Infant mortality: comparison between two birth cohorts from Southeast and Northeast, Brazil

• Published in: Revista de saúde pública Vol. 38; no. 6; pp. 773 - 779
• Main Authors: Ribeiro, Valdinar S, Silva, Antônio A M, Barbieri, Marco A, Bettiol, Heloisa, Aragão, Vânia M F, Coimbra, Liberata C, Alves, Maria T S S B
• Format: Journal Article
• Language: English
• Published: Brazil Faculdade de Saúde Pública da Universidade de São Paulo 01.12.2004
• Subjects: Adolescent; Adult; Brazil - epidemiology; Cohort Studies; Female; Gestational Age; Health Policy & Services; Humans; Infant; Infant Mortality; Male; Maternal Age; Population Dynamics; Pregnancy; Risk Factors; Socioeconomic Factors; Brazil; Fatores socioeconômicos; Recém-nascido de baixo peso; Infant mortality; Fatores de risco; Risk factors; Coeficiente de mortalidade; Mortality rate; Neonatal mortality; Infant, low birth weight; Socioeconomic factors; Mortalidade infantil; Mortalidade pós-neonatal; Post-neonatal mortality; Mortalidade neonatal
• ISSN: 0034-8910; 1518-8787; 0034-8910
• DOI: 10.1590/s0034-89102004000600004

To obtain population estimates and profile risk factors for infant mortality in two birth cohorts and compare them among cities of different regions in Brazil. In Ribeirão Preto, southeast Brazil, infant mortality was determined in a third of hospital live births (2,846 singleton deliveries) in 1994. In São Luís, northeast Brazil, data were obtained using systematic sampling of births stratified by maternity unit (2,443 singleton deliveries) in 1997-1998. Mothers answered standardized questionnaires shortly after delivery and information on infant deaths was retrieved from hospitals, registries and the States Health Secretarys' Office. The relative risk (RR) was estimated by Poisson regression. In São Luís, the infant mortality rate was 26.6/1,000 live births, the neonatal mortality rate was 18.4/1,000 and the post-neonatal mortality rate was 8.2/1,000, all higher than those observed in Ribeirão Preto (16.9, 10.9 and 6.0 per 1,000, respectively). Adjusted analysis revealed that previous stillbirths (RR=3.67 vs 4.13) and maternal age <18 years (RR=2.62 vs 2.59) were risk factors for infant mortality in the two cities. Inadequate prenatal care (RR=2.00) and male sex (RR=1.79) were risk factors in São Luís only, and a dwelling with 5 or more residents was a protective factor (RR=0.53). In Ribeirão Preto, maternal smoking was associated with infant mortality (RR=2.64). In addition to socioeconomic inequalities, differences in access to and quality of medical care between cities had an impact on infant mortality rates.