Neonatal mortality in intensive care units of central Brazil
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Data
2005
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Resumo
Objective: To identify potential prognostic factors for neonatal mortality among newborns referred
to intensive care units.
Methods: A live-birth cohort study was carried out in Goiânia, Central Brazil, from November
1999 to October 2000. Linked birth and infant death certificates were used to ascertain
the cohort of live born infants. An additional active surveillance system of neonatalbased
mortality was implemented. Exposure variables were collected from birth and
death certificates. The outcome was survivors (n=713) and deaths (n=162) in all intensive
care units in the study period. Cox’s proportional hazards model was applied and a
Receiver Operating Characteristic curve was used to compare the performance of
statistically significant variables in the multivariable model. Adjusted mortality rates by
birth weight and 5-min Apgar score were calculated for each intensive care unit.
Results: Low birth weight and 5-min Apgar score remained independently associated to death.
Birth weight equal to 2,500g had 0.71 accuracy (95% CI: 0.65-0.77) for predicting
neonatal death (sensitivity =72.2%). A wide variation in the mortality rates was found
among intensive care units (9.5-48.1%) and two of them remained with significant
high mortality rates even after adjusting for birth weight and 5-min Apgar score.
Conclusions
This study corroborates birth weight as a sensitive screening variable in surveillance
programs for neonatal death and also to target intensive care units with high mortality
rates for implementing preventive actions and interventions during the delivery period.
Descrição
Palavras-chave
Infant mortality, Intensive care units neonatal, Infant, Low birth weight, Information systems, Mortality rate, Mortalidade infantil, Unidades de terapia intensiva neonatal, Recém nascido de baixo peso, Sistemas de informação, Coeficiente de mortalidade
Citação
WEIRICH, Claci Fátima et al. Neonatal mortality in intensive care units of central Brazil. Revista de Saúde Pública, São Paulo, v. 39, n. 5, p. 775-781, 2005.