Evolution of neonatal mortality by preventable causes over the past ten years in Espírito Santo State

Abstract Objectives: analyze neonatal mortality causes, highlighting the pteventable ones from 2008 to 2017, in Espírito Santo State and health regions. Methods: ecological study of temporal series on neonatal mortality using data from Mortality Information System and from Live Birth Information System. The death causes were classified based on the List of Avoidable Causes of Deaths due to Interventions of the Brazilian Health System. The temporal tendency was analyzed using linear regression. Results: the neonatal mortality rate reduced, approximately 5%, with a reduction of almost 27% in the late neonatal component. Approximately, 70% of neonatal deaths were preventable, with a higher frequency of reducible causes by adequate care at pregnancy, childbirth and to the newborn. The reduction was significant for adequate care for pregnant women in Espírito Santo and in Metropolitan Region and due to adequate care to the newborn in the South Region. Conclusions: the main causes of neonatal deaths were due inadequate care for women during pregnancy, at childbirth and to the newborn, despite the reduction in neonatal mortality over the past 10 years. This study may contribute to the planning of health policies to improve care for pregnant women, parturient and to the newborn.

摘要
研究目标：分析2008至2017年圣埃斯皮里图州（Espírito Santo State）及其卫生区域的新生儿死亡原因，重点凸显其中可预防的死亡案例。
研究方法：采用死亡信息系统（Mortality Information System）与活产信息系统（Live Birth Information System）的数据，开展新生儿死亡率时间序列生态学研究；死亡原因依据《巴西卫生系统干预可避免死亡清单》（List of Avoidable Causes of Deaths due to Interventions of the Brazilian Health System）进行分类，并通过线性回归（linear regression）分析时间变化趋势。
研究结果：新生儿死亡率下降约5%，其中晚期新生儿死亡组分的降幅近27%；约70%的新生儿死亡属于可预防死亡，妊娠、分娩及新生儿期的优质照护可有效降低此类可归因病因的发生频率。圣埃斯皮里图州及大都市区针对孕妇的优质护理相关死亡率下降、南部地区针对新生儿的优质护理相关死亡率下降均具有统计学显著性。
研究结论：尽管过去十年间新生儿死亡率有所下降，但新生儿死亡的主要诱因仍为孕妇妊娠、分娩期及新生儿期的照护不足。本研究可为优化孕妇、产妇及新生儿的医疗照护政策规划提供参考依据。