Mortality among children under the age of one: analysis of cases after discharge from maternity

Rev Esc Enferm USP. 2016 May-Jun;50(3):390-8. doi: 10.1590/S0080-623420160000400003.
[Article in English, Portuguese]

Abstract

Objective: To analyze infant death after discharge from maternity in the time period between 2000 and 2013.

Method: A cross-sectional retrospective quantitative study in a municipality northward in the state of Paraná. Data were analyzed using the SPSS®, and were subjected to Chi-square test, logistical regression, 95% confidence interval, and a significance level of p <0.05.

Results: Two hundred forty-nine children were born, discharged from maternity and subsequently died; 10.1% in the neonatal period and 89.9% in the post-neonatal period. Pregnancy follow-up, birth, and child monitoring took place mainly in the public health system. There was a statistically significant association between the infant component and place of delivery (p =0.002; RR=1.143; IC95%=1.064-1.229), and a lower number of childcare medical visits (p =0.001; RR=1.294; IC95%=1.039-1.613). The causes of death in the neonatal period were perinatal conditions (40%); external causes (32%); and congenital malformations (20%). In the post-neonatal period, congenital malformations (29.9%), external causes (24.1%); and infectious-parasitic diseases (11.2%) were the causes of death.

Conclusion: Virtually all children were born in conditions of good vitality that were worsened due to potentially preventable diseases that led to death.

Objetivo: Analisar as mortes infantis após alta das maternidades ocorridas entre 2000 e 2013.

Método: Pesquisa quantitativa retrospectiva transversal, em município no norte do Paraná. Os dados foram analisados no SPSS®. .Aplicaram-se teste qui-quadrado, regressão logística, intervalo de confiança 95% e nível de significância p <0,05.

Resultados: 249 crianças nasceram, receberam alta e evoluíram para óbito, 10,1% no período neonatal e 89,9% no pós-neonatal. O acompanhamento gestacional, nascimento e seguimento da criança ocorreram, predominantemente, no serviço público. Houve associação estatisticamente significativa entre componente infantil e local de parto (p =0,002; RR=1,143; IC95%=1,064-1,229); realizar menos consultas de puericultura (p =0,001; RR=1,294; IC95%=1,039-1,613). As causas de morte no período neonatal foram afecções perinatais (40%), causas externas (32%) e malformações congênitas (20%). No pós-neonatal, malformações congênitas (29,9%), causas externas (24,1%) e doenças infectoparasitárias (11,2%).

Conclusão: A quase totalidade das crianças nasceu em boas condições de vitalidade, apresentou agravos por doenças potencialmente preveníveis que culminaram no óbito.

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Humans
  • Infant
  • Infant Mortality*
  • Infant, Newborn
  • Male
  • Patient Discharge
  • Retrospective Studies