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Neonatal mortality by gestational age in days in infants born at term: A cohort study in Sao Paulo city, Brazil
Indexado
WoS WOS:000924955100045
Scopus SCOPUS_ID:85142362426
DOI 10.1371/JOURNAL.PONE.0277833
Año 2022
Tipo artículo de investigación

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras


Abstract



Birth at term comprises a period with heterogeneous neonatal outcomes that tend to be worse for infants born earlier. However, few studies have analyzed this period, in which each day can make a difference. Therefore, we aim to assess neonatal mortality (NM) according to gestational age (GA) at birth measured in days in term liveborn infants born in 2012-2017 in São Paulo, the largest city in Latin America. This population-based cohort study assessed term liveborn infants followed until the end of the neonatal period. We analyzed 7 models for NM according to GA in days: crude NM adjusted for maternal and prenatal variables, NM additionally adjusted for type of birth and type of hospital, and adjusted NM stratified by type of birth (cesarean and vaginal) and by type of hospital (public and private). We included 440,119 live infants born at 259-293 days of gestation. The median GA at birth was 274 days. In all models, NM was higher for infants born early term, decreasing in infants born full term and rising again in infants born late term. In the unadjusted model, hazard ratios of NM changed daily, decreasing from 3.34 to 1.00 on day 278 and increasing again thereafter. In the stratified analysis according to type of hospital, being born in a public hospital was associated with a reduced risk of NM for infants born at 278-283 days of pregnancy. There was a decrease in GA related to obstetric interventions, especially cesarean sections, which increased NM. The loss of days of pregnancy was larger in private hospitals. Increasing the granularity of GA to days is feasible and has the potential to drive public policies. To the best of our knowledge, this is the first Brazilian study on GA in days using a national live births database.

Revista



Revista ISSN
P Lo S One 1932-6203

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Disciplinas de Investigación



WOS
Biology
Multidisciplinary Sciences
Scopus
Sin Disciplinas
SciELO
Sin Disciplinas

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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

Colaboración Institucional



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Autores - Afiliación



Ord. Autor Género Institución - País
1 Queiroz, Marcel Reis Hombre Universidade Nove de Julho - Brasil
Universidade de São Paulo - Brasil
Nove de Julho Univ - Brasil
UNIV SAO PAULO - Brasil
2 Junqueira, Maria Elizangela Ramos - Universidade do Estado da Bahia - Brasil
Salvador Municipal Health Department - Brasil
Univ Estado Bahia - Brasil
Hlth Surveillance Board - Brasil
2 Ramos Junqueira, Maria Elizangela Mujer Universidade do Estado da Bahia - Brasil
Salvador Municipal Health Department - Brasil
Univ Estado Bahia - Brasil
Hlth Surveillance Board - Brasil
3 Roman Lay, Alejandra Andrea Mujer Universidad de Tarapacá - Chile
4 de Aquino Bonilha, Eliana Mujer Municipal Health Department of São Paulo - Brasil
São Camilo University - Brasil
Municipal Hlth Dept Sao Paulo - Brasil
Sao Camilo Univ - Brasil
4 Bonilha, Eliana de Aquino Mujer Municipal Hlth Dept Sao Paulo - Brasil
Sao Camilo Univ - Brasil
Municipal Health Department of São Paulo - Brasil
São Camilo University - Brasil
5 Borba, Mariane Furtado Mujer Universidade de São Paulo - Brasil
UNIV SAO PAULO - Brasil
5 Furtado Borba, Mariane Mujer Universidade de São Paulo - Brasil
6 Aly, Celia Maria Castex Mujer Municipal Health Department of São Paulo - Brasil
Municipal Hlth Dept Sao Paulo - Brasil
7 Moreira, Roberto Aparecido Hombre Municipal Health Department of São Paulo - Brasil
Municipal Hlth Dept Sao Paulo - Brasil
8 Diniz, Carmen Simone Grilo - Universidade de São Paulo - Brasil
UNIV SAO PAULO - Brasil
8 Grilo Diniz, Carmen Simone Mujer Universidade de São Paulo - Brasil
UNIV SAO PAULO - Brasil

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Financiamiento



Fuente
National Council for Scientific and Technological Development (CNPq)
Bill and Melinda Gates Foundation

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Agradecimientos



Agradecimiento
CSGD and EAB are responsible for the research "Potential pregnancy days lost" (PPDL): an innovative gestational age measure for to assess maternal and child health interventions and outcomes., which received funding from Bill and Melinda Gates Foundation (Investment ID OPP1201939) and National Council for Scientific and Technological Development (CNPq) (process number 443775 / 2018-4). https://www.gatesfoundation.org. https://www.gov.br/cnpq/pt-br. The funders didn't play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
CSGD and EAB are responsible for the research "Potential pregnancy days lost" (PPDL): an innovative gestational age measure for to assess maternal and child health interventions and outcomes., which received funding from Bill and Melinda Gates Foundation (Investment ID OPP1201939) and National Council for Scientific and Technological Development (CNPq) (process number 443775/2018-4). https://www.gatesfoundation.org.https://www.gov.br/cnpq/ptbr.The funders didn't play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
CSGD and EAB are responsible for the research "Potential pregnancy days lost" (PPDL): an innovative gestational age measure for to assess maternal and child health interventions and outcomes., which received funding from Bill and Melinda Gates Foundation (Investment ID OPP1201939) and National Council for Scientific and Technological Development (CNPq) (process number 443775 / 2018-4). https://www.gatesfoundation.org. https://www.gov.br/cnpq/pt-br. The funders didn't play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
CSGD and EAB are responsible for the research "Potential pregnancy days lost" (PPDL): an innovative gestational age measure for to assess maternal and child health interventions and outcomes., which received funding from Bill and Melinda Gates Foundation (Investment ID OPP1201939) and National Council for Scientific and Technological Development (CNPq) (process number 443775/2018-4). https://www.gatesfoundation.org.https://www.gov.br/cnpq/ptbr.The funders didn't play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
CSGD and EAB are responsible for the research "Potential pregnancy days lost" (PPDL): an innovative gestational age measure for to assess maternal and child health interventions and outcomes., which received funding from Bill and Melinda Gates Foundation (Investment ID OPP1201939) and National Council for Scientific and Technological Development (CNPq) (process number 443775 / 2018-4). https://www.gatesfoundation.org. https://www.gov.br/cnpq/pt-br. The funders didn't play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
CSGD and EAB are responsible for the research "Potential pregnancy days lost" (PPDL): an innovative gestational age measure for to assess maternal and child health interventions and outcomes., which received funding from Bill and Melinda Gates Foundation (Investment ID OPP1201939) and National Council for Scientific and Technological Development (CNPq) (process number 443775/2018-4). https://www.gatesfoundation.org.https://www.gov.br/cnpq/ptbr.The funders didn't play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Muestra la fuente de financiamiento declarada en la publicación.