Survival at nine neonatal intensive care units in São Paulo, Brazil

A collaborative effort to assess factors affecting newborn survival at neonatal intensive care units (NICUs) was made by studying 1948 newborns admitted to nine NICUs in the city of São Paulo between 1 June and 30 November 1991. Data on the study subjects were obtained using a standardized form. This was the first activity undertaken by a network of neonatologists (the Paulista Collaborative Group on Neonatal Care) dedicated to jointly evaluating and improving neonatal care in that city. The study results showed an overall mortality of 59 deaths per 1,000 neonates, with survival improving as gestational age and birthweight rose. Other variables significantly affecting survival were a poor maternal obstetric history (a previous stillbirth or neonatal death, or two or more spontaneous abortions); birth asphyxia (Apgar at 5 minutes < 7); respiratory distress syndrome; severe infections; and major malformations. However, multiple logistic regression analysis showed that the rates of neonatal survival in the nine NICUs differed even when these factors were considered. Potential sources of this variability included undetermined population differences in neonatal disease severity and medical care. These results suggest a need for greater efforts to identify and reduce risk factors associated with neonatal mortality, and to adequately evaluate the medical care provided in NICUs. Within this context, the collaborative network of neonatologists established in São Paulo provides a sound organizational structure for evaluating and improving the effectiveness of neonatal care

Asphyxia · Context (archaeology · Environmental health · Gestational age · Intensive care · Intensive care medicine · Logistic regression · Neonatal intensive care unit · Population · Pregnancy · Respiratory distress · Global Maternal and Child Health · Infant Development and Preterm Care · Maternal and Neonatal Healthcare · Medicine · Emergency Medicine · Pediatrics

• Aplicação do escore CRIB como preditor de óbito em unidade de terapia intensiva neonatal

  Open Access•Luiz Fernando Costa Nascimento, Rosana dos Santos Ramos•Revista Brasileira de Saúde…•2004

  Incluir item

• Estudo da mortalidade de recém-nascidos internados na UTI neonatal do Hospital Geral de Caxias do Sul, Rio Grande do Sul

  Open Access•Breno Fauth De Araújo, Ana Cristina D''Andretta Tanaka et al.•Revista Brasileira de Saúde…•2005

  Incluir item

• Mortalidade infantil e acesso geográfico ao parto nos municípios brasileiros

  Open Access•Wanessa Da Silva De Almeida, Célia Landmann Szwarcwald•Revista de Saúde Pública•2012

  Incluir item

• Neonatal mortality in intensive care units of Central Brazil

  Open Access•Claci Fátima Weirich, Ana Lúcia Sampaio Sgambatti De Andrade et al.•Revista de Saúde Pública•2005

  Incluir item

• The Adequacy of Prenatal Care Utilization Index

  Milton Kotelchuck•American Journal of Public Health•1994

  Incluir item

• Situação de saúde materna e perinatal no Estado de São Paulo, Brasil

  Open Access•Ana Cristina D''Andretta Tanaka, Ana Cristina D'Andretta Tanaka et al.•Revista de Saúde Pública•1989

  Incluir item

• Comparing Hospital Perinatal Mortality Rates

  BRUNO HOLTHOF, PETER PRINS•Medical Care•1993

  Incluir item

• World Development Report 1993

  World Bank•World Development Report 1993•1993

  Incluir item