Abstract
Background: A better understanding of neonatal mortality risk factors in Brazil would guide improvements in these indicators. Thus, this study seeks to identify risk factors associated with early and late neonatal mortality stratified by public and private hospitals.
Methods: This is a cohort study of newborns between January 1, 2012 and December 31, 2017. Mortality data were obtained through linkage between two Brazilian national government databases from São Paulo city. Cox regression models were used to estimate the associations between maternal and newborn characteristics on ENM (0-6 days) and LNM (7-27 days).
Results: In the public sector, mother's age (≥35), gestational age (<38 and ≥41 weeks), inadequate and intermediate Kotelchuk index, cesarean section and low birth weight (LBW) were risk factors for ENM. In the private sector, mother's skin color (black), inadequate Kotelchuk index, parity (2 or more) and LBW were risk factors for ENM, as for the mother's education (university), gestational age of 39 weeks and female sex of the newborn were protective factors for ENM. Furthermore, in the public sector, mother's age (≤19), gestational age (< 38 weeks), inadequate and intermediate Kotelchuk index, cesarean section and LBW were risk factors for LMN. While in the private sector gestational age of ≤ 37 weeks and LBW were risk factors for LNM, on the other hand, mother's education (university) and female sex remain protective factors for LNM.
Conclusions: In Brazil, there are differences in mother's characteristics and newborn between women cared for in the public and private sectors that could influence neonatal mortality.