Fatores associados à internação e à mortalidade neonatal em uma coorte de recém-nascidos do Sistema Único de Saúde, no município de São Paulo
Bárbara Laisa Alves Moura, Gizelton Pereira Alencar, Zilda Pereira da Silva, Márcia Furquim de Almeida
Abstract
INTRODUCTION: Newborn care is an important factor associated with hospitalization and neonatal mortality. OBJECTIVE: To analyze factors associated with hospitalization and neonatal mortality of newborns (NBs) admitted to the Unified Health System (SUS), São Paulo, 2012. METHODS: A cohort of NBs from the SUS was obtained by linking data: SUS Hospital Information System, Live Birth Information System, Mortality Information System and National Health Facility Registry. Poisson and Cox regression were performed. RESULTS: 16.5% (9,127) of the NBs were hospitalized, 4.7% (2,613) were admitted to a Neonatal Intensive Care Unit (NICU) and 11.8% (6,514) to a Neonatal Intermediate Care Unit (NIMCU). Maternal age ≥ 35 years (RR = 1.1, IC95% 1.1 - 1.2), inadequate prenatal care (RR = 1.2, IC95% 1.1 - 1.3), hospitalization for obstetric complications (RR = 1.1, IC95% 1.1 - 1.2), prematurity (≤ 32 weeks: RR = 1.6, IC95% 1.5 - 1.8; 32 to 36 weeks: RR = 1.7, IC95% 1.6 - 1,7), low weight (< 1,500 g: RR = 2.4, IC95% 2.1 - 2.6; 1,500 to 2,499 g: RR = 2.6, IC95% 2.5 - 2.7), APGAR 5º < 7 (RR = 1.9, IC95% 1.7 - 2.0), Cesarean section (RR = 1.1, IC95% 1.1 - 1.2) and Congenital Malformation (RR = 1.4, IC95% 1.3 - 1,5) were associated with the hospitalization of newborns. Neonatal mortality was associated with infants under 1,500 g (RR = 9.1, IC95% 6.3 - 13.1), very premature (RR = 2.6, IC95% 1.9 - 3.5), low APGAR (RR = 5.5, IC95% 4.6 - 6.7). CONCLUSION: Inadequate prenatal care, prematurity and low weight were risk factors for hospitalization and neonatal mortality.