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Clusters of cause specific neonatal mortality and its association with per capita gross domestic product: A

Daniela Testoni Costa-Nobre1, Mandira Daripa Kawakami1, Kelsy Catherina Nema Areco1

  • 1Escola Paulista de Medicina-Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.

Plos One
|August 17, 2021
PubMed

Insights

High rates of neonatal mortality due to asphyxia are clustered in specific areas of São Paulo State, Brazil. These clusters often overlap with regions of lower per capita GDP, indicating a link between economic status and infant health outcomes.

Area of Science:

  • Public Health
  • Spatial Epidemiology
  • Neonatal Mortality Research

Background:

  • Infant mortality rate is a key indicator of population health.
  • Neonatal mortality constitutes a significant proportion of infant deaths.
  • Underdevelopment and associated factors can increase neonatal mortality risk.

Purpose of the Study:

  • Investigate spatial clusters of asphyxia-associated neonatal mortality.
  • Explore the association between these mortality clusters and per capita GDP in São Paulo State, Brazil.

Main Methods:

  • Ecological study of live births in São Paulo State (2004-2013).
  • Defined neonatal deaths (0-27 days) related to perinatal asphyxia.
  • Employed geoprocessing, spatial autocorrelation (Moran, LISA), and Bayesian smoothing.
  • Correlated asphyxia-associated neonatal mortality with per capita GDP using Spearman correlation.

Main Results:

  • Identified 6,713 asphyxia-associated neonatal deaths (1.13/1000 live births).
  • Spatial analysis revealed significant clusters of neonatal mortality (p=0.001 after Bayesian smoothing).
  • Clusters were concentrated in the south, southeast, and northwest regions.
  • Areas with high neonatal mortality showed partial overlap with areas of low per capita GDP.

Conclusions:

  • Spatial analysis successfully identified high-risk areas for asphyxia-associated neonatal mortality.
  • A significant negative correlation exists between high neonatal mortality clusters and low per capita GDP.
  • This approach can guide public health interventions to reduce neonatal mortality.
Abstract

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