de Souza R K, Gotlieb S L
Departamento de Enfermagem, Fundação Universidade Estadual de Maringá, PR - Brasil.
Rev Saude Publica. 1993 Dec;27(6):445-54. doi: 10.1590/s0034-89101993000600007.
A birth-cohort of 4,876 children born alive in hospital were selected and followed through up to the age of one year with a view to estimating the risk of dying in the first year of life. All of them were born in 1989, in one of the seven hospitals of an urban area of Southern Brazil and the only requirement for belonging to the cohort was that of residence on the area. The selected variables were: sex, birthweight, age at moment of death, underlying cause of death, and maternal age. The estimated probability of dying in the first year was of 19.9 per 1,000 (77.3% of the deaths occurred during the neonatal period). Perinatal causes and congenital malformations contributed to 80% of the deaths, and infectious diseases were the underlying cause of death in only 1.1% of the losses. The risk of dying in the first year of life due to afections arising during the perinatal period was higher among vaginally delivered babies (20.3 per 1,000) than it was for those born by cesarean section (9 per 1,000). A higher probability of death was present among infants born to adolescent mothers, and those with low birthweight (less than 2,500g). The results brought out the need for improving the quality of prenatal and infant care. They also suggested the hypothesis of a possible association between higher infant mortality and lower socio-economic level.
选取了4876名在医院出生的活产儿童组成一个出生队列,并对他们进行追踪,直至一岁,以评估一岁前的死亡风险。他们均于1989年出生在巴西南部一个市区的七家医院之一,入选该队列的唯一要求是居住在该地区。选取的变量有:性别、出生体重、死亡时年龄、死亡根本原因和母亲年龄。估计一岁内的死亡概率为每1000人中有19.9人(77.3%的死亡发生在新生儿期)。围产期原因和先天性畸形占死亡原因的80%,传染病仅占死亡原因的1.1%。围产期发生的感染导致一岁内死亡的风险在阴道分娩婴儿中(每1000人中有20.3人)高于剖宫产出生的婴儿(每1000人中有9人)。青少年母亲所生婴儿以及低体重(低于2500克)婴儿的死亡概率更高。结果表明需要提高产前和婴儿护理质量。它们还提出了婴儿死亡率较高与社会经济水平较低之间可能存在关联的假设。