Maternal characteristics and the risk of neonatal mortality in Brazil between 2006 and 2016
Neonatal deaths account for more than 60% of infant deaths and are a major concern in Brazil. The reduction of the occurrence of these events appears to be more challenging than post-neonatal deaths, as such a reduction depends more on factors related to the pregnancy and childbirth than sanitary and health conditions. The aim of the present study was to evaluate the influence of maternal factors (schooling, marital status, and age) on the risk of neonatal mortality in Brazil between 2006 and 2016. Data were collected from the Brazilian Institute of Geography and Statistics as well as two information systems of the public health-care system: Mortality Information System and Live Birth Information System. The total valid sample size was 28,362,359 children. Visualization and classification methods were performed. The results revealed a considerably higher risk of neonatal deaths when the mothers were unmarried, had a low level of schooling, and were outside the 20-34-year-old age group. Different demographic profiles in Brazil exert an influence on neonatal health. The identification of the risk factors of neonatal mortality can assist in ensuring pregnancy, delivery, and a neonatal period of greater quality.
Bertoldi AD, Barros FC, Hallal PR, Mielke GI, Oliveira PD, Maia MF and Horta BL. (2019). Trends and Inequalities in Maternal and Child Health in a Brazilian City: Methodology and Sociodemographic Description of Four Population-based Birth Cohort Studies, 1982-2015. International Journal of Epidemiology, 48(S1):i4-15. DOI 10.1093/ije/dyy170.
Carvalho CA, Silva AA, Victora C, Goldani M, Bettiol H, Thomaz EB, Barros F and Menezes A. (2020). Changes in Infant and Neonatal Mortality and Associated Factors in Eight Cohorts from Three Brazilian Cities. Scientific Reports, 10(1):3249. DOI 10.1038/s41598-020-59910-7.
César CC, Ribeiro PM and Abreu DM. (2000). Efeito-idade ou Efeito-pobreza? Mães Adolescentes e Mortalidade Neonatal em Belo Horizonte. Revista Brasileira de Estudos de População, 17:177-96.
DeRose LF, Salazar-Arango A, García PC, Gas-Aixendri M and Rivera R. (2017). Maternal Union Instability and Childhood Mortality Risk in the Global South, 2010-14. Population Studies (Camb), 71(2):211-28. DOI 10.1080/00324728.2017.1316866.
Dietl A, Cupisti S, Beckmann MW, Schwab M and Zollner U. (2015). Pregnancy and Obstetrical Outcomes in Women Over 40 Years of Age. Geburtshilfe und Frauenheilkunde, 75:827-32. DOI 10.1055/s-0035-1546109.
Duarte CM. (2007). Reflexos das Políticas de Saúde Sobre as Tendências da Mortalidade Infantil no Brasil: Revisão da Literatura Sobre a Última Década. [Health Policy Effects on Infant Mortality Trends in Brazil: A Literature Review from the Last Decade]. Cadernos de Saúde Pública [Reports in Public Health], 23(7):1511-28. DOI 10.1590/s0102-311x2007000700002.
Flenady V. (2015). Epidemiology of Fetal and Neonatal Death. In: Keeling JW, editor. Fetal and Neonatal Pathology. Berlin: Springer. p141-64. DOI 10.1007/978-3-319-19207-9_6.
Fonseca SC, Flores PV, Camargo KR Jr., Pinheiro RS and Coeli CM. (2017). Maternal Education and Age: Inequalities in Neonatal Death. Revista de Saúde Pública, 51:94. DOI 10.11606/s1518-8787.2017051007013.
Gaiva MA, Fujimori E and Sato AP. (2015). Mortalidade Neonatal: Análise das Causas Evitáveis [Neonatal Mortality: Analysis of Preventable Causes]. Revista Enfermagem UERJ [UERJ Nursing Journal], 23(2):247-53. DOI 10.12957/reuerj.2015.5794.
Golding N, Burstein R, Longbottom J, Browne AJ, Fullman N, Osgood-Zimmerman A, Earl L, Bhatt S, Cameron E, Casey DC and Dwyer-Lindgren L. (2017). Mapping under-5 and Neonatal Mortality in Africa, 2000-15: A Baseline Analysis for the Sustainable Development Goals. The Lancet, 390(10108):2171-82. DOI 10.1016/s0140-6736(17)31758-0.
IGME. (2020). United Nations Inter-agency Group for Child Mortality Estimation. Viewed January 5, 2020. Available from: https:// www.childmortality.org/data/Brazil. [Last accessed on 2020 Apr 19].
Jahromi BN and Husseini Z. (2008). Pregnancy Outcome at Maternal Age 40 and Older. Taiwanese Journal of Obstetrics and Gynecology, 47(3):318-21. DOI 10.1016/s1028-4559(08)60131-x.
James G, Witten D, Hastie T and Tibshirani R. (2003). An Introduction to Statistical Learning. New York: Springer.
Maia LT, Souza WV, Mendes AC. (2015). A Contribuição do Linkage Entre o SIM e SINASC Para a Melhoria das Informações da Mortalidade Infantil em Cinco Cidades Brasileiras [The Contribution of the Linkage between the SIM and SINASC to Improving Information on Infant Mortality in Five Brazilian Cities]. Revista Brasileira de Saúde Materno Infantil [Brazilian Journal of Mother and Child Health], 5(1):57-66. DOI 10.1590/s1519-38292015000100005.
Morais RM and Costa AL. (2017). An Evaluation of the Brazilian Mortality Information System. Saúde Debate, 41:101-17.
Mosley WH and Chen LC. (2003). An Analytical Framework for the Study of Child Survival in Developing Countries. 1984. Bulletin of the World Health Organization, 81(2):140-5.
ODS. (2020). Objetivos do Desenvolvimento Sustentável [Sustainable Development Goals], Viewed January 5, 2020. Available from: https://www.odsbrasil.gov.br/objetivo/objetivo?n=3. [Last accessed on 2020 Apr 19].
Oliveira EF, Gama SG and Silva CM. (2010). Gravidez na Adolescência e Outros Fatores de Risco Para Mortalidade Fetal e Infantil no Município do Rio de Janeiro, Brasil. [Teenage Pregnancy and Other Risk Factors for Fetal and Infant Mortality in the City of Rio de Janeiro, Brazil]. Cadernos de Saúde Pública [Reports Public Health], 26(3):567-78. DOI 10.1590/s0102-311x2010000300014.
Oliveira LL, Gonçalves AD, Costa JS and Bonilha AL. (2016). Maternal and Neonatal Factors Related to Prematurity. Journal of School of Nursing USP, 50(3):382-9.
Szwarcwald CL, Leal MD, Esteves-Pereira AP, Almedia WD, Frias PG and Damacena GN. (2019). [Evaluation of Data from the Brazilian Information System on Live Births (SINASC)]. Cadernos de Saude Publica, 35(10):e00214918. DOI 10.1590/0102- 311x00214918.
Teixeira GA, Costa FM, Mata MS, Carvalho JB, Souza NL and Silva RA. (2016). Fatores de Risco Para a Mortalidade Neonatal na Primeira Semana de Vida [Risk Factors for Neonatal Mortality in the Life of First Week]. Revista de Pesquisa Cuidado é Fundamental Online, 8(1):4036. DOI 10.9789/2175-5361.2016.v8i1.4036-4046.
UN Resolution. (2015). RES/70/1. Transforming our World: The 2030 Agenda for Sustainable Development. New York: 7th United Nations General Assembly. p25.
UNFPA. (2018). Fundo de População das Nações Unidas. Fecundidade e Dinâmica da População Brasileira. Brasília: UNFPA.
UNICEF. (2013). Ending Child Marriage: Progress and Prospects. New York: UNICEF.
United Nations Inter-agency Group for Child Mortality Estimation. (2019) UN IGME. Levels and Trends in Child Mortality, Report 2019. Available from: https://www.unicef.org/media/60561/file/UN-IGME-child-mortality-report-2019.pdf. DOI 10.1371/ journal.pone.0101112. [Last accessed on 2020 Apr 19].
Veloso FC, Kassar LM, Oliveira MJ and Ricardo QG. (2019). Análise Dos Fatores de Risco na Mortalidade Neonatal no Brasil: Uma Revisão Sistemática e Metanálise de Estudos Observacionais. [Analysis of Neonatal Mortality Risk Factors in Brazil: A Systematic Review and Meta-analysis of Observational Studies]. Jornal de Pediatria, 95(5), 519-30. DOI 10.1016/j.jped.2018.12.014.
Vidal E, Silva SM, Tuon RA, Probst LF, Gondinho BV, Pereira AC. (2018) Factors Associated with Preventable Infant Death: A Multiple Logistic Regression. Revista de Saúde Pública, 52:32. DOI 10.11606/s1518-8787.2018052000252.
WHO. (1981). Development of Indicators for Monitoring Progress towards Health for All by the Year 2000. Geneva: World Health Organization.
WHO. (2020). Available from: https://www.who.int/pmnch/media/press_materials/fs/fs_mdg4_childmortality/en. [Last accessed on 2020 Jan 05].
World Bank. (2019), Available from: https://www.data.worldbank.org/indicator/SH.DYN.MORT. [Last accessed on 2019 Dec 17].