[Early neonatal mortality according to level of hospital complexity in Greater Metropolitan São Paulo, Brazil].
The aim of this study was to analyze the profile of newborns, mothers, and early neonatal mortality according to the hospital's complexity and affiliation (or lack thereof) with the Unified National Health System (SUS) in Greater Metropolitan São Paulo, Brazil. The study was based on data for live births, deaths, and hospital registries. Factor and cluster analysis were used to obtain the typology of hospital complexity and user profile. The SUS treats more high-risk newborns and mothers with low schooling, insufficient prenatal care, and teenage mothers. The probability of early neonatal death was 5.6 live births (65% higher in the SUS), with no significant differences by level of hospital complexity, except those with extremely high (SUS) and medium (non-SUS) complexity. The difference in early neonatal mortality between the two systems was smaller in the group of newborns with birth weight < 1,500g (22%), but the rate was 131% higher in the SUS for newborns > 2,500g. There was a concentration of high-risk births in the SUS, but the difference in early neonatal mortality between SUS and non-SUS hospitals was smaller in this group of newborns. New studies are needed to elucidate the high mortality rate among newborns with birth weight > 2,500g in the SUS.
Silva
Zilda Pereira da
ZP
Fundação Sistema Estadual de Análise de Dados, São Paulo, Brasil. zildapereira@usp.br
Almeida
Márcia Furquim de
MF
Ortiz
Luís Patrício
LP
Alencar
Gizelton Pereira
GP
Alencar
Airlane Pereira
AP
Schoeps
Daniela
D
Minuci
Elaine Garcia
EG
Novaes
Hillegonda Maria Dutilh
HM
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D001938:Brazil / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D016304:Hospitals, Private / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008423:Maternal Age; D011247:Pregnancy; D014505:Urban Population