Probabilidade de morte infantil e fatores associados no município de Aparecida de Goiânia, Goiás, Brasil
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2020-03-05
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Universidade Federal de Goiás
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Childhood is a phase of life in which the human being is fragile, dependent and requires special care. Policies that prioritize childcare are often consensus policies. In recent years, infant mortality (up to 1 year of life) represents approximately 86% of under-five deaths (childhood mortality) in Brazil and still has a high percentile of preventable causes, indicating that there are still spaces for its reduction. The objective of this study was to investigate risk factors for neonatal and post-neonatal mortality in the city of Aparecida de Goiânia, Goiás. The study population consisted of a cohort of 8,145 live births of mothers residing in Aparecida de Goiânia in the year of 2012. The Birthdate Declaration of the Live Birth Information System (Sinasc) was used as data source; and the Death Certificate of the Mortality Information System (SIM), as well as the Child Death Investigation Cards. A linkage procedure was performed between the databases to identify the selected variables and the construction of the indicators for estimating the magnitude of the outcomes that were the probability of death in the neonatal and post-neonatal periods. The odds of death in both periods were equal to 9.94 and 3.68 per thousand live births, respectively. The main causes of infant death were diseases originating in the perinatal period (65.8%), followed by congenital malformations (23.4%) and respiratory diseases (4.5%). Hierarchical logistic regression analysis was performed to evaluate the association of infant death with study variables. Factors associated with neonatal death were: male gender (OR = 2.48; 95% CI: 1.24-4.96), low birth weight (<1500g: OR = 557.26; 95% CI: 239.59- 1296.11; 1500g to 2499g: OR = 16.75; 95% CI: 7.35-38.17), prematurity (20 to 32 weeks: OR = 99.19; 95% CI: 46.55-211.33) ; 33 to 36 weeks: OR = 6.68; 95% CI: 2.57-17.35), low maternal education (up to complete elementary school: OR = 0.32; 95% CI: 0.10-0.97; Complete high school: OR = 0.32; 95% CI: 0.11-0.89) and yellow and indigenous race / color (OR = 10.56; 95% CI: 1.02 - 109.08). For the post-neonatal period, low weight (<1500g: OR = 29.55; 95% CI: 8.22-106.26; 1500g to 2499g: OR = 7.39; 95% CI: 3.23- 16.93) and prematurity between 20 and 32 weeks (OR = 11.35; 95% CI: 3.50-36.84). The challenge of reducing infant deaths in the municipality encompasses the need for improvements in access, especially in the quality of maternal and child health services and the demand for public policies aimed at reducing socioeconomic inequalities. This work allowed the identification of factors associated with infant mortality in the municipality of Aparecida de Goiânia, Goiás, and may support interventions that reduce the impact of these factors during pregnancy, childbirth and after the birth of children.
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SILVA, K. M. Probabilidade de morte infantil e fatores associados no município de Aparecida de Goiânia, Goiás, Brasil. 2020. 69 f. Dissertação (Mestrado em Saúde Coletiva) - Universidade Federal de Goiás, Goiânia, 2020.