Author(s)

Rosângela Aparecida Pimenta Ferrari^1*, Maria Rita Girotto², Edmarlon Girotto³, José Carlos Dalmas⁴, Alexandrina Aparecida Maciel Cardelli¹

¹Department of Nursing, Health Sciences Center, State University of Londrina (UEL), Londrina, Brazil.
²Department of Public Health, School of Nursing, University of Sao Paulo (EEUSP), Sao Paulo, Brazil.
³Department of Pharmacy, Health Sciences Center, State University of Londrina (UEL), Londrina, Brazil.
⁴Department of Statistics, Centre for Mathematical Sciences, State University of Londrina (UEL), Londrina, Brazil.

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 < 0.05. Results: 63.7% of 537 neonates were born in hospitals with maternities and neonatal intensive therapy unit; 60.7% weighed ≤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.

Accessibility to Health Services, Neonatal Mortality, Gynecology and Obstetrics Hospital Unit, Ne-onatal Intensive Therapy Unit

Ferrari, R. , Girotto, M. , Girotto, E. , Dalmas, J. and Cardelli, A. (2016) Neonatal Death Rates: Lack of Equal Access to Hospital Obstetric Service and Intensive Therapy. Open Journal of Obstetrics and Gynecology, 6, 259-267. doi: 10.4236/ojog.2016.65033.