Factors associated with neonatal near miss in Brazil

Detalhes bibliográficos
Autor(a) principal: Pereira, Theonas Gomes
Data de Publicação: 2020
Outros Autores: Rocha, Daniele Marano da, Moreira, Maria Elisabeth Lopes, Gama, Silvana Granado Nogueira da
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/180006
Resumo: OBJECTIVE: This study evaluates the association between sociodemographic factors, maternal characteristics, organization of health services and neonatal near miss in public and private maternity hospitals in Brazil. METHODS: This is a prospective cohort of live births from the Nascer no Brasil survey, carried out between 2011 and 2012. Variables were established from the literature and organized on three levels: distal, intermediate, and proximal. The assessment was performed based on results of the bivariate analyzes and their respective p-values, with a significance level <0.20, using the Wald test. For multivariate analysis, the variables contained at the distal level were inserted, preserved in the model when significant (p < 0.05). This was also done when adjusting the intermediate and proximal levels. RESULTS: At the distal level, no variable was significantly associated with the outcome. At the intermediate level, mother’s age greater than or equal to 35 years (relative risk – RR = 1.32; 95%CI 1.04–1.66), cesarean delivery (RR = 1.34; 95%CI 1.07–1.67), smoking (RR = 1.48; 95%CI 1.04–2.10), gestational hypertensive syndrome (RR = 2.29; 95%CI 1.98–3.14), pre-gestational diabetes (RR = 2.63; 95%CI 1.36–5.05) and twin pregnancy (RR = 2.98; 95%CI 1.90–4.68) were variables associated with the outcome. At the proximal level, inadequate prenatal care (RR = 1.71; 95%CI 1.36–2.16) and the hospital/maternity being located in a capital city (RR = 1.89; 95%CI 1.40–2.55) were associated with neonatal near miss. CONCLUSIONS: The results show that neonatal near miss was influenced by variables related to the organization of health services and by maternal characteristics.
id USP-23_226057b84484687583b8b343317c969c
oai_identifier_str oai:revistas.usp.br:article/180006
network_acronym_str USP-23
network_name_str Revista de Saúde Pública
repository_id_str
spelling Factors associated with neonatal near miss in BrazilFatores associados ao near miss neonatal no BrasilNear missComplicações na GravidezFatores de RiscoFatores SocioeconômicosServiços de Saúde Materno-InfantilNear missHealthcarePregnancy ComplicationsRisk FactorsSocioeconomic FactorsMaternal-Child Health ServicesOBJECTIVE: This study evaluates the association between sociodemographic factors, maternal characteristics, organization of health services and neonatal near miss in public and private maternity hospitals in Brazil. METHODS: This is a prospective cohort of live births from the Nascer no Brasil survey, carried out between 2011 and 2012. Variables were established from the literature and organized on three levels: distal, intermediate, and proximal. The assessment was performed based on results of the bivariate analyzes and their respective p-values, with a significance level <0.20, using the Wald test. For multivariate analysis, the variables contained at the distal level were inserted, preserved in the model when significant (p < 0.05). This was also done when adjusting the intermediate and proximal levels. RESULTS: At the distal level, no variable was significantly associated with the outcome. At the intermediate level, mother’s age greater than or equal to 35 years (relative risk – RR = 1.32; 95%CI 1.04–1.66), cesarean delivery (RR = 1.34; 95%CI 1.07–1.67), smoking (RR = 1.48; 95%CI 1.04–2.10), gestational hypertensive syndrome (RR = 2.29; 95%CI 1.98–3.14), pre-gestational diabetes (RR = 2.63; 95%CI 1.36–5.05) and twin pregnancy (RR = 2.98; 95%CI 1.90–4.68) were variables associated with the outcome. At the proximal level, inadequate prenatal care (RR = 1.71; 95%CI 1.36–2.16) and the hospital/maternity being located in a capital city (RR = 1.89; 95%CI 1.40–2.55) were associated with neonatal near miss. CONCLUSIONS: The results show that neonatal near miss was influenced by variables related to the organization of health services and by maternal characteristics.OBJETIVO: Este estudo avalia a associação entre fatores sociodemográficos, características maternas, organização dos serviços de saúde e near miss neonatal em maternidades públicas e privadas do Brasil. MÉTODOS: Trata-se de uma coorte prospectiva de nascidos vivos da pesquisa Nascer no Brasil, realizada entre 2011 e 2012. As variáveis foram estabelecidas a partir da literatura e organizadas em três níveis: distal, intermediário e proximal. A avaliação foi realizada a partir dos resultados das análises bivariadas e de seus respectivos valores-p, com nível de significância < 0,20, pelo teste de Wald. Para a análise multivariada, foram inseridas as variáveis contidas no nível distal, conservadas no modelo quando significativas (p < 0,05). O mesmo foi feito no ajuste dos níveis intermediário e proximal. RESULTADOS: No nível distal, nenhuma variável apresentou associação significativa com o desfecho. No nível intermediário, idade da mãe maior ou igual a 35 anos (risco relativo – RR = 1,32; IC95% 1,04–1,66), parto cesáreo (RR = 1,34; IC95% 1,07–1,67), uso de fumo (RR = 1,48; IC95% 1,04–2,10), síndrome hipertensiva gestacional (RR = 2,29; IC95% 1,98–3,14), diabetes pré-gestacional (RR = 2,63; IC95% 1,36–5,05) e gestação gemelar (RR = 2,98; IC95% 1,90–4,68) foram variáveis associadas ao desfecho. No nível proximal, o pré-natal não adequado (RR = 1,71; IC95% 1,36–2,16) e a localização do hospital/maternidade na capital (RR = 1,89; IC95% 1,40–2,55) foram associados ao near miss neonatal. CONCLUSÃO: Os resultados mostram que o near miss neonatal foi influenciado pelas variáveis da organização dos serviços de saúde e pelas características maternas.Universidade de São Paulo. Faculdade de Saúde Pública2020-12-29info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdftext/xmlhttps://www.revistas.usp.br/rsp/article/view/18000610.11606/s1518-8787.2020054002382Revista de Saúde Pública; Vol. 54 (2020); 123Revista de Saúde Pública; Vol. 54 (2020); 123Revista de Saúde Pública; v. 54 (2020); 1231518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/180006/167501https://www.revistas.usp.br/rsp/article/view/180006/167502https://www.revistas.usp.br/rsp/article/view/180006/167503Copyright (c) 2020 Revista de Saúde Públicahttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessPereira, Theonas GomesRocha, Daniele Marano daMoreira, Maria Elisabeth LopesGama, Silvana Granado Nogueira da2020-12-16T16:13:34Zoai:revistas.usp.br:article/180006Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2020-12-16T16:13:34Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Factors associated with neonatal near miss in Brazil
Fatores associados ao near miss neonatal no Brasil
title Factors associated with neonatal near miss in Brazil
spellingShingle Factors associated with neonatal near miss in Brazil
Pereira, Theonas Gomes
Near miss
Complicações na Gravidez
Fatores de Risco
Fatores Socioeconômicos
Serviços de Saúde Materno-Infantil
Near miss
Healthcare
Pregnancy Complications
Risk Factors
Socioeconomic Factors
Maternal-Child Health Services
title_short Factors associated with neonatal near miss in Brazil
title_full Factors associated with neonatal near miss in Brazil
title_fullStr Factors associated with neonatal near miss in Brazil
title_full_unstemmed Factors associated with neonatal near miss in Brazil
title_sort Factors associated with neonatal near miss in Brazil
author Pereira, Theonas Gomes
author_facet Pereira, Theonas Gomes
Rocha, Daniele Marano da
Moreira, Maria Elisabeth Lopes
Gama, Silvana Granado Nogueira da
author_role author
author2 Rocha, Daniele Marano da
Moreira, Maria Elisabeth Lopes
Gama, Silvana Granado Nogueira da
author2_role author
author
author
dc.contributor.author.fl_str_mv Pereira, Theonas Gomes
Rocha, Daniele Marano da
Moreira, Maria Elisabeth Lopes
Gama, Silvana Granado Nogueira da
dc.subject.por.fl_str_mv Near miss
Complicações na Gravidez
Fatores de Risco
Fatores Socioeconômicos
Serviços de Saúde Materno-Infantil
Near miss
Healthcare
Pregnancy Complications
Risk Factors
Socioeconomic Factors
Maternal-Child Health Services
topic Near miss
Complicações na Gravidez
Fatores de Risco
Fatores Socioeconômicos
Serviços de Saúde Materno-Infantil
Near miss
Healthcare
Pregnancy Complications
Risk Factors
Socioeconomic Factors
Maternal-Child Health Services
description OBJECTIVE: This study evaluates the association between sociodemographic factors, maternal characteristics, organization of health services and neonatal near miss in public and private maternity hospitals in Brazil. METHODS: This is a prospective cohort of live births from the Nascer no Brasil survey, carried out between 2011 and 2012. Variables were established from the literature and organized on three levels: distal, intermediate, and proximal. The assessment was performed based on results of the bivariate analyzes and their respective p-values, with a significance level <0.20, using the Wald test. For multivariate analysis, the variables contained at the distal level were inserted, preserved in the model when significant (p < 0.05). This was also done when adjusting the intermediate and proximal levels. RESULTS: At the distal level, no variable was significantly associated with the outcome. At the intermediate level, mother’s age greater than or equal to 35 years (relative risk – RR = 1.32; 95%CI 1.04–1.66), cesarean delivery (RR = 1.34; 95%CI 1.07–1.67), smoking (RR = 1.48; 95%CI 1.04–2.10), gestational hypertensive syndrome (RR = 2.29; 95%CI 1.98–3.14), pre-gestational diabetes (RR = 2.63; 95%CI 1.36–5.05) and twin pregnancy (RR = 2.98; 95%CI 1.90–4.68) were variables associated with the outcome. At the proximal level, inadequate prenatal care (RR = 1.71; 95%CI 1.36–2.16) and the hospital/maternity being located in a capital city (RR = 1.89; 95%CI 1.40–2.55) were associated with neonatal near miss. CONCLUSIONS: The results show that neonatal near miss was influenced by variables related to the organization of health services and by maternal characteristics.
publishDate 2020
dc.date.none.fl_str_mv 2020-12-29
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/180006
10.11606/s1518-8787.2020054002382
url https://www.revistas.usp.br/rsp/article/view/180006
identifier_str_mv 10.11606/s1518-8787.2020054002382
dc.language.iso.fl_str_mv por
eng
language por
eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/180006/167501
https://www.revistas.usp.br/rsp/article/view/180006/167502
https://www.revistas.usp.br/rsp/article/view/180006/167503
dc.rights.driver.fl_str_mv Copyright (c) 2020 Revista de Saúde Pública
http://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2020 Revista de Saúde Pública
http://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
text/xml
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 54 (2020); 123
Revista de Saúde Pública; Vol. 54 (2020); 123
Revista de Saúde Pública; v. 54 (2020); 123
1518-8787
0034-8910
reponame:Revista de Saúde Pública
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Revista de Saúde Pública
collection Revista de Saúde Pública
repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
repository.mail.fl_str_mv revsp@org.usp.br||revsp1@usp.br
_version_ 1800221801840640000