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Research article
Fernando Kenji Nampo
Universidade Federal da Integracao Latino-Americana
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6411-6131
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BACKGROUND: Neonatal deaths correspond to 44% of the deaths in children under five globally. The most populous international border of Brazil includes Foz do Iguassu (Brazil), Puerto Iguazu (Argentina) and Ciudad del Este (Paraguay). Similarly to any other Brazilian city, the public health services located in Foz do Iguassu provide medical care to foreigners, including pregnant women who go to Brazil to deliver. Although the international importance of Foz do Iguassu in terms of healthcare, neonatal mortality in the city (15.3/1,000 live births) is higher than Brazil’s average (13.8/1,000 live births) and corresponds to 61% of all deaths in children under five. Unfortunately, the causes of the neonatal deaths in Foz do Iguassu remain unclear, which make it more difficult to manage the problem. The current study aimed to identify the determinants of neonatal mortality in Foz do Iguassu. METHODS: In this case-control study, we analyzed all neonatal deaths occurred in Foz do Iguassu from 2012 to 2016. Birth and mortality data were extracted from two national governmental databases (SINASC and SIM). We extracted data on (i) maternal sociodemographic characteristics, (ii) pregnancy care, and (iii) newborn characteristics. Multiple logistic regression with the conceptual framework was applied to examine the factors associated with neonatal mortality. RESULTS: Most of the deaths occurred in the early neonatal period (65.9%). The factors associated with neonatal death were fetal congenital anomaly (OR 22.4; CI 95% 7.41-67.76; p = <0.001); low birth weight (OR 17.4; CI 95% 8.70-35.17; p = <0.001), first minute Apgar score under 7 (OR 15.4; CI 95% 8.11- 29.24; p = <0.001); zero to 3 prenatal appointments (OR 3.3; CI 95% 1.28-8.70; p = 0.014) and prematurity (OR 3.5; CI 95% 1.79 6.92; p = <0.001). CONCLUSION: The high rate of neonatal death in Foz do Iguassu is strongly associated with newborn characteristics and not associated with maternal sociodemographic characteristics. Thus, the health services in the Brazilian side of this international borders should be aware of the quality of the prenatal care and childbirth attention provided.
Keywords
Neonatal mortality, Determinants, Border region
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CURRENT STATUS: Published
View the published article at BMC Public Health.
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On 18 Nov, 2019
Editorial decision: Accept
On 13 Sep, 2019
Editor assigned
On 12 Sep, 2019
Editor invited
On 11 Sep, 2019
No comments provided
Editorial decision: Minor revision
On 28 Aug, 2019
Review #1 received
Received 23 Aug, 2019
Editor assigned
On 02 Aug, 2019
Reviewers invited
Invitations sent on 02 Aug, 2019
Reviewer #1 agreed
On 02 Aug, 2019
Submission checks complete
On 01 Aug, 2019
Editor invited
On 01 Aug, 2019
Version 1
Posted 04 Jul, 2019
No comments provided
Editorial decision: Minor revision
On 30 Jul, 2019
Review #2 received
Received 29 Jul, 2019
Review #1 received
Received 22 Jul, 2019
Reviewer #2 agreed
On 12 Jul, 2019
Reviewer #1 agreed
On 28 Jun, 2019
First submitted
On 26 Jun, 2019
Submission checks complete
On 26 Jun, 2019
Editor assigned
On 26 Jun, 2019
Reviewers invited
Invitations sent on 26 Jun, 2019
Editor invited
On 25 Jun, 2019
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See the published version of this preprint at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Fernando Kenji Nampo
Universidade Federal da Integracao Latino-Americana
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6411-6131
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
No community comments so far
Submission checks complete
On 18 Nov, 2019
Editorial decision: Accept
On 13 Sep, 2019
Editor assigned
On 12 Sep, 2019
Editor invited
On 11 Sep, 2019
No comments provided
Editorial decision: Minor revision
On 28 Aug, 2019
Review #1 received
Received 23 Aug, 2019
Editor assigned
On 02 Aug, 2019
Reviewers invited
Invitations sent on 02 Aug, 2019
Reviewer #1 agreed
On 02 Aug, 2019
Submission checks complete
On 01 Aug, 2019
Editor invited
On 01 Aug, 2019
Version 1
Posted 04 Jul, 2019
No comments provided
Editorial decision: Minor revision
On 30 Jul, 2019
Review #2 received
Received 29 Jul, 2019
Review #1 received
Received 22 Jul, 2019
Reviewer #2 agreed
On 12 Jul, 2019
Reviewer #1 agreed
On 28 Jun, 2019
First submitted
On 26 Jun, 2019
Submission checks complete
On 26 Jun, 2019
Editor assigned
On 26 Jun, 2019
Reviewers invited
Invitations sent on 26 Jun, 2019
Editor invited
On 25 Jun, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
BACKGROUND: Neonatal deaths correspond to 44% of the deaths in children under five globally. The most populous international border of Brazil includes Foz do Iguassu (Brazil), Puerto Iguazu (Argentina) and Ciudad del Este (Paraguay). Similarly to any other Brazilian city, the public health services located in Foz do Iguassu provide medical care to foreigners, including pregnant women who go to Brazil to deliver. Although the international importance of Foz do Iguassu in terms of healthcare, neonatal mortality in the city (15.3/1,000 live births) is higher than Brazil’s average (13.8/1,000 live births) and corresponds to 61% of all deaths in children under five. Unfortunately, the causes of the neonatal deaths in Foz do Iguassu remain unclear, which make it more difficult to manage the problem. The current study aimed to identify the determinants of neonatal mortality in Foz do Iguassu. METHODS: In this case-control study, we analyzed all neonatal deaths occurred in Foz do Iguassu from 2012 to 2016. Birth and mortality data were extracted from two national governmental databases (SINASC and SIM). We extracted data on (i) maternal sociodemographic characteristics, (ii) pregnancy care, and (iii) newborn characteristics. Multiple logistic regression with the conceptual framework was applied to examine the factors associated with neonatal mortality. RESULTS: Most of the deaths occurred in the early neonatal period (65.9%). The factors associated with neonatal death were fetal congenital anomaly (OR 22.4; CI 95% 7.41-67.76; p = <0.001); low birth weight (OR 17.4; CI 95% 8.70-35.17; p = <0.001), first minute Apgar score under 7 (OR 15.4; CI 95% 8.11- 29.24; p = <0.001); zero to 3 prenatal appointments (OR 3.3; CI 95% 1.28-8.70; p = 0.014) and prematurity (OR 3.5; CI 95% 1.79 6.92; p = <0.001). CONCLUSION: The high rate of neonatal death in Foz do Iguassu is strongly associated with newborn characteristics and not associated with maternal sociodemographic characteristics. Thus, the health services in the Brazilian side of this international borders should be aware of the quality of the prenatal care and childbirth attention provided.
This is a list of supplementary files associated with this preprint. Click to download.
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