Comportamento das taxas de mortalidade infantil antes e após a implantação de Unidades de Terapia Intensiva Neonatais

Abstract

The evaluation of the infant mortality rate involves the understanding of the health scenario of a given region. In recent years, there has been a progressive decline in deaths occurring in early childhood worldwide. In Brazil, there was also a decline in the number of infant deaths. However, despite the progress made, these rates remain high compared to those of developed countries and some South American developing countries. As there was a great development of technological devices in the care of high-risk newborns and, consequently, of neonatal intensive care units (NICUs), an improvement in their expectation of survival occurred. Thus, the study aimed to evaluate the impact of NICUs on infant mortality in the northern macroregion of Minas Gerais. The information used in the research to calculate the mortality rates were obtained through DATASUS and were used to calculate the rates of early, late neonatal and fetal death. The analyzed years corresponded to the interval of four years before and six years after the implantation of the NICUs in the municipality of Montes Claros-MG. The year 2002 was excluded from the analysis because it was the year of implantation of the first NICU in the macroregion. The t parallelism test was performed considering the respective slope coefficients (β) and their standard deviations, assuming a significance level of 5% (p <0.05). In the analysis of the early mortality rate there was a decline in the values observed over the years studied. This rate went from 16.6 per thousand live births in 1998 to 8.8 per thousand live births in 2008, but the velocity of the slope in the curve for the period prior to NICU implantation was higher than in the subsequent periods (p = 0.009). As for late neonatal mortality, the parallelism test exhibited that the behavior of the rates was not statistically different between the two periods evaluated (p = 0.170). For fetal death, the slope in the curve for the period prior to the implantation of the NICU was negative, while for the period afterwards the slope was positive, revealing an increase in the fetal death rate in the studied period (p <0.001). In conclusion, the implementation of NICU beds in the northern macroregion of Minas Gerais did not have an impact on neonatal and fetal mortality in the evaluated period, requiring a longer study period to try to verify the influence of these units on neonatal and fetal mortality rates . It is also necessary to institute public policies aimed at maternal and child health, which address the particularities of the region studied.