Análise da distribuição dos nascimentos com marcadores de gravidade em maternidades com unidade de terapia intensiva neonatal no Sistema Único de Saúde

Costa, Maria de Fátima dos Santos; Gomes, Saint Clair; Magluta, Cynthia

doi:10.1590/1414-462x201800020419

Cited by 7 publications

(5 citation statements)

References 16 publications

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“…Apgar é um marcador importante, considerado de gravidade quando o valor estiver menor que sete (Muniz, et al, 2016;Costa, Gomes Junior & Magluta, 2018). Nesse sentido, observa-se que a maioria dos NV no presente estudo apresentou boa adaptação fora do útero, com pouca variação entre as AP.…”

Section: Discussionunclassified

Perfil epidemiológico de nascidos vivos: Uma análise comparativa em um território marcada por mosaicos geográficos

Lopes

Silva

Nicol

et al. 2021

RSD

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Objetivo: analisar o perfil epidemiológico dos nascidos vivos e comparar entre cinco áreas de planejamento em saúde de uma mesma região geográfica. Métodos: estudo epidemiológico, do tipo ecológico, observacional, descritivo, quantitativo, elaborado com base nos dados contidos no Sistema de Informação sobre Nascidos Vivos. Os dados foram processados nos programas Tab para Windows e analisados no LibreOffice Excel versão 5.4. Os resultados descritivos foram exibidos em frequência absoluta e relativa e os indicadores em proporções de acordo com AP de residência da mãe. Resultados: Foram analisadas 82.780 declarações de Nascidos vivos. A maioria apresentou-se a termo, o peso adequado, Apgar no primeiro e quinto minutos entre 7 a 10 pontos. As mães foram em sua maioria pardas, solteiras, com 8 a 11 anos de estudo e idade entre 20 a 34. O tipo de parto mais frequente foi à cesárea. Considerações finais: A avaliação do perfil epidemiológico dos nascidos vivos deve fazer parte dos serviços de saúde para que as ações estratégicas sejam direcionadas, com vistas a intervir nos agravos de saúde que levam a situação de prematuridade, a desigualdade do acesso ao pré-natal, e cesarianas sem critério. Logo, os serviços de saúde devem dispor de Plano de ações locais.

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Section: Discussionunclassified

Perfil epidemiológico de nascidos vivos: Uma análise comparativa em um território marcada por mosaicos geográficos

Lopes

Silva

Nicol

et al. 2021

RSD

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“…The rates of deaths due to care in this group reduced by 52.68% in Brazil considering the first and last three years of the study. This result was expected due to the expansion of beds in neonatal intensive care units and scientific advances in some regions, which influence the supply of new care technologies, 29 mainly for the prevention of death in the first 24 hours of life. 2,15 Rates of neonatal mortality preventable by immunoprevention, diagnosis, timely treatment and health promotion actions were less frequent and reduced during the study period.…”

Section: Discussionmentioning

confidence: 99%

Trend of preventable neonatal mortality in the States of Brazil

Prezotto

Oliveira

Pelloso

et al. 2021

Rev. Bras. Saude Mater. Infant.

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Objectives: to describe the trend of preventable neonatal mortality due to interventions by the Unified Health System in Brazil from 2000 to 2018, according to groups of causes of death and maternal residence. Methods: mixed ecological study with data from the Mortality Information System and Information System on Live Births. The analysis occurred based on the number and rates of avoidable neonatal mortality, polynomial regression models by least squares method and thematic maps. Results: the avoidable neonatal mortality rate decreased from 10.98 in 2000 to 6.76 per 1,000 live births in 2018. Preventable causes prevailed due to adequate care for women during pregnancy, childbirth, fetus and newborn. Deaths from preventable causes from health promotion actions during pregnancy increased in Maranhão (p=0.003) and the Federal District (p=0.001) and remained stable in nine states. There was stability in the rates of mortality due to delivery in Maranhão, Piauí and Amazonas. The causes avoidable by actions with the newborn showed a decreasing trend, except for Roraima where there was stability. Conclusions: there are inequalities in trends of avoidable neonatal mortality rates in the states second according to the group of causes and the need to improve access to and quality of maternal and child health care in these places

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“…The main obstacles for a comprehensive and effective ROP screening in Brazil, and probably in other middle-income countries, are the lack of skilled ophthalmologists to provide ROP care, the uneven distribution of these professionals among units, and the unequal access to appropriate quality neonatal care ( 11 , 15 – 17 ). An alternative to improve accessibility and quality ROP care is the use of wide-field imaging ( 16 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

Cost–Utility Analysis of Wide-Field Imaging as an Auxiliary Technology for Retinopathy of Prematurity Care in Brazil

et al. 2021

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Purpose: To evaluate the cost–utility of wide-field imaging (WFI) as a complementary technology for retinopathy of prematurity (ROP) screening from the Brazilian Unified Health System's perspective.Introduction: ROP is one of the leading causes of avoidable childhood blindness worldwide, especially in middle-income countries. The current ROP screening involves indirect binocular ophthalmoscopy (IBO) by ROP expert ophthalmologists. However, there is still insufficient ROP screening coverage. An alternative screening strategy is the combination of WFI with IBO.Methods: A cost–utility analysis was performed using a deterministic decision-tree simulation model to estimate incremental cost–utility for ROP care. Two screening strategies were compared: (1) IBO and (2) combination of WFI of all eligible preterm infants and IBO for type 2 ROP or worse and for non-readable images. Eligible population included preterm infants <32 weeks of gestational age or birth weight equal to or <1,500 g. The temporal horizon was lifetime. Visual outcome data was converted to utility, and the health benefits were estimated on quality-adjusted life-years (QALY). Incremental cost per QALY gained was calculated from the health system perspective. Costs were estimated considering equipment, maintenance, consumables, and staff. A micro-costing approach was used for WFI. Two technician nurses were trained for imaging execution and had their time evaluated. Two ROP expert ophthalmologists had their time evaluated for imaging reading. One-way sensitivity analysis and probabilistic sensitivity analysis were performed.Results: Combined screening strategy resulted in a cost-effective program considering 90% ROP screening coverage. Costs per examination: (1) screening with IBO: US dollar (US $) 34.36; (2) screening with combination: US $58.20; (3) laser treatment: US $642.09; (4) long-term follow-up: ranged from US $69.33 to 286.91, based on the infant's visual function. Incremental cost per QALY gained was US $1,746.99/QALY per infant screened with the combination strategy. One-way sensitivity analysis resulted in cost-effectiveness for all parameters. Probabilistic sensitivity analyses yielded a 100% probability of combination being cost-effective in a willingness-to-pay threshold of US $1,800/QALY.Conclusion: The combined strategy for ROP screening was cost-effective. It enhances access for appropriate ROP care in middle-income countries and dminishes opportunity costs for ophthalmologists.

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Análise da distribuição dos nascimentos com marcadores de gravidade em maternidades com unidade de terapia intensiva neonatal no Sistema Único de Saúde

Cited by 7 publications

References 16 publications

Perfil epidemiológico de nascidos vivos: Uma análise comparativa em um território marcada por mosaicos geográficos

Perfil epidemiológico de nascidos vivos: Uma análise comparativa em um território marcada por mosaicos geográficos

Trend of preventable neonatal mortality in the States of Brazil

Cost–Utility Analysis of Wide-Field Imaging as an Auxiliary Technology for Retinopathy of Prematurity Care in Brazil

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