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The Impact of Time, Region, and Income Level on Stillbirth and Neonatal Mortality in Brazil, 2000-2019.
Rent, Sharla; Rocha, Thiago; Silva, Lincoln; Souza, João Vitor Perez; Guinsburg, Ruth; Filho, Alexandre Chiavegatto; Staton, Catherine; Vissoci, João Ricardo Nickenig.
Afiliação
  • Rent S; Department of Pediatrics, Duke University School of Medicine, Durham, NC; Duke Global Health Institute, Durham, NC. Electronic address: Sharla.Rent@duke.edu.
  • Rocha T; Department of Emergency Medicine, Duke University School of Medicine, Durham, NC; Global Emergency Medicine Innovation and Implementation Center, Duke University, Durham, NC.
  • Silva L; Global Emergency Medicine Innovation and Implementation Center, Duke University, Durham, NC.
  • Souza JVP; Department of Emergency Medicine, Duke University School of Medicine, Durham, NC.
  • Guinsburg R; Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Filho AC; School of Public Health, University of São Paulo, São Paulo, Brazil.
  • Staton C; Duke Global Health Institute, Durham, NC; Department of Emergency Medicine, Duke University School of Medicine, Durham, NC.
  • Vissoci JRN; Duke Global Health Institute, Durham, NC; Department of Emergency Medicine, Duke University School of Medicine, Durham, NC.
J Pediatr ; 262: 113613, 2023 11.
Article em En | MEDLINE | ID: mdl-37459908
OBJECTIVE: To describe trends in perinatal loss across Brazil, a country that transitioned in 2006 from a lower-middle income to an upper-middle income country, from 2000 to 2019 and analyze the effect of municipal wealth status on perinatal outcomes. STUDY DESIGN: We conducted an ecological cohort study, based on publicly available data from the Brazilian Ministry of Health's data repository on live births and deaths. The Atlas of Human Development in Brazil was used to associate each region with a World Bank income classification. RESULTS: The national neonatal mortality rate (NMR) for infants born at ≥22 weeks of gestation decreased from 21.2 in 2000 to 12.4 in 2019. The stillbirth rate (SBR) decreased from 12.0 to 10.2 during this period. For infants born between 22 and 27 weeks of gestation, worsening perinatal outcomes were seen after 2012. In 2019, the median rates of neonatal mortality and stillbirth were both 4 points higher in lower- to middle-income municipalities compared with high-income municipalities (P < .01). CONCLUSION: Brazil has made significant progress in neonatal mortality and stillbirth from 2000 to 2019, yet inequity in perinatal outcomes remains and is correlated with municipal economic status. Nationally, ongoing improvement is needed for infants <28 weeks of gestation, and closer exploration is needed into why there are increasing rates of negative perinatal outcomes among infants born at 22-27 weeks of gestation after 2012.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Mortalidade Infantil / Natimorto Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Female / Humans / Infant / Newborn / Pregnancy País/Região como assunto: America do sul / Brasil Idioma: En Revista: J Pediatr Ano de publicação: 2023 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Mortalidade Infantil / Natimorto Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Female / Humans / Infant / Newborn / Pregnancy País/Região como assunto: America do sul / Brasil Idioma: En Revista: J Pediatr Ano de publicação: 2023 Tipo de documento: Article País de publicação: Estados Unidos