Preventable neonatal mortality in the state of São Paulo: a spatial approach

Óbitos neonatais evitáveis no estado de São Paulo: uma abordagem espacial

ABSTRACT

Objective:  Identify spatial patterns for preventable neonatal deaths in municipalities in the state of São Paulo between the years of 2015 and 2019, looking for possible correlations with socioeconomic and demographic indices.

Methods:  This is an ecological study, with data obtained from the Department of Informatics of the Unified Health System (DATASUS), from the of Mortality Information System (SIM) and Live Birth Information System (SINASC), regarding preventable deaths due to adequate care for women during pregnancy, childbirth and for the newborns, were analysed. Proportions per thousand live births were built. The independent variables used were the proportion of adolescent mothers; insufficient number of antenatal consultations (0–6 consultations); low birthweight (500–2499 g); low Apgar score in the 1^st and 5^th minute of life (0–7), all of which were used to calculate the Univariate Moran Index (I_MU). The Social Vulnerability Index (SVI) and the Municipal Human Development Index (MHDI) were used to calculate the Bivariate Moran Index (I_M). The Univariate and Bivariate Moran’s indexes were calculated, thematic maps and box maps were constructed, and a significance level of α < 5% was adopted.

Results:  There were four thematic maps, and three box maps created to analyse the dependent variables, mentioned above. SVI and MHDI, inadequate antenatal care and reduced Apgar score at the 1^st and 5^th minute showed I_M significant with preventable deaths in the neonatal population. A concentration of preventable deaths was identified in the southern region of the state.

Conclusions:  The data presented can support municipal managers, demonstrating the need for investment in maternal and child health.

Keywords:
Neonatal mortality; Spatial analysis; Antenatal care; Apgar score; Perinatal care