Factores de riesgo para mortalidad neonatal en niños con bajo peso al nacer

Abstract

Objective: To analyze the risk factors associated with neonatal deaths among children with low birth weight. Methods: A cohort study was carried out on live births weighing between 500 g and 2,499 g from single pregnancies without anencephaly in Recife (Northeastern Brazil) between 2001 and 2003. Data on 5,687 live births and 499 neonatal deaths obtained from the Live Birth Information System and the Mortality Information System were integrated through the linkage technique. Using a hierarchical model, variables from the distal level (socioeconomic factors), intermediate level (healthcare factors) and proximal level (biological factors) were subjected to univariate analysis and multivariate logistic regression. Results: After adjusting the variables through multivariate logistic regression, the factors from the distal level that remained significantly associated with neonatal death were: cohabitation by the parents, number of live births and type of maternity hospital. At the intermediate level, the factors were: number of prenatal consultations, complexity of the maternity hospital and type of delivery. At the proximal level, the factors were: sex, gestational age, birth weight, Apgar score and presence of congenital malformation. Conclusions: The main factors associated with neonatal mortality among low weight live births are related to prenatal and postnatal care. Such factors are reducible through health sector actions. © 2009 Faculdade de Saúde Pública da Universidade de São Paulo.