Avaliação dos fatores de risco para mortalidade infantil em Cubatão no período compreendido entre os anos 2011 e 2016

Abstract

Introduction: Infant mortality rate is considered worldwide one of the most important epidemiological indicators to evaluate regional health conditions and socioeconomic development. It comprises the sum of deaths occurred in the early neonatal period (0-6 days of life), late neonatal period (7-28 days) and post-neonatal period (between 29 and 364 days). The city of Cubatão has consistently shown high infant mortality rates, despite its rich industrial pole. Objective: this study aimed to identify the determinants of infant mortality in the city of Cubatão between the years 2011 and 2016. Method: A case-control study was carried out with 50 case mothers (whose children were born alive in the studied period died before the first birthday) and 50 control mothers (whose children were born alive in the studied period and who did not die before the first birthday). To conduct the interviews, a questionnaire was prepared and validated using other validated and non-validated instruments. Descriptive analysis was performed. To assess the association between qualitative variables, Chi-square and Fischer's exact tests were used. To evaluate the factors associated with the analyzed outcomes, the univariate and multiple logistic regression model was used. The level of significance adopted was 5%. Result: Among the 50 cases, 76% died in the neonatal period, 25 (50%) died in the early neonatal period and 13 (26%) in the late neonatal period. Only in the group of cases did we find low birth weight (64%) and malformations (26%). The variables analyzed in the final multiple model were maternal education, preterm birth, gestational hypertensive disease and premature onset of work delivery. Of these variables, prematurity showed a strong association with infant mortality (ODDS RATIO = 34.401; 95% CI: 5.772-205.039) and maternal education showed a strong trend of association with this health indicator (ODDS RATIO = 4.950; 95% CI: 0.905-27.069). Conclusion: Among the risk factors studied, prematurity showed a clear association with infant mortality. Premature care requires investment in infrastructure and personnel to ensure adequate care for the newborn.