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 研究目的：分析2008至2017年圣埃斯皮里图州（Espírito Santo State）及其各卫生区域的新生儿死亡原因，重点明确其中可预防的死亡案例。研究方法：本研究为时间序列生态学研究，采用巴西死亡信息系统（Mortality Information System）与活产信息系统（Live Birth Information System）的相关数据；死亡原因依据《巴西卫生系统可避免死亡干预清单》（List of Avoidable Causes of Deaths due to Interventions of the Brazilian Health System）进行分类；采用线性回归方法分析时间趋势。研究结果：研究期间新生儿死亡率下降约5%，其中晚期新生儿死亡组分降幅近27%；约70%的新生儿死亡属于可预防范畴，其中以妊娠、分娩及新生儿期可通过规范照护避免的死亡原因占比更高；圣埃斯皮里图州及都会区孕妇规范照护相关死亡率、南部地区新生儿规范照护相关死亡率均出现显著下降。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、分娩期及新生儿期照护不足；本研究可为优化孕妇、分娩期妇女及新生儿的卫生照护政策规划提供参考依据。