调查黑人、黄种人和原住民女性的新生儿危殆情况，以及产前检查依从性或覆盖率低的问题。
