Magnitude and determinants of neonatal and postneonatal mortality in Goiânia, Goiás, Brazil: a retrospective cohort study, 2012

Saloio, Caio Átila; Morais Neto, Otaliba Libânio de; Gonçalves, Dayanne Augusta; Bessa, Hugo Estevam Marques; Coelho Júnior, Jadson Pinheiro; Afonso, May Socorro Martinez; Carvalho, Simone Resende de

Caio Átila Saloio Correspondence: Caio Átila Saloio – Universidade Federal de Goiás, Faculdade de Medicina, Rua 235, S/N, Setor Leste Universitário, Goiânia, GO, Brazil. Postcode: 74605-050 . E-mail: caioatilasaloio@gmail.com

Universidade Federal de Goiás, Faculdade de Medicina, Goiânia, GO, Brazil

http://orcid.org/0000-0003-2159-6141

Otaliba Libânio de Morais Neto

Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Goiânia, GO, Brazil

http://orcid.org/0000-0002-3786-318X

Dayanne Augusta Gonçalves

Universidade Federal de Goiás, Faculdade de Medicina, Goiânia, GO, Brazil

http://orcid.org/0000-0003-3744-9867

Hugo Estevam Marques Bessa

Universidade Federal de Goiás, Faculdade de Medicina, Goiânia, GO, Brazil

http://orcid.org/0000-0003-2361-2563

Jadson Pinheiro Coelho Júnior

Universidade Federal de Goiás, Faculdade de Medicina, Goiânia, GO, Brazil

http://orcid.org/0000-0002-3133-3145

May Socorro Martinez Afonso

Hospital das Clínicas da Universidade Federal de Goiás, Goiânia, GO, Brazil

http://orcid.org/0000-0001-8122-6770

Simone Resende de Carvalho

Secretaria de Estado da Saúde de Goiás, Goiânia, GO, Brazil

http://orcid.org/0000-0001-8400-1067

Correspondence: Caio Átila Saloio – Universidade Federal de Goiás, Faculdade de Medicina, Rua 235, S/N, Setor Leste Universitário, Goiânia, GO, Brazil. Postcode: 74605-050 . E-mail: caioatilasaloio@gmail.com

Associate editor: Lúcia Rolim Santana de Freitas - orcid.org/0000-0003-0080-2858

Authors' contributions

Saloio CA and Morais Neto OL contributed to the study concept and design, data acquisition, analysis and interpretation, drafting and critically reviewing the contents of the manuscript. Gonçalves DA, Bessa HEM and Coelho Junior JP contributed to data acquisition, analysis and interpretation, drafting and critically reviewing the contents of the manuscript. Carvalho SR and Afonso MSM contributed to the study concept and design, drafting and critically reviewing the contents of the manuscript. All the authors have approved the final version of the manuscript and are responsible for all aspects thereof, including the guarantee of its accuracy and integrity.

Variable	Category	Completeness quality (%)
Variable	Category	Neonatal	Postneonatal
Distal determinants
Schooling	Complete higher education High school/incomplete higher education Complete elementary education Incomplete elementary education or no schooling	97.0	96.9
Mother's race/skin color	White Brown Black Other (indigenous and yellow)	80.9	80.9
Mother's marital status	Married/common law marriage Single/separated/widowed	97.6	97.6
Intermediate determinants
Mother's age (years)	20 - 34 ≥35 10 - 19	99.9	99.9
Delivery type	Vaginal Cesarean	99.8	99.9
Number of prenatal care visits	7 - 14 15 - 20 4 - 6 0 - 3	95.3	95.3
Proximal determinants
Weeks of pregnancy	37 - 45 34 - 36 19 - 34	86.0	86.0
Birth weight	≥2.500g 1.500 a 2.499g <1.500g	99.9	99.9
Sex of the newborn	Female Male	99.9	99.9
Mother's health district of residence	Southern Campinas-Central Eastern Northern Western Southwestern Northwestern	98.2	98.2

Category				Deaths	Total ^a a) Unknown/blank cases were excluded from the analysis. (%)	Neonatal mortality rate	p-value	OR ^b b) OR: adjusted odds ratio . (95%CI ^c c) 95%CI: 95% confidence interval. )
Determinantes distais
	Schooling						0.440
		Complete higher education		53	4,558 (22.1)	11.63	–	–
		High school/incomplete higher education		97	11,641 (56.4)	8.33	–	0.75 (0.51;1.12)
		Complete elementary education		42	3,886 (18.8)	10.81	–	0.87 (0.52;1.48)
		Incomplete elementary education or no schooling		5	551 (2.7)	9.07	–	0.47 (0.11;1.97)
		Total		197	20,636	9.55	–	–
	Mother's race/skin color						0.570
		White		74	6,895 (40.0)	10.73	–	–
		Brown		79	9,713 (56.4)	8.13	–	0.85 (0.60;1.21)
		Black		2	461 (2.7)	4.34	–	0.47 (0.11;1.96)
		Other (indigenous and yellow)		2	149 (0.9)	13.42	–	1.42 (0.34;5.87)
		Total		157	17,218	9.12	–	–
	Mother's marital status						0.660
		Married/common law marriage		133	14,196 (68.4)	9.37	–	–
		Single/separated/widowed		61	6,568 (31.6)	9.29	–	0.92 (0.64;1.33)
		Total		194	20,764	9.34	–	–
	Intermediate determinants
		Mother's age (in years)					0.210
			10-19	36	2,891 (13.6)	12.45	–	0.99 (0.58;1.69)
			20-34	132	15,819 (74.3)	8.34	–	–
			≥35	33	2,567 (12.1)	12.86	–	1.55 (0.95;2.52)
		Total		201	21,277	9.45	–	–
		Delivery type					<0.001
			Vaginal	88	5,298 (24.9)	16.61	–	–
			Cesarean	112	15,952 (75.1)	7.02	–	0.54 (0.37;0.79)
			Total	200	21,250	9.41	–	–
		Number of prenatal care visits					<0.001
			15-20	3	412 (2.0)	7.28	–	0.89 (0.22;3.69)
			7-14	75	14,508 (71.6)	5.17	–	–
			4-6	70	4,650 (22.9)	15.05	–	4.57 (2.96;7.04)
			0-3	32	702 (3.5)	45.58	–	13.10 (7.48;22.96)
			Total	180	20,272	8.88	–	–
	Proximal determinants
		Weeks of pregnancy					<0.001
			37-45	30	16,147 (88.2)	1.86	–	–
			34-36	27	1,630 (8.9)	16.56	–	4.11 (1.92;8.76)
			19-34	110	523 (2.9)	210.33	–	6.25 (2.26;17.29)
			Total	167	18,300	9.13	–	–
		Birth weight					<0.001
			≥2.500g	48	19,454 (91.4)	2.47	–	–
			1.500 a 2.499g	34	1,564 (7.3)	21.74	–	2.70 (1.21;6.07)
			<1.500g	118	262 (1.2)	450.38	–	62.42 (22.72;171.48)
			Total	200	21,280	9.40	–	–
		Sex					0.640
			Female	81	10,541 (49.6)	7.68	–	–
			Male	115	10,716 (50.4)	10.73	–	1.12 (0.69;1.82)
			Total	196	21,257	9.22	–	–

Category				Deaths	Total ^a a) Unknown/blank cases were excluded from the analysis. (%)	Postneonatal mortality rate	p-value	OR ^b b) OR: adjusted odds ratio . (95%CI ^c c) 95%CI: 95% confidence interval. )
Distal determinants
	Schooling						0.540
		Complete higher education		8	4,513 (22.0)	1.77	–	–
		High school/incomplete higher education		39	11,583 (56.5)	3.37	–	1.61 (0.71;3.65)
		Complete elementary education		13	3,857 (18.8)	3.37	–	1.04 (0.35;3.09)
		Incomplete elementary education or no schooling		1	547 (2.7)	1.83	–	1.06 (0.13;8.89)
		Total		61	20,500	2.98	–	–
	Mother's race/skin color						0.620
		White		21	6,842 (40.0)	3.07	–	–
		Brown		27	9,661 (56.5)	2.79	–	0.80 (0.43;1.49)
		Black		2	461 (2.7)	4.34	–	1.39 (0.32;6.12)
		Other (indigenous and yellow)		1	148 (0.9)	6.76	–	2.30 (0.31;17.37)
		Total		51	17,112	2.98	–	–
	Mother's marital status						0.100
		Married/common law marriage		34	14,097 (68.3)	2.41	–	–
		Single/separated/widowed		28	6,535 (31.7)	4.28	–	1.65 (0.91;2.97)
		Total		62	20,632	3.01	–	–
	Intermediate determinants
		Mother's age (in years)					0.490
			10-19	9	2,864 (13.5)	3.14	–	0.85 (0.34;2.10)
			20-34	47	15,734 (74.4)	2.99	–	–
			≥35	8	2,542 (12.0)	3.15	–	1.59 (0.69;3.67)
			Total	64	21,140	3.03	–	–
		Delivery type					0.990
			Vaginal	8	5,228 (24.8)	1.53	–	–
			Cesarean	46	15,886 (75.2)	2.90	–	1.00 (0.49;2.01)
			Total	64	21,114	3.03	–	–
		Number of prenatal care visits					0.050
			15-20	1	410 (2.0)	2.44	–	1.28 (0.17;9.52)
			7-14	36	14,469 (71.8)	2.49	–	–
			4-6	18	4,598 (22.8)	3.91	–	1.21 (0.58;2.50)
			0-3	5	675 (3.3)	7.41	–	4.16 (1.51;11.43)
			Total	60	20,152	2.98	–	–
	Proximal determinants
		Weeks of pregnancy					0.160
			37-45	29	16,146 (88.8)	1.80	–	–
			34-36	7	1,610 (8.9)	4.35	–	1.27 (0.42;3.90)
			19-34	18	431 (2.4)	41.76	–	3.40 (0.95;12.11)
			Total	54	18,187	2.97	–	–
		Birth weight					<0.001
			≥2.500g	33	19,439 (91.9)	1.70	–	–
			1.500 a 2.499g	18	1,548 (7.3)	11.63	–	6.71 (2.58;17.51)
			<1.500g	13	157 (0.7)	82.80	–	18.74 (4.04;87.00)
			Total	64	21,144	3.03	–	–
		Sex					0.520
			Female	36	10,496 (49.7)	3.43	–	–
			Male	28	10,629 (50.3)	2.63	–	0.79 (0.39;1.60)
			Total	64	21,125	3.03	–	–

Health district		Deaths	Total ^a a) Unknown/blank cases were excluded from the analysis. (%)	Infant mortality rate	p-value	OR ^b b) OR: adjusted odds ratio . (95%CI ^c c) 95%CI: 95% confidence interval. )
Neonatal death					0.630
	Southern	29	3,191 (15.7)	9.09	–	–
	Campinas-Central	21	2,921 (14.4)	7.19	–	0.79 (0.45;1.39)
	Eastern	18	2,682 (13.2)	6.71	–	0.74 (0.41;1.33)
	Northern	15	2,327 (11.4)	6.45	–	0.71 (0.38;1.32)
	Western	19	2,373 (11.7)	8.01	–	0.88 (0.49;1.57)
	Southwestern	37	3,587 (17.6)	10.32	–	1.14 (0.70;1.85)
	Northwestern	29	3,255 (16.0)	8.91	–	0.98 (0.58;1.64)
	Total	168	20,336	8.26	–	–
Postneonatal death					0.580
	Southern	8	3,170 (15.7)	2.52	–	–
	Campinas-Central	7	2,907 (14.4)	2.41	–	0.95 (0.35;2.63)
	Eastern	7	2,671 (13.2)	2.62	–	1.04 (0.38;2.87)
	Northern	3	2,315 (11.4)	1.30	–	0.51 (0.14;1.94)
	Western	10	2,364 (11.7)	4.23	–	1.68 (0.66;4.26)
	Southwestern	13	3,563 (17.6)	3.65	–	1.45 (0.60;3.50)
	Northwestern	8	3,234 (16.0)	2.47	–	0.98 (0.37;2.62)
	Total	56	20,224	2.77	–	–

\begin{array}{l} IMR = \frac{\begin{array}{l} T o t a l n u m b e r o f d e a t h s o f b a b i e s u n d e r \\ 1 y e a r o l d b o r n a l i v e i n 2012 \end{array}}{T o t a l n u m b e r o f l i v e b i r t h s i n 2012} X 1, 000 \\ _{neonatal} IMR = \frac{\begin{array}{l} N u m b e r o f d e a t h s a t 0 - 27 c o m p l e t e \\ d a y s o f l i f e o f b a b i e s b o r n a l i v e \\ i n 2012 \end{array}}{\begin{array}{l} T o t a l n u m b e r o f l i v e b i r t h s i n \\ 2012 x 1, 000 \end{array}} X 1, 000 \\ _{postneonatal} IMR = \frac{\begin{array}{l} N u m b e r o f d e a t h s a t 28 - 364 \\ c o m p l e t e d a y s o f l i f e o f b a b i e s \\ b o r n a l i v e i n 2012 \end{array}}{\begin{array}{l} T o t a l n u m b e r o f l i v e b i r t h s i n \\ 2012 x 1, 000 \end{array}} X 1, 000 \end{array}

[1] Correspondence: Caio Átila Saloio – Universidade Federal de Goiás, Faculdade de Medicina, Rua 235, S/N, Setor Leste Universitário, Goiânia, GO, Brazil. Postcode: 74605-050 . E-mail: caioatilasaloio@gmail.com

Brasil

Brasil

Abstract

Objective:

Methods:

Results:

Conclusion: