TITLE:
Neonatal Death Rates: Lack of Equal Access to Hospital Obstetric Service and Intensive Therapy
AUTHORS:
Rosângela Aparecida Pimenta Ferrari, Maria Rita Girotto, Edmarlon Girotto, José Carlos Dalmas, Alexandrina Aparecida Maciel Cardelli
KEYWORDS:
Accessibility to Health Services, Neonatal Mortality, Gynecology and Obstetrics Hospital Unit, Ne-onatal Intensive Therapy Unit
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.6 No.5,
April
7,
2016
ABSTRACT: Aim: To identify the association between
access to obstetric and neonatal hospital service and neonatal death rates.
Method: Quantitative and retrospective research retrieved from Declaration of
Live Newly-born Children; Declaration of Death; Investigation Chart on
Municipal Child Mortality, between 2000 and 2009, at the Nucleus of Information
on Mortality Rates. The population studied comprised 537 neonatal deaths and
mothers with residence in the municipality, and investigated by the work team
of the Committee for the Investigation of Mother-Child Deaths. Data were
analyzed in Epi Info 2002? computer program and the Statistical Package for the
Social Sciences? was used. Chi-square Test and Fischer’s Exact Test were
applied at p ≤1.500 grams;
76.7% had a pregnancy age of ≤36 weeks; 73% died of asphyxia in the 1st minute and 73.5% died
during the perinatal period. Throughout the ten years of analysis, access to
hospital obstetric service without NITU reduced death rate from 25% in 2000 to
6.8% in 2009. There was a significant statistical association between place of
delivery and maternal socio-demographic variables (maternal age bracket p =
0.028; schooling p = 0.000; family income p = 0.000); occupation p = 0.000) and
neonatal variables (race/skin color p = 0.007; type of delivery p = 0.000;
weight at birth p = 0.000; pregnancy age p = 0.000 and Apgar Score 1st minute p
= 0.000 and Apgar Score 5th minute p = 0.007). Conclusion: Although the
municipal government provides obstetric services and specialized neonatal care,
this right is not extensive to all; gaps at different levels in mother-child
care should be identified to reduce neonatal deaths.