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Increased survival among lower-birthweight children in Southern Brazil
Carlos Eduardo Andrade Pinheiro1, Marco Aurélio Peres, Eleonora D' Orsi
1Departamento de Pediatria, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil. ceapinheiro1@gmail.com
Insights
Infant survival rates improved for low birth weight babies, particularly those born in private or teaching hospitals. However, overall infant mortality did not change due to an increase in low birth weight prevalence.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Infant survival is a key indicator of public health.
- Factors influencing first-year survival require ongoing analysis.
Purpose of the Study:
- To identify factors associated with infant survival in the first year of life.
- To analyze trends in infant mortality and survival rates.
Main Methods:
- Historical cohort study utilizing live birth and mortality data (1999-2006).
- Kaplan-Meier survival analysis and Cox regression for mortality risk.
- Analysis stratified by birth weight, birth period, and hospital type.
Main Results:
- Overall survival was 98.8%, with no significant change across all birth weight categories.
- Survival improved for infants under 2,000g (77.7% to 81.2%, p=0.029) between 1999-2002 and 2003-2006.
- Hospital type significantly impacted survival probability, with higher rates in private and teaching hospitals.
Conclusions:
- Higher survival probability observed for infants born in private and teaching hospitals.
- Improved survival for low birth weight infants in the later period.
- Increased prevalence of low birth weight offset gains, leading to unchanged overall infant mortality rates.
Objective:
To analyze factors associated with survival in the first year of life.
Methods:
A historical cohort study was carried out using data from live birth and mortality information systems, including 90,153 live birth records and 1,053 records of death before age one year in hospitals in the cities of Florianópolis and São José, Southern Brazil, between 1999 and 2006. Survival curves were estimated (Kaplan-Meier) for birthweight categories, date of birth (four-year periods), and type of maternity. Proportional hazard ratios for mortality were calculated using Cox regression.
Results:
Survival (98.8%) did not change among all birthweight categories, but increased among babies born weighing under 2,000 g (77.7% to 81.2%, p=0.029), between 1999-2002 and 2003-2006. There was an increase in the proportion of babies under 2,000 g in the second period. Type of hospital was significantly associated with probability of survival.
Conclusions:
Probability of survival is higher among babies born in private hospitals and in the teaching hospital in all birthweight categories combined and for babies born weighing under 2,000 g. Survival among the latter increased in the most recent period. However, the infant mortality rate did not change between the two periods given the increase in the prevalence of children with ligther birth weight.
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