Secular trends, spatial evolution, and maternal & neonatal conditions associated to early and late neonatal deaths caused by respiratory distress, perinatal asphyxia, infections, and congenital anomalies, in São Paulo State, Brazil, between 2002 and 2015

Abstract

The comprehension of the evolution of neonatal mortality by analyzing its main causes, its temporal and geographical distribution and the demographic variables associated to these deaths could help to design strategies to achieve the Sustainable Development Goals, established by the United Nations in 2015.Objective: To analyze non-aleatory patterns of secular trends, spatial evolution, and maternal and neonatal conditions associated to neonatal deaths caused by prematurity, respiratory distress, perinatal asphyxia, infections, and congenital anomalies, in São Paulo State, Brazil, between 2002 and 2015.Method: Populational cohort study of live born infants between 2002-2015, in São Paulo State, Brazil, classified in two groups: Those that died between 0-27 days and those alive at the 27th day of life (estimate: 8,400,000 births and 75,000 neonatal deaths). Regarding the deaths, the source will be the linkage of SEADE Foundation databases of births and death registries, analyzed by: 1) Secular trend of neonatal deaths by mathematical exponential or polynomial modelling; 2) Spatial analysis in order to verify non-aleatory patterns of neonatal deaths in geographic units of São Paulo State during the passage of time; 3) Evaluation of the risk factors associated with neonatal death by conditional logistic regression after pairing each death to a similar live newborn. All approaches will follow the cause of death (prematurity, respiratory distress, perinatal asphyxia, infections, and congenital anomalies) and age at death (1st hour, 1st 24 hours, 0-6 days, and 7-27 days after birth). (AU)