title: Determinants of neonatal death with emphasis on health care during pregnancy, childbirth and reproductive history.
abstract: OBJECTIVE
  To identify risk factors for neonatal mortality, focusing on factors related to assistance care during the prenatal period, childbirth, and maternal reproductive history.
  
  
  METHODS
  This was a case-control study conducted in Maceió, Northeastern Brazil. The sample consisted of 136 cases and 272 controls selected from official Brazilian databases. The cases consisted of all infants who died before 28 days of life, selected from the Mortality Information System, and the controls were survivors during this period, selected from the Information System on Live Births, by random drawing among children born on the same date of the case. Household interviews were conducted with mothers.
  
  
  RESULTS
  The logistic regression analysis identified the following as determining factors for death in the neonatal period: mothers with a history of previous children who died in the first year of life (OR=3.08), hospitalization during pregnancy (OR=2.48), inadequate prenatal care (OR=2.49), lack of ultrasound examination during prenatal care (OR=3.89), transfer of the newborn to another unit after birth (OR=5.06), admittance of the newborn at the ICU (OR=5.00), and low birth weight (OR=2.57). Among the socioeconomic conditions, there was a greater chance for neonatal mortality in homes with fewer residents (OR=1.73) and with no children younger than five years (OR=10.10).
  
  
  CONCLUSIONS
  Several factors that were associated with neonatal mortality in this study may be due to inadequate care during the prenatal period and childbirth, and inadequate newborn care, all of which can be modified.
authors.affiliation: Departamento de Pediatria, Universidade Estadual Ciências da Saúde de Alagoas (UNCISAL), Maceió, AL, Brazil. samirbkr@uol.com.br
authors.forename: Samir B
authors.initials: SB
authors.lastname: Kassar
authors.forename: Ana M C
authors.initials: AM
authors.lastname: Melo
authors.forename: Sônia B
authors.initials: SB
authors.lastname: Coutinho
authors.forename: Marilia C
authors.initials: MC
authors.lastname: Lima
authors.forename: Pedro I C
authors.initials: PI
authors.lastname: Lira
mesh_terms: D016022:Case-Control Studies; D002423:Cause of Death; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D018743:Perinatal Care / Q000592:standards*; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D017584:Reproductive History; D012307:Risk Factors; D012959:Socioeconomic Factors