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