Infant mortality in Mato Grosso, Brazil: trend and causes of death between 2007 and 2016

Abstract Geographical and temporal variations in infant mortality subsidize the process of planning and assessing maternal and child health. This is a time-series study that set out to analyze the trend of infant mortality in Mato Grosso and its health regions from 2007 to 2016 and to identify the distribution of causes of death according to age group and birth weight. For the trend analysis, the infant mortality rates stratified by causes of death between 2007 and 2016 were evaluated using polynomial regression models. There was a decreasing linear trend in infant mortality rates in the state, but individually only four of the 16 health regions followed this trend. Half of the deaths occurred in the early neonatal period. Causes avoidable by adequate attention to women during pregnancy and childbirth and to the newborn represented 51.1% of the deaths. There was an increasing tendency of proportional mortality for causes not manifestly avoidable. It is acknowledged that it is important to know the trend of rates in order to define priority population groups for early interventions that increase survival and reduce infant mortality. In addition, the investigation of deaths in the state should be implemented to establish the underlying cause.

摘要 婴儿死亡率的地理与时间变异特征，可为妇幼卫生规划与评估工作提供关键支撑。本研究为时间序列研究，旨在分析2007至2016年马托格罗索州及其所辖各卫生区域的婴儿死亡率变化趋势，并按年龄组与出生体重分类，明确死亡原因的分布情况。针对趋势分析环节，本研究采用多项式回归模型，对2007至2016年间按死亡原因分层的婴儿死亡率数据进行评估。结果显示，该州整体婴儿死亡率呈线性下降趋势，但16个卫生区域中仅4个区域契合这一整体下降趋势。研究期间，近半数死亡病例发生于早期新生儿阶段。经孕期、分娩期照护及新生儿照护可避免的死因，占总死亡数的51.1%；而非明显可避免死因的死亡构成比则呈上升趋势。本研究证实，明确死亡率变化趋势，有助于确定早期干预的优先人群，以提升新生儿生存率、降低婴儿死亡率。此外，需针对该州的死亡病例开展调查，以明确其根本死亡原因。