Factors associated with neonatal near miss and death in public referral maternity hospitals

• Main Author: Carvalho,Ocília Maria Costa
• Publication Date: 2020
• Other Authors: Viana Junior,Antônio Brazil, Augusto,Matheus Costa Carvalho, Xavier,Ana Tallita Oliveira, Gouveia,Ana Paula Mendes, Lopes,Fernanda Nogueira Barbosa, Carvalho,Francisco Herlânio Costa
• Format: Article
• Language: eng
• Source: Revista Brasileira de Saúde Materno Infantil (Online)
• Download full: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1519-38292020000300839
• topic: Near miss; Child mortality; Infant low birth weight

Abstract Objectives: to evaluate factors associated with neonatal near miss and death in reference hospitals. Methods: this case-control study included 364 cases and 728 controls among 4,929 births. Cases were identified by Apgar < 7 at 5 minutes, weight < 1500 g, gestational age <32 weeks, mechanical ventilation or congenital malformation. After follow-up, outcomes were reclassified into: true controls, near miss and neonatal death. Hierarchically, variables with a p-value < 0.20 were included in the multiple logistic regression. Results: the neonatal near miss rate was 54.1 per 1,000 live births, and the near-miss-to-death ratio was 2.75. Between the control and near miss groups, the predictor variables were neonatal intensive care admission [OR = 35.6 (16.7 - 75.9)] and central venous access [OR= 74.8 (29.4 - 190.4)]. Between the control and death groups, neonatal intensive care admission [OR = 100.4 (18.8 - 537.0)] and central venous access [OR = 12.7 (3.7 - 43.2)] were significant. Between the near miss and death groups, only Apgar < 7 at 5 minutes [OR = 4.1 (1.6 - 10.6)] and vasoactive drug use [OR = 42.2 (17.1 - 104.5)] were significant. Conclusion: factors associated with a greater chance of near miss and/or neonatal death were: Apgar score <7 at 5 minutes, neonatal intensive care confinement, having central venous access, and use of vasoactive drugs.