Clusters of preterm live births and respiratory distress syndrome-associated neonatal deaths: spatial distribution and cooccurrence patterns

• Main Authors: Ana Sílvia Scavacini Marinonio (Author), Daniela Testoni Costa-Nobre (Author), Milton Harumi Miyoshi (Author), Rita de Cassia Xavier Balda (Author), Kelsy Catherina Nema Areco (Author), Tulio Konstantyner (Author), Mandira Daripa Kawakami (Author), Adriana Sanudo (Author), Paulo Bandiera-Paiva (Author), Rosa Maria Vieira de Freitas (Author), Lilian Cristina Correia Morais (Author), Mônica La Porte Teixeira (Author), Bernadette Cunha Waldvogel (Author), Maria Fernanda Branco de Almeida (Author), Ruth Guinsburg (Author), Carlos Roberto Veiga Kiffer (Author)
• Format: Book
• Published: BMC, 2022-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Abstract Background Prematurity and respiratory distress syndrome (RDS) are strongly associated. RDS continues to be an important contributor to neonatal mortality in low- and middle-income countries. This study aimed to identify clusters of preterm live births and RDS-associated neonatal deaths, and their cooccurrence pattern in São Paulo State, Brazil, between 2004 and 2015.  Methods Population-based study of all live births with gestational age ≥ 22 weeks, birthweight ≥ 400 g, without congenital anomalies from mothers living in São Paulo State, Brazil, during 2004-2015. RDS-associated neonatal mortality was defined as deaths < 28 days with ICD-10 codes P22.0 or P28.0. RDS-associated neonatal mortality and preterm live births rates per municipality were submitted to first- and second-order spatial analysis before and after smoothing using local Bayes estimates. Spearman test was applied to identify the correlation pattern between both rates. Results Six hundred forty-five thousand two hundred seventy-six preterm live births and 11,078 RDS-associated neonatal deaths in São Paulo State, Brazil, during the study period were analyzed. After smoothing, a non-random spatial distribution of preterm live births rate (I = 0.78; p = 0.001) and RDS-associated neonatal mortality rate (I = 0.73; p = 0.001) was identified. LISA maps confirmed clusters for both, with a negative correlation (r = -0.24; p = 0.0000). Clusters of high RDS-associated neonatal mortality rates overlapping with clusters of low preterm live births rates were detected. Conclusions Asymmetric cluster distribution of preterm live births and RDS-associated neonatal deaths may be helpful to indicate areas for perinatal healthcare improvement.

Item Description

10.1186/s12889-022-13629-4
1471-2458