Neonatal mortality of live births with congenital diaphragmatic hernia in São Paulo State, Brazil: Failure of care?
ABSTRACT Objective: The aim of this study was to analyze if the healthcare organization of perinatal care and availability of referral neonatal intensive care units (NICU) impacted congenital diaphragmatic hernia (CDH) neonatal mortality in the period 2004–2020. This study analyzed the spatial dist...
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Sociedade de Pediatria de São Paulo
2025-01-01
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| Series: | Revista Paulista de Pediatria |
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| author | Ana Sílvia Scavacini Marinonio Milton Harumi Miyoshi Daniela Testoni Costa Nobre Adriana Sanudo Kelsy Catherina Nema Areco Mandira Daripa Kawakami Rita de Cássia Xavier Balda Tulio Konstantyner Carina Nunes Vieira e Oliveira Paulo Bandiera-Paiva Rosa Maria Vieira de Freitas Monica La Porte Teixeira Bernadette Cunha Waldvogel Carlos Roberto Veiga Kiffer Maria Fernanda Branco de Almeida Ruth Guinsburg |
| author_facet | Ana Sílvia Scavacini Marinonio Milton Harumi Miyoshi Daniela Testoni Costa Nobre Adriana Sanudo Kelsy Catherina Nema Areco Mandira Daripa Kawakami Rita de Cássia Xavier Balda Tulio Konstantyner Carina Nunes Vieira e Oliveira Paulo Bandiera-Paiva Rosa Maria Vieira de Freitas Monica La Porte Teixeira Bernadette Cunha Waldvogel Carlos Roberto Veiga Kiffer Maria Fernanda Branco de Almeida Ruth Guinsburg |
| author_sort | Ana Sílvia Scavacini Marinonio |
| collection | DOAJ |
| description | ABSTRACT Objective: The aim of this study was to analyze if the healthcare organization of perinatal care and availability of referral neonatal intensive care units (NICU) impacted congenital diaphragmatic hernia (CDH) neonatal mortality in the period 2004–2020. This study analyzed the spatial distribution of neonatal deaths of live births with CDH in São Paulo State, Brazil, and its association with NICU beds’ availability. Methods: Population-based study of all live births in São Paulo State from mothers residing in the same State, from 2004 to 2020. CDH definition was based on WHO-ICD-10 codes; CDH-associated neonatal death was defined as death up to 27 days after birth of infants with CDH. The distribution of CDH-associated neonatal mortality (per 10,000 live births) and NICU beds’ availability (≥1 or not available) was mapped, and their association was evaluated by the Mann–Whitney test. Results: Among 10,246,686 live births, there were 1378 CDH-associated neonatal deaths across 124/645 (19.2%) municipalities of the State. The median CDH-associated neonatal mortality rate in municipalities with NICU beds was 1.22 (95%CI 0.99–1.51), similar to that found in municipalities with no NICU beds (1.40; 95%CI 1.15–1.67; p=0.224). Conclusions: CDH-associated neonatal deaths were spread throughout São Paulo State with no difference in CDH-associated neonatal mortality rates between municipalities with and without NICU beds available. These findings suggest the necessity of implementing regionalization strategies for CDH perinatal care in the State. |
| format | Article |
| id | doaj-art-97bd2b39a25f4126937aa335eef68111 |
| institution | Kabale University |
| issn | 1984-0462 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Sociedade de Pediatria de São Paulo |
| record_format | Article |
| series | Revista Paulista de Pediatria |
| spelling | doaj-art-97bd2b39a25f4126937aa335eef681112025-01-21T07:43:59ZengSociedade de Pediatria de São PauloRevista Paulista de Pediatria1984-04622025-01-014310.1590/1984-0462/2025/43/2024138Neonatal mortality of live births with congenital diaphragmatic hernia in São Paulo State, Brazil: Failure of care?Ana Sílvia Scavacini Marinoniohttps://orcid.org/0000-0001-9845-6097Milton Harumi Miyoshihttps://orcid.org/0000-0002-4935-6505Daniela Testoni Costa Nobrehttps://orcid.org/0000-0001-7629-4904Adriana Sanudohttps://orcid.org/0000-0003-1187-0143Kelsy Catherina Nema Arecohttps://orcid.org/0000-0002-7801-757XMandira Daripa Kawakamihttps://orcid.org/0000-0001-5230-1989Rita de Cássia Xavier Baldahttps://orcid.org/0000-0002-7553-466XTulio Konstantynerhttps://orcid.org/0000-0002-7931-9692Carina Nunes Vieira e Oliveirahttps://orcid.org/0009-0003-7086-3696Paulo Bandiera-Paivahttps://orcid.org/0000-0001-9409-3970Rosa Maria Vieira de Freitashttps://orcid.org/0000-0003-4266-6110Monica La Porte Teixeirahttps://orcid.org/0000-0001-7571-8154Bernadette Cunha Waldvogelhttps://orcid.org/0000-0001-5267-7361Carlos Roberto Veiga Kifferhttps://orcid.org/0000-0003-1122-0693Maria Fernanda Branco de Almeidahttps://orcid.org/0000-0001-5864-3808Ruth Guinsburghttps://orcid.org/0000-0003-1967-9861ABSTRACT Objective: The aim of this study was to analyze if the healthcare organization of perinatal care and availability of referral neonatal intensive care units (NICU) impacted congenital diaphragmatic hernia (CDH) neonatal mortality in the period 2004–2020. This study analyzed the spatial distribution of neonatal deaths of live births with CDH in São Paulo State, Brazil, and its association with NICU beds’ availability. Methods: Population-based study of all live births in São Paulo State from mothers residing in the same State, from 2004 to 2020. CDH definition was based on WHO-ICD-10 codes; CDH-associated neonatal death was defined as death up to 27 days after birth of infants with CDH. The distribution of CDH-associated neonatal mortality (per 10,000 live births) and NICU beds’ availability (≥1 or not available) was mapped, and their association was evaluated by the Mann–Whitney test. Results: Among 10,246,686 live births, there were 1378 CDH-associated neonatal deaths across 124/645 (19.2%) municipalities of the State. The median CDH-associated neonatal mortality rate in municipalities with NICU beds was 1.22 (95%CI 0.99–1.51), similar to that found in municipalities with no NICU beds (1.40; 95%CI 1.15–1.67; p=0.224). Conclusions: CDH-associated neonatal deaths were spread throughout São Paulo State with no difference in CDH-associated neonatal mortality rates between municipalities with and without NICU beds available. These findings suggest the necessity of implementing regionalization strategies for CDH perinatal care in the State.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822025000100426&lng=en&tlng=enCongenital diaphragmatic herniaNeonatal mortalityNeonatal intensive careEpidemiological studiesSpatial distributionPopulation |
| spellingShingle | Ana Sílvia Scavacini Marinonio Milton Harumi Miyoshi Daniela Testoni Costa Nobre Adriana Sanudo Kelsy Catherina Nema Areco Mandira Daripa Kawakami Rita de Cássia Xavier Balda Tulio Konstantyner Carina Nunes Vieira e Oliveira Paulo Bandiera-Paiva Rosa Maria Vieira de Freitas Monica La Porte Teixeira Bernadette Cunha Waldvogel Carlos Roberto Veiga Kiffer Maria Fernanda Branco de Almeida Ruth Guinsburg Neonatal mortality of live births with congenital diaphragmatic hernia in São Paulo State, Brazil: Failure of care? Revista Paulista de Pediatria Congenital diaphragmatic hernia Neonatal mortality Neonatal intensive care Epidemiological studies Spatial distribution Population |
| title | Neonatal mortality of live births with congenital diaphragmatic hernia in São Paulo State, Brazil: Failure of care? |
| title_full | Neonatal mortality of live births with congenital diaphragmatic hernia in São Paulo State, Brazil: Failure of care? |
| title_fullStr | Neonatal mortality of live births with congenital diaphragmatic hernia in São Paulo State, Brazil: Failure of care? |
| title_full_unstemmed | Neonatal mortality of live births with congenital diaphragmatic hernia in São Paulo State, Brazil: Failure of care? |
| title_short | Neonatal mortality of live births with congenital diaphragmatic hernia in São Paulo State, Brazil: Failure of care? |
| title_sort | neonatal mortality of live births with congenital diaphragmatic hernia in sao paulo state brazil failure of care |
| topic | Congenital diaphragmatic hernia Neonatal mortality Neonatal intensive care Epidemiological studies Spatial distribution Population |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822025000100426&lng=en&tlng=en |
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