Analysis of neonatal viability in Brazil, 2012-2019: a population-based study and the development of an online public consultation tool

Abstract

This study aimed to evaluate the viability of preterm neonates born in Brazil between 2012 and 2019. An observational, ecological, population-based design was employed, including neonates with a gestational age of 22 to 31 weeks as recorded in the National Live Birth Information System (SINASC). Neonatal viability was assessed through linkage of SINASC data with the Mortality Information System (SIM), applying the linkage method to examine associations between mortality outcomes and childbirth care. The study also enabled the development of a practical tool for streamlined access to the compiled dataset. Findings indicated a national viability threshold of 26 weeks of gestation, with notable regional variations across Brazil. This study represents the first nationwide assessment of the viability of very and extremely preterm neonates in the country, establishing a threshold of 26 weeks. The results highlight the urgent need for greater investment in perinatal healthcare infrastructure and practices, as Brazil still lags behind countries such as the United States and Japan, which have successfully implemented proactive neonatal resuscitation protocols for infants born as early as 22 weeks of gestation. Furthermore, adequate antenatal counseling for parents is essential to support shared decision-making regarding the initiation of resuscitation or the provision of palliative care for these extremely preterm infants.

Keywords:
Neonatology; Epidemiology; Public health; Prematurity; Information systems