期刊
JORNAL DE PEDIATRIA
卷 95, 期 5, 页码 519-530出版社
SOC BRASIL PEDIATRIA
DOI: 10.1016/j.jped.2018.12.014
关键词
Neonatal mortality; Risk factors; Brazil; Review systematic; Meta-analysis
类别
资金
- Conselho Nacional de Pesquisa e Desenvolvimento Cientifico e Tecnologico [129015/2017-2]
Objective: To identify, using a systematic review and meta-analysis of observational studies, which risk factors are significantly associated with neonatal mortality in Brazil, and to build a comprehensive national analysis on neonatal mortality. Sources: This review included observational studies on neonatal mortality, performed between 2000 and 2018 in Brazilian cities. The MEDLINE, Elsevier, Cochrane, LILACS, SciELO, and Open-Grey databases were used. For the qualitative analysis, the Newcastle-Ottawa Scale was used. For the quantitative analysis, the natural logarithms of the risk measures and their confidence intervals were used, as well as the DerSimonian and Laird method as a random effects model, and the Mantel-Haenszel model for heterogeneity estimation. A confidence level of 95% was considered. Summary of findings: The qualitative analysis resulted in six studies of low and four studies of intermediate-low bias risk. The following exposure factors were significant: absence of partner, maternal age >= 35 years, male gender, multiple gestation, inadequate and absent prenatal care, presence of complications during pregnancy, congenital malformation in the assessed pregnancy, Apgar < 7 at the fifth minute, low and very low birth weight, gestational age <= 37 weeks, and caesarean delivery. Conclusion: The most significant risk factors presented in this study are modifiable, allowing aiming at a real reduction in neonatal deaths, which remain high in the country. (C) 2019 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda.
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