Hospital admissions in the first year of life: inequalities over three decades in a southern Brazilian city

Abstract

Background Hospital admissions in infancy are declining in several countries. We describe admissions to neonatal intensive care units (NICU) and other hospitalizations over a 33-year period in the Brazilian city of Pelotas. Methods We analysed data from four population-based birth cohorts launched in 1982, 1993, 2004 and 2015, each including all hospital births in the calendar year. NICU and other hospital admissions during infancy were reported by the mothers in the perinatal interview and at the 12-month visit, respectively. We describe these outcomes by sex of the child, family income and maternal skin colour. Results In 1982, NICUs did not exist in the city; admissions into NICUs increased from 2.7% of all newborns in 1993 to 6.7% in 2015, and admission rates were similar in all income groups. Hospitalizations during the first year of life fell by 29%, from 23.7% in 1982 to 16.8% in 2015, and diarrhoea admissions fell by 95.2%. Pneumonia admissions fell by 46.3% from 1993 to 2015 (no data available for 1982). Admissions due to perinatal causes increased during the period. In the poorest income quintile, total admissions fell by 33% (from 35.7% to 23.9%), but in the richest quintile these remained stable at around 10%, leading to a reduction in inequalities. Over the whole period, children born to women with black or brown skin were 30% more likely to be admitted than those of white-skinned mothers. Conclusions Whereas NICU admissions increased, total admissions in the first year of life declined by nearly one-third. Socioeconomic disparities were reduced, but important gaps remain.

Stillbirth, newborn and infant mortality: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

“…This decline is similar to what has been observed over a shorter time period in Brazil 7 . Our analyses of hospitalizations in the four cohorts 33 show similar declining trends for infectious diseases.…”

Factors associated with respiratory morbidity in the first year of life

“…In Brazil, data from the National Information System indicate that, in 2017, 46% of hospitalizations in the first year of life were due to perinatal conditions, with 24% due to respiratory diseases. 1 Many factors can synergistically contribute to the development of these conditions, among which socioeconomic and demographic factors, environmental factors, type of feeding, and nutritional status can be highlighted. 2 …”

Neonatal outcomes associated with tobacco, alcohol, and crack use during pregnancy in three Neonatal Intensive Care Units

“…In addition to the aforementioned, the admission rate to NICUs in the study region has been on the rise over the years. A cohort study conducted in the city of Pelotas, one of the cities included in our study, illustrated that the number of NICU admissions in the region increased from 2.7% of all newborns in 1993 to 6.7% in 2015 (Wehrmeister et al 2019). This growth trend is also observable in other regions across Brazil (Moura et al 2020), suggesting a broader pattern where maternal habits may increasingly contribute to adverse outcomes in newborns, necessitating specialized care in the early stages of life.…”

“…Data from the Brazilian Live Birth Monitoring Panel (Brasil, 2024) indicate approximately 4,300 and 2,700 live births in the cities of Pelotas and Rio Grande, respectively, during the study year. Additionally, a cohort study conducted in Pelotas demonstrated that NICU admissions in the region accounted for 6.7% of all births in 2015 (Wehrmeister et al 2019).…”