Time to change focus? Transitioning from higher neonatal to higher stillbirth mortality in Sao Paulo State, Brazil

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art_ANDREWS_Time_to_change_focus_Transitioning_from_higher_neonatal_2017.PDF (10.23 MB)
Citações na Scopus
6
Tipo de produção
article
Data de publicação
2017
DOI
Scopus
Web of Science
PubMed
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ISSN da Revista
Título do Volume
Editora
PUBLIC LIBRARY SCIENCE
Autores
ANDREWS, Kathryn
FINK, Gunther
Citação
PLOS ONE, v.12, n.12, article ID e0190060, 13p, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background Differential trends in mortality suggest that stillbirths may dominate neonatal mortality in the medium to long run. Brazil has made major efforts to improve data collection on health indicators at granular geographic levels, and provides an ideal environment to test this hypothesis. Our goals were to examine levels and trends in stillbirths and neonatal deaths and the extent to which the mortality burden caused by stillbirths dominates neonatal mortality at the municipality-and state-level. Methods We used data from the Brazilian Ministry of Health's repository on births, fetal, and neonatal deaths (2010 +/- 2014) to calculate stillbirth and neonatal mortality rates for Sao Paulo state's 645 municipalities. Results At the state level, 7.9 per 1000 pregnancies ended in stillbirth (fetal death >22 weeks gestation or fetal weight >500g), but this varied from 0.0 to 28.4 per 1000 across municipalities. 7.9 per 1000 live births also died within the first 28 days. 42% of municipalities had a higher stillbirth rate than neonatal mortality rate, and in 61% of areas with low neonatal mortality (<8.0 per 1000), stillbirth rates exceeded neonatal mortality rates. Conclusions This analysis suggests large variability and inequality in mortality outcomes at the sub-national level. The results also imply that stillbirth mortality may exceed neonatal mortality in Brazil and similar settings in the next few decades, which suggests a need for a shift in policy. This work further underscores the importance of continued research into causes and prevention of stillbirth.
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https://observatorio.fm.usp.br/handle/OPI/25641
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPE
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - LIM/21
Artigos e Materiais de Revistas Científicas - ODS/03