Factors associated with neonatal near miss in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , |
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. |
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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 |