Qualineo Strategy Indicators Associated with Neonatal Death: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Sample and Data Collection
2.3. Study Variables
2.4. Data Analysis
2.5. Ethical and Legal Aspects of Research
3. Results
4. Discussion
4.1. Social and Clinical Profile of Mothers of Newborns Being Monitored for Neonatal Care by the Qualineo Strategy
4.2. Care and Clinical Characteristics of Newborns Monitored by the Qualineo Neonatal Care Strategy
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Deaths | PR * (95% CI **) | p-Value | |
---|---|---|---|---|
No. | % | |||
Mother’s age (years) | ||||
10 to 14 | 6 | 35.3 | 1.0 | - |
15 to 19 | 70 | 27.0 | 0.76 (0.39–1.50) | 0.438 |
20 to 29 | 183 | 21.4 | 0.61 (0.32–1.17) | 0.137 |
30 to 39 | 117 | 20.4 | 0.58 (0.30–1.12) | 0.104 |
≥40 | 31 | 29.8 | 0.84 (0.41–1.71) | 0.640 |
Skin color | ||||
White | 36 | 25.0 | 1.0 | - |
Black | 24 | 21.4 | 0.86 (0.54–1.35) | 0.506 |
Brown | 280 | 23.1 | 0.92 (0.68–1.25) | 0.604 |
Asian/Indigenous | 5 | 20.8 | 0.83 (0.36–1.91) | 0.667 |
Schooling (years of study) | ||||
<8 | 43 | 22.0 | 1.0 | - |
≥8 | 340 | 22.8 | 1.03 (0.78–1.37) | 0.822 |
Smoking | ||||
Yes | 22 | 30.6 | 1.0 | - |
No | 382 | 22.0 | 0.72 (0.50–1.03) | 0.075 |
Frequency of alcohol intake during pregnancy | ||||
No drinking or twice a month | 382 | 22.2 | 1.0 | |
Weekly | 13 | 24.5 | 1.11 (0.68–1.79) | 0.679 |
Drug intake | ||||
Yes | 8 | 25.0 | 1.0 | |
No | 390 | 22.3 | 0.89 (0.49–1.64) | 0.716 |
Undergone violence | ||||
Yes | 1 | 7.7 | 1.0 | - |
No | 386 | 22.3 | 2.9 (0.44–19.13) | 0.268 |
Hypertension | ||||
Yes | 109 | 18.4 | 1.0 | - |
No | 295 | 24.2 | 1.32 (1.10–1.60) | 0.006 |
Multiple pregnancy | ||||
Yes | 45 | 17.2 | 1.0 | - |
No | 355 | 23.2 | 1.34 (1.01–1.78) | 0.039 |
Rupture of membranes (hours) | ||||
<18 | 48 | 19.9 | 0.87 (0.66–1.15 | 0.331 |
18 to 24 | 7 | 13.2 | 0.58 (0.29–1.16) | 0.125 |
>24 | 45 | 23.7 | 1.04 (0.79–1.37) | 0.783 |
No | 304 | 22.8 | 1.0 | - |
Antenatal steroids | ||||
Yes | 220 | 24.3 | 1.0 | - |
No | 184 | 20.2 | 0.83 (0.70–0.99) | 0.037 |
Type of delivery | ||||
Vaginal/Forceps | 135 | 28.2 | 1.0 | - |
Cesarean section | 273 | 20.1 | 0.71 (0.60–0.85) | <0.001 |
Variables | Deaths | PR * (95% CI **) | p-Value | |
---|---|---|---|---|
No. | % | |||
Gender | ||||
Male | 219 | 22.5 | 1.0 | - |
Female | 188 | 21.7 | 0.96 (0.81–1.14) | 0.671 |
Undefined or Unclassified | 6 | 66.7 | 2.96 (1.84–4.77) | <0.001 |
Birth weight (grams) | ||||
≤500 | 8 | 80.0 | 5.69 (3.90–8.30) | <0.001 |
501 to 999 | 161 | 76.3 | 5.43 (4.32–6.82) | <0.001 |
1000 to 1499 | 86 | 26.8 | 1.90 (1.44–2.52) | <0.001 |
1500 to 2499 | 88 | 11.0 | 0.78 (0.58–1.04) | 0.095 |
≥2500 | 71 | 14.1 | 1.0 | - |
Gestational age (weeks) | ||||
<24 | 25 | 86.2 | 5.05 (3.91–6.52) | <0.001 |
24 to 27 | 104 | 74.8 | 4.39 (3.47–5.53) | <0.001 |
28 to 30 | 83 | 41.5 | 2.43(1.86–3.18) | <0.001 |
31 to 33 | 62 | 15.5 | 0.91 (0.66–1.24) | 0.535 |
34 to 36 | 68 | 10.3 | 0.60 (0.44–0.82) | 0.001 |
≥37 | 72 | 17.1 | 1.0 | - |
Neonatal resuscitation | ||||
Yes | 269 | 37.0 | 1.0 | - |
No | 144 | 12.9 | 0.35 (0.29–0.42) | <0.001 |
Use of oxygen | ||||
Yes | 251 | 38.2 | 1.0 | - |
No | 12 | 21.4 | 0.56 (0.34–0.94) | 0.027 |
Use of mask or balloon ventilation | ||||
Yes | 133 | 33.4 | 1.0 | - |
No | 131 | 42.8 | 1.28 (1.06–1.55) | 0.011 |
Use of high-flow nasal cannula | ||||
Yes | 222 | 56.4 | 1.0 | - |
No | 45 | 14.1 | 0.25 (0.19–0.33) | <0.001 |
Cardiac massage | ||||
Yes | 44 | 71.0 | 1.0 | - |
No | 224 | 34.0 | 0.48 (0.40–0.58) | <0.001 |
Drug intake | ||||
Yes | 40 | 72.7 | 1.0 | - |
No | 227 | 34.2 | 0.47 (0.39–0.57) | <0.001 |
1-min Apgar score | ||||
<7 | 276 | 42.2 | 1.0 | - |
≥7 | 125 | 11.1 | 0.26 (0.22–0.32) | <0.001 |
5-min Apgar score | ||||
<7 | 100 | 58.8 | 1.0 | |
≥7 | 301 | 18.6 | 0.32 (0.27–0.37) | <0.001 |
Cpap in the delivery room | ||||
Yes | 89 | 14.0 | 1.0 | - |
No | 270 | 30.1 | 0.71 (0.60–0.85) | <0.001 |
Umbilical cord clamping time | ||||
<1 min | 362 | 25.8 | 1.0 | - |
≥1 min | 34 | 9.6 | 0.37 (0.26–0.52) | <0.001 |
Measures to avoid hypothermia in the delivery room | ||||
Yes | 261 | 29.1 | 1.0 | - |
No | 145 | 16.4 | 0.56 (0.47–0.57) | <0.001 |
Admission to the Neonatal Intensive Care Unit | ||||
Yes | 345 | 38.8 | 1.0 | - |
No | 61 | 7.2 | 0.18 (0.14–0.24) | <0.001 |
Admission to the Conventional Intermediate Care Unit | ||||
Yes | 54 | 5.9 | 1.0 | - |
No | 332 | 39.4 | 6.63 (5.05–8.70) | <0.001 |
Admission to the Kangaroo Intermediate Care Unit | ||||
Yes | 4 | 0.6 | 1.0 | - |
No | 369 | 40.9 | 73.74 (27.65–196.61) | <0.001 |
Conventional mechanical ventilation | ||||
Yes | 209 | 37.5 | 1.0 | - |
No | 165 | 14.2 | 0.38 (0.32–0.45) | 0.001 |
Use of surfactant | ||||
Yes | 177 | 47.8 | 1.0 | - |
No | 229 | 16.0 | 0.33 (0.28–0.39) | <0.001 |
Early infection | ||||
Yes | 223 | 30.6 | 1.0 | - |
No | 179 | 16.4 | 0.54 (0.45–0.64) | <0.001 |
Late infection | ||||
Yes | 187 | 34.7 | 1.0 | - |
No | 205 | 16.9 | 0.49 (0.41–0.58) | <0.001 |
Use of antibiotics in the first week of life | ||||
Not used | 127 | 15.5 | 1.0 | - |
≤48 h | 135 | 35.7 | 2.30 (1.87–2.84) | <0.001 |
>48 h and ≤72 h | 32 | 24.4 | 1.58 (1.12–2.22) | 0.009 |
>72 h and ≤7 days | 65 | 20.7 | 1.34 (1.02–1.75) | 0.035 |
>7 days | 54 | 26.2 | 1.69 (1.28–2.24) | <0.001 |
Variables | PR * (95% CI **) | Standard Error | p-Value |
---|---|---|---|
Newborn on term | |||
Drug intake | 2.89 (1.74–4.81) | 0.75 | <0.001 |
Admission to the Neonatal Intensive Care Unit | 3.52 (1.40–8.85) | 1.66 | 0.007 |
Preterm newborn | |||
Use of cannula ventilation | 2.89 (2.22–4.64) | 0.60 | <0.001 |
1 min Apgar <7 | 1.51 (1.09–2.08) | 0.25 | 0.016 |
Admission to the Neonatal Intensive Care Unit | 1.40 (1.09–1.79) | 0.18 | 0.012 |
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Evangelista de Sousa Campelo, C.; Dias Torres Silva, C.R.; Corrêa Marques, R.; Ribeiro dos Santos, A.M.; Marques Santos Machado, N.; Teles de Oliveira Gouveia, M. Qualineo Strategy Indicators Associated with Neonatal Death: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2024, 21, 1096. https://doi.org/10.3390/ijerph21081096
Evangelista de Sousa Campelo C, Dias Torres Silva CR, Corrêa Marques R, Ribeiro dos Santos AM, Marques Santos Machado N, Teles de Oliveira Gouveia M. Qualineo Strategy Indicators Associated with Neonatal Death: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2024; 21(8):1096. https://doi.org/10.3390/ijerph21081096
Chicago/Turabian StyleEvangelista de Sousa Campelo, Camila, Cynthia Roberta Dias Torres Silva, Rejane Corrêa Marques, Ana Maria Ribeiro dos Santos, Nathaly Marques Santos Machado, and Márcia Teles de Oliveira Gouveia. 2024. "Qualineo Strategy Indicators Associated with Neonatal Death: A Cross-Sectional Study" International Journal of Environmental Research and Public Health 21, no. 8: 1096. https://doi.org/10.3390/ijerph21081096