ArticleBMC pregnancy and childbirth2021
Neonatal mortality associated with perinatal asphyxia: a population-based study in a middle-income country.
Article in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Incidence of neonatal asphyxia and associated risk factors: a systematic review and cumulative meta-analysis.BMC pediatrics · 2025Pooled it
- Prevalence and risk factors associated with birth asphyxia among neonates delivered in China: a systematic review and meta-analysis.BMC pediatrics · 2024Pooled it
- Prevalence, risk factors and adverse outcomes of intrapartum related asphyxia amongst newborns from mothers with low-risk deliveries in peri-urban Gambian health facilities: a retrospective cohort study.BMC pregnancy and childbirth · 2026Observational
- Early adverse outcomes of neonatal hypoxic-ischemic encephalopathy in a resource-constrained setting.BMC pediatrics · 2026Article
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- Gestational age, birthweight, and maternal factors associated with neonatal mortality in the United States.Frontiers in public health · 2026Article
- Article
- Quality improvement on reducing neonatal mortality through intensive Clinical Mentorship Intervention: a case study in Biak Regional Hospital, Papua-Indonesia.BMJ open quality · 2025Article
- Development and validation of an epidemiological risk score for neonatal death in a middle-income country.Frontiers in public health · 2025Article
- An analysis of cause-specific under-5 mortality in Bangladesh using the demographic and health survey 2011 and 2017-2018.BMC pediatrics · 2024Article
- Temporal Trend and Risk Factors for Respiratory Distress Syndrome-Associated Neonatal Mortality in Preterm Infants: A Population-Based Study in a Middle-Income Country.American journal of perinatology · 2024Article
- Article
- Using geographically weighted regression analysis to assess predictors of home birth hot spots in Ethiopia.PloS one · 2023Article
- Factors associated with 5-min APGAR score, death and survival in neonatal intensive care: a case-control study.BMC pediatrics · 2022Article
- Cause and risk factors of early neonatal death in Ethiopia.PloS one · 2022Article
- Article
- Passive Fetal Movement Recognition Approaches Using Hyperparameter Tuned LightGBM Model and Bayesian Optimization.Computational intelligence and neuroscience · 2021Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is challenging to decrease neonatal mortality in middle-income countries, where perinatal asphyxia is an important cause of death. This study aims to analyze the annual trend of neonatal mortality with perinatal asphyxia according to gestational age in São Paulo State, Brazil, during a 10-year period and to verify demographic, maternal and neonatal characteristics associated with these deaths.
methodsPopulation-based study of neonatal deaths associated with perinatal asphyxia from 0 to 27 days in São Paulo State, Brazil, from 2004 to 2013. Perinatal asphyxia was considered as associated to death if intrauterine hypoxia, birth asphyxia or neonatal aspiration of meconium were noted in any line of the Death Certificate according to ICD-10. Poisson Regression was applied to analyze the annual trend of neonatal mortality rate according to gestational age. Kaplan-Meier curve was used to assess age at death during the 10-year study period. Hazard ratio of death during the neonatal period according to gestational age was analyzed by Cox regression adjusted by year of birth and selected epidemiological factors.
resultsAmong 74,002 infant deaths in São Paulo State, 6648 (9%) neonatal deaths with perinatal asphyxia were studied. Neonatal mortality rate with perinatal asphyxia fell from 1.38‰ in 2004 to 0.95‰ in 2013 (p = 0.002). Reduction started in 2008 for neonates with 32-41 weeks, in 2009 for 28-31 weeks, and in 2011 for 22-27 weeks. Median time until 50% of deaths occurred was 25.3 h (95%CI: 24.0; 27.2). Variables independently associated with higher risk of death were < 7 prenatal visits, 1st minute Apgar score 0-3, and death at the same place of birth. Cesarean delivery compared to vaginal was protective against death with perinatal asphyxia for infants at 28-36 weeks.
conclusionsThere was an expressive reduction in neonatal mortality rates associated with perinatal asphyxia during this 10-year period in São Paulo State, Brazil. Variables associated with these deaths highlight the need of public health policies to improve quality of regionalized perinatal care.
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