Condições de risco ao nascer relacionadas aos critérios de near miss neonatal : estudo de linkage entre o SINASC e o SIM no estado de Sergipe

• Ano de defesa: 2018
• Autor(a) principal: Silva, Márcia Estela Lopes da
• Orientador(a): Nunes, Marco Antônio Prado
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Programa de Pós-Graduação: Pós-Graduação em Ciências da Saúde
• Palavras-chave em Português: Near miss; Fatores de risco; Sistemas de informação; Registro médico coordenado
• Palavras-chave em Inglês: Near miss; Risk factors; Information systems; Medical record linkage
• Área do conhecimento CNPq: CIENCIAS DA SAUDE
• Link de acesso: http://ri.ufs.br/jspui/handle/riufs/9371

The technological advance has been contributing to the survival of newborns considered to be at risk for infant mortality. The concept of Near Miss Neonatal, defined as a newborn who presented a severe complication at birth but survived the neonatal period, came to define further studies on those infants who overcame causes of probable early neonatal death, and to evaluate the conditions of perinatal care. Objective: To identify the birth risk conditions related to the Near Miss Neonatal criteria from the secondary database analysis through a linkage between SINASC and SIM, in the period from 2011 to 2016 in the State of Sergipe. Methodology: an analytical retrospective cohort study with analysis of secondary data in a historical series in the official databases, through the linkage between SINASC and SIM. Data were collected on live births resident in the State of Sergipe, and the sample was selected from all newborns with early Near Miss Neonatal criteria: gestational age less than 31 weeks, birth weight less than 1,500 g and APGAR at the fifth minute below 7. We selected variables present in the SINASC: sociodemographic, obstetric and newborn, categorized and analyzed within the sample. The final statistical analysis evaluated the results by determining the relative risk and their respective confidence intervals, which identified the probability of the outcome selected by the study. Results: the variables that most had relation with the risk conditions at birth with a relative risk greater than 1 were: place of birth in the capital, home birth, illiteracy or low maternal schooling, age under 20 years and over 35 years, losses fetal abortions, prenatal care with 6 or fewer visits, number of prenatal consultations not suitable for gestational age at the start of follow-up, multiple gestation, non-cephalic presentation and congenital anomaly. The variables identified as protection factors with relative risk less than 1 were: the presence of partners, pregnant women aged between 20 and 35 years, maternal schooling over 4 years, cesarean delivery and induced labor. And the variables unrelated to the outcome, with relative risk crossing the 1 value in their confidence interval, were the maternal color / race and the sex of the newborn. Conclusion: In this study it was verified that the variables found as risk factors come according to what the literature has described and, therefore, it is intended that it serve as support for other studies on the subject and contributes to the survey of evidences that can subsidize bases for the construction of programs and public policies directed to the reduction of the infant morbimortality.