edoc

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

Andrews, Kathryn and Bourroul, Maria Lúcia Moraes and Fink, Günther and Grisi, Sandra and Scoleze Ferrer, Ana Paula and Diniz, Edna Maria de Albuquerque and Brentani, Alexandra. (2017) Time to change focus? Transitioning from higher neonatal to higher stillbirth mortality in São Paulo State, Brazil. PLoS ONE, 12 (12). e0190060.

[img] PDF - Published Version
Available under License CC BY (Attribution).

9Mb

Official URL: http://edoc.unibas.ch/58323/

Downloads: Statistics Overview

Abstract

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.; 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 São Paulo state's 645 municipalities.; 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.; 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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Household Economics and Health Systems Research > Household Economics and Health Systems Research (Fink)
UniBasel Contributors:Fink, Günther
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Public Library of Science
e-ISSN:1932-6203
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:31 Aug 2018 06:38
Deposited On:02 Feb 2018 10:05

Repository Staff Only: item control page