Risk factors to early neonatal mortality in the city of Juiz de Fora - Minas Gerais

Abstract

Objective: Risk factors for early neonatal mortality were evaluated in the city of Juiz de For a over the period from July 1998 to June 1999.Material and Methods: All of the cases of early neonatal deaths were studied made up of 109 cases out of a total of 8489 births, through a case-controlled study. For each case, two controles were included, chosen consecutively to the given fatality, in the same maternity unit, independent of the clinical condition. Bivariable and multivarialble analyses followed. Results: Maternal obstetrical factors which made up the final results were the following: gestational age less than 37 weeks (OR = 3.99; CI = 1.45 - 10.96); congenital malformation: OR = 24.12; CI = 4.14 - 140.81); urinary tract infection (OR = 2.75; CI = 1.08 - 7.03); third trimester hemorrhape (OR = 5.07; CI = 1.33 - 19.28); hypertensive syndrome (OR = 2.64; CI = 1.02 - 6.85); birth weight less than 2.500 grams (OR = 6.17; CI = 2.20 -17.31); and fewer than six prenatal appointments (OR 4.00; CI 1.87 - 8.54). Factors related to neonatal care were: APGAR at 5 minutes less than 7 (OR = 56.94; CI = 21.81 - 148.64); hyaline membrane syndrome (OR = 37.18; CI = 10.76 - 128.42); meconium aspiration (OR = 30.45; CI 2.81 - 329.38); congenital pneumonia (OR = 28.36; CI = 2.48 - 323.92) and neonatal infection (OR = 9.82; CI = 1.63 - 59.18).Conclusion: Early neonatal mortality in the city of Juiz de Fora is high particularly because many of the risk factors are amenable to prevention through better care during the prenatal period, during delivery and through better care of the newborn in the delivery room. It is hoped that the identification of these risk factors can make a contribution toward the improvement of maternal and neonatal health care in Juiz de Fora.