Maternal education and age

Inequalities in neonatal death

Bibliographic Data

ID16779903
AuthorsSérgio C Fonseca (0000-0001-5493-494X, Universidade Federal Fluminense), Sandra Costa Fonseca, Patricia Viana Guimarães Flores (Universidade Federal do Rio de Janeiro), Kenneth R De Camargo Jr (0000-0003-3606-5853, Universidade do Estado do Rio de Janeiro), Kenneth Rochel Camargo Júnior, Rômulo Sampaio Pinheiro (0000-0002-3361-3626, Universidade Federal do Rio de Janeiro), Rejane Sobrino Pinheiro, Claudia Medina Coeli (0000-0003-1757-3940, Universidade Federal do Rio de Janeiro)
Year2017
Volume51
Pages94
Publication date2017-11-24
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueRevista de Saúde Pública (JOURNAL)
Journal identifiersISSN: 0034-8910 • E-ISSN: 0034-8910
PublisherUniversidade de Sao Paulo, Agencia USP de Gestao da Informacao Academica (AGUIA) (PUBLISHER)
DOI10.11606/s1518-8787.2017051007013
PMID29166446
OpenAlexW2767518501
LanguageEN
Citations received11
References cited15

OBJECTIVE: Evaluate the interaction between maternal age and education level in neonatal mortality, as well as investigate the temporal evolution of neonatal mortality in each stratum formed by the combination of these two risk factors. METHODS: A nonconcurrent cohort study, resulting from a probabilistic relationship between the Mortality Information System and the Live Birth Information System. To investigate the risk of neonatal death we performed a logistic regression, with an odds ratio estimate for the combined variable of maternal education and age, as well as the evaluation of additive and multiplicative interaction. The neonatal mortality rate time series, according to maternal education and age, was estimated by the Joinpoint Regression program. RESULTS: The neonatal mortality rate in the period was 8.09‰ and it was higher in newborns of mothers with low education levels: 12.7‰ (adolescent mothers) and 12.4‰ (mother 35 years old or older). Low level of education, without the age effect, increased the chance of neonatal death by 25% (OR = 1.25, 95%CI 1.14–1.36). The isolated effect of age on neonatal death was higher for adolescent mothers (OR = 1.39, 95%CI 1.33–1.46) than for mothers aged ≥ 35 years (OR = 1.16, 95%CI 1.09–1.23). In the time-trend analysis, no age group of women with low education levels presented a reduction in the neonatal mortality rate for the period, as opposed to women with intermediate or high levels of education, where the reduction was significant, around 4% annually. CONCLUSIONS: Two more vulnerable groups – adolescents with low levels of education and older women with low levels of education – were identified in relation to the risk of neonatal death and inequality in reducing the mortality rate

Cohort study · Environmental health · Infant mortality · Logistic regression · Mortality rate · Neonatal mortality · Population · Demography · Global Maternal and Child Health · Maternal and fetal healthcare · Maternal and Neonatal Healthcare · Medicine · Surgery · Pediatrics