OBJECTIVE: To analyze neonatal mortality determinants using multilevel logistic regression and classic hierarchical models. METHODS: Cohort study including 138,407 live births with birth certificates and 1,134 neonatal deaths recorded in 2003, in the state of Rio Grande do Sul, Southern Brazil. The Information System on Live Births and mortality records were linked for gathering information on individual-level exposures. Sociodemographic data and information on the pregnancy, childbirth care and characteristics of the children at birth were collected. The associated factors were […]

OBJECTIVE: To analyze factors associated with survival in the first year of life. METHODS: A historical cohort study was carried out using data from live birth and mortality information systems, including 90,153 live birth records and 1,053 records of death before age one year in hospitals in the cities of Florianópolis and São José, Southern Brazil, between 1999 and 2006. Survival curves were estimated (Kaplan-Meier) for birthweight categories, date of birth (four-year periods), and type of maternity. Proportional hazard ratios […]

OBJECTIVE: To analyze the risk factors associated with neonatal deaths among children with low birth weight. METHODS: A cohort study was carried out on live births weighing between 500 g and 2,499 g from single pregnancies without anencephaly in Recife (Northeastern Brazil) between 2001 and 2003. Data on 5,687 live births and 499 neonatal deaths obtained from the Live Birth Information System and the Mortality Information System were integrated through the linkage technique. Using a hierarchical model, variables from the […]

OBJECTIVE: The historical evolution of infant mortality rate and neonatal mortality according to birth weight and term of delivery in the state of São Paulo are presented to assess the role of the number of prenatal visits and others factors for determining mortality. METHODS: Based on data available from the Seade Institute of Vital Statistics, four variables (maternal age, marital status, education, and childbirth order) were analyzed and divided into two categories according to the relative risk of low birth […]

OBJECTIVE: To determine changes in the incidence of vaginal deliveries, cesarean sections, and forceps deliveries and their potential association with fetal, early neonatal, and perinatal mortality rates over time. METHODS: A retrospective study was carried out and the occurrence of deliveries supervised by university services between January 1991 and December 2000 was determined. Data regarding fetal, early neonatal, and perinatal deaths were assessed using obstetric and pediatric records and autopsy reports. RESULTS: Of a total of 33,360 deliveries, the incidence […]

OBJECTIVE: To analyze IMR evolution in the São Paulo Metropolitan Area (SPMA) between 1980 and 2000, in terms of spatial, age and, causal differences. METHODS: SPMA municipalities were divided into 5 groups, based on their 1980 IMRs: ³90‰ lb (Group 1); 70-89‰ lb (Group 2); 50-69‰ lb (Group 3); <50‰ lb (Group 4). Group 5 comprised the municipality of São Paulo itself (IMR=51‰ lb). The analysis of trends was carried out using exponential regression models. RESULTS: IMR and its components […]

OBJECTIVES: To evaluate and compare birthweight and scores as predictors of neonatal mortality in a Neonatal Intensive Care Unit (NICU). METHODS: The survey included 494 newborns admitted to the neonatal intensive care unit (NICU) of a general hospital in Porto Alegre, southern Brazil, immediately after delivery, between March 1997 and June 1998. Birthweight and scores were evaluated in terms of the variable “death while in NICU”. Exclusion criteria were: discharge or death less than 24 hours after admission, admission not […]

OBJECTIVE: To evaluate the mortality rate of very low birth weight babies born at a Neonatal Intensive Care Unit (NICU) during a specified period of time according to variations in CRIB (Clinical Risk Index for Babies) score, birth weight and gestational age. METHODS: From January 1997 to December 2000, the CRIB score was prospectively applied to all newborn infants admitted to the NICU of an university hospital of Londrina, Brazil, with birthweight under 1,500 g and/or gestational age of less […]

OBJECTIVE: To determine the trends of infant mortality from 1995 to 1999 according to a geographic area-based measure of maternal education in Porto Alegre, Brazil. METHODS: A registry-based study was carried out and a municipal database created in 1994 was used. All live births (n=119,170) and infant deaths (n=1,934) were considered. Five different geographic areas were defined according to quintiles of the percentage of low maternal educational level (<6 years of schooling): high, medium high, medium, medium low, and low. […]

OBJECTIVE: Data from municipal databases can be used to plan interventions aimed at reducing inequities in health care. The objective of the study was to determine the distribution of infant mortality according to an urban geoeconomic classification using routinely collected municipal data. METHODS: All live births (total of 42,381) and infant deaths (total of 731) that occurred between 1994 and 1998 in Ribeirão Preto, Brazil, were considered. Four different geoeconomic areas were defined according to the family head’s income in […]