Neonatal mortality in intensive care units of Central Brazil

Revista de Saúde Pública

Claci F Weirich²  Ana Lucia S S Andrade¹  Marilia Dalva Turchi¹  Simonne A Silva¹  Otaliba L Morais-neto¹  Ruth Minamisava²  Solomar M Marques¹ 

[1] ,Universidade Federal de Goiás Faculdade de Enfermagem e Nutrição Goiânia GO ,Brasil

关键词: 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;   

DOI  :  10.1590/S0034-89102005000500012

来源: SciELO

【 摘 要 】

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 neonatal-based 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.

【 授权许可】

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