Stillbirth, newborn and infant mortality: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982-2015

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art_MENEZES_Stillbirth_newborn_and_infant_mortality_trends_and_inequalities_2019.PDF (632.66 KB)
Citações na Scopus
20
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
OXFORD UNIV PRESS
Autores
MENEZES, Ana M. B.
BARROS, Fernando C.
HORTA, Bernardo L.
BERTOLDI, Andrea Damaso
OLIVEIRA, Paula D.
VICTORA, Cesar G.
BARROS, Aluisio J. D.
BASSANI, Diego G.
WEHRMEISTER, Fernando C.
Citação
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, v.48, suppl.1, p.i54-i62, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background Infant-mortality rates have been declining in many low- and middle-income countries, including Brazil. Information on causes of death and on socio-economic inequalities is scarce. Methods Four birth cohorts were carried out in the city of Pelotas in 1982, 1993, 2004 and 2015, each including all hospital births in the calendar year. Surveillance in hospitals and vital registries, accompanied by interviews with doctors and families, detected fetal and infant deaths and ascertained their causes. Late-fetal (stillbirth)-, neonatal- and post-neonatal-death rates were calculated. Results All-cause and cause-specific death rates were reduced. During the study period, stillbirths fell by 47.8% (from 16.1 to 8.4 per 1000), neonatal mortality by 57.0% (from 20.1 to 8.7) and infant mortality by 62.0% (from 36.4 to 13.8). Perinatal causes were the leading causes of death in the four cohorts; deaths due to infectious diseases showed the largest reductions, with diarrhoea causing 25 deaths in 1982 and none in 2015. Late-fetal-, neonatal- and infant-mortality rates were higher for children born to Brown or Black women and to low-income women. Absolute socio-economic inequalities based on incomeexpressed in deaths per 1000 birthswere reduced over time but relative inequalitiesexpressed as ratios of mortality ratestended to remain stable. Conclusion The observed improvements are likely due to progress in social determinants of health and expansion of health care. In spite of progress, current levels remain substantially greater than those observed in high-income countries, and social and ethnic inequalities persist.
Palavras-chave
stillbirth, infant mortality, cohort studies, socio-economic factors, infant newborn
URI
https://observatorio.fm.usp.br/handle/OPI/31796
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPR
Artigos e Materiais de Revistas Científicas - LIM/39
Artigos e Materiais de Revistas Científicas - ODS/01
Artigos e Materiais de Revistas Científicas - ODS/03
Artigos e Materiais de Revistas Científicas - ODS/10