Early neonatal mortality trend in adolescent pregnant women in the State of São Paulo, Brazil, from 1996 to 2017

Adriana Gonçalves de Oliveira; Hugo Macedo Jr; Edigê Felipe de Sousa Santos; Claudio Leone; Francisco Naildo Cardoso Leitão; Renata M M Pimentel; Luiz Carlos de Abreu; Rubens Wajnsztejn

doi:10.21037/tp-20-438

Early neonatal mortality trend in adolescent pregnant women in the State of São Paulo, Brazil, from 1996 to 2017

Transl Pediatr. 2021 Jun;10(6):1573-1585. doi: 10.21037/tp-20-438.

Authors

Affiliations

¹ Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário Saúde ABC, Santo André, SP, Brasil.
² Serviço de Neonatologia, Hospital Municipal de Diadema, SP, Brasil.
³ Programa de Pós-graduação em Ciências da Saúde, Centro Universitário Saúde ABC, Santo André, SP, Brasil.
⁴ Departamento de Epidemiologia, Faculdade de Saúde Pública da Universidade de São Paulo, Brazil.
⁵ Adjunct Professor, School of Medicine, University of Limerick, Limerick, Ireland.
⁶ Professor Titular, Departamento de Educação Integrada em Saúde e Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, ES, Brasil.
⁷ Orientador Pleno, Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Abstract

Background: The Infant mortality rate indicates the quality of life of a population. Infant mortality has two important components: neonatal mortality, divided into early and late and post-neonatal mortality. The more developed a country is and the greater its population's well-being, the greater the weight of the neonatal component on infant mortality. In addition several factors may determine or be associated with the occurrence of infant deaths including maternal age. The teenage pregnancy rates in Latin America and the Caribbean remain the second highest in the world, In Brazil, between 2010 and 2015, for every thousand adolescents between 15 and 19 years old, about 69 became pregnant and gave birth to their babies. Thus, the objective of this study is to evaluate the trend of Early Neonatal Mortality Rates in children of pregnant adolescents, which occurred in the period 1996-2017, in the state of São Paulo, Brazil, according to the maternal age group.

Methods: This is an ecological study of time series using official mortality data obtained from the Mortality Information System and live birth data obtained from the Live Birth Information System. Deaths of newborns aged between zero and six complete days were collected by place of residence. The trends in rates per 1,000 live births were calculated by Prais-Winsten regression, obtaining their annual percentage change (VPA) and the respective 95% confidence intervals, analyzed by age group. All analyzes were processed using the STATA 15.1 software.

Results: In the state of São Paulo, between 1996 and 2017, 16,161 deaths were reported in children from zero to six days old and 2,320,584 live births in mothers aged 10-19 years, living in the state of São Paulo, Brazil. Of this total, it was observed that the early neonatal mortality rate decreased until the year 2005-2006, remained stationary after, and was higher in newborns of mothers aged 10-14 years (13.18 per 1,000) compared to mothers between 15-19 years (6.75 per 1,000).

Conclusions: In conclusion, although the early neonatal mortality rate showed a significant decreasing trend until approximately 2005, it remained stables after that.

Keywords: Perinatal mortality; death certificates; pregnant women adolescent; risk factors; time series studies.