Uma descrição das causas básicas e múltiplas de óbitos neonatais do município do Rio de Janeiro nos anos de 2022 e 2023

Abstract

This study investigates the profile of neonatal deaths in the municipality of Rio de Janeiro in 2022 and 2023 using two analytical approaches: multiple cause analysis and analysis restricted to the underlying cause of death. With a cross-sectional design, data from the Mortality Information System (SIM) were used, restricted to neonatal deaths of residents in the municipality. After processing, 998 records were analyzed. The results indicated significant differences between early neonatal deaths (up to 6 days), which accounted for 71.4% of the total, and late neonatal deaths (7 to 27 days). Early neonatal deaths were more associated with neonates with lower birth weight and lower gestational age, while late neonatal deaths showed higher proportions of newborns with greater weight and full-term pregnancies. The leading causes of early neonatal death included maternal and gestational complications, respiratory and cardiovascular disorders, and specific infections of the perinatal period. For late neonatal deaths, the most frequent causes were infections, respiratory disorders, and congenital malformations. The multiple-cause analysis revealed conditions underestimated in the traditional classification of the underlying cause. In the early neonatal period, the groups "Specific respiratory and cardiovascular disorders of the perinatal period" (ratio: 11.7), "Disorders related to gestational duration and fetal growth" (10.3), and "Transient endocrine and metabolic disorders" (5.6) presented the highest ratios between mentioned causes and underlying causes, indicating the greater relevance of these conditions when all causes are considered. In the late neonatal period, the highest values were observed for "Disorders related to gestational duration and fetal growth" (ratio: 135.0), "Other disorders originating in the perinatal period" (7.3), and "Transient endocrine and metabolic disorders" (6.0). The quality of the information was evidenced by the absence of poorly defined underlying causes and the high proportion of investigated deaths (80% for early deaths and 85% for late deaths). The results demonstrate that multiple cause analysis broadens the understanding of conditions associated with neonatal mortality, contributing to more effective interventions and public policies in the municipality of Rio de Janeiro.