Factors associated with 5-min APGAR score, death and survival in neonatal intensive care: a case-control study.

BACKGROUND: The 5-minute APGAR score is clinically used as a screening tool to assess how the newborn has reacted to previous care, remaining relevant for predicting neonatal survival. This study aimed to analyze the determinants of the 5th minute APGAR score, and the factors associated with the death and survival of newborns with low APGAR scores hospitalized in the neonatal intensive care unit (NICU) at a referral public hospital in North Brazil. METHODS: This was a hospital-based retrospective case-control study with 277 medical records. Newborns who presented with a 1-minute APGAR score < 7 followed by a 5-minute APGAR score < 7 were considered cases, while a score ≥ 7 was categorized as controls. Univariate and multivariable logistic regression analyses were used to establish the determinant factors of the low APGAR score and death outcome in this group. Survival curves were obtained using the Kaplan-Meier estimator, and then univariate and multivariate Cox regression was performed. RESULTS: After adjusted analysis, the factor associated with low APGAR scores was vaginal delivery (OR = 3.25, 95%CI = 1.60-6.62, p = 0.001). Birth injury (OR = 0.39, 95%CI = 0.19-0.83, p = 0.014) was associated with upper APGAR scores. No significant independent associations were observed between the variables analyzed and death in the low APGAR score group. The Kaplan-Meier curve showed that individuals who presented Cesarean delivery had a shorter survival time in the ICU. CONCLUSION: In this setting, a 5-minute Apgar score < 7 was associated with the occurrence of vaginal delivery and birth injury with a 5-minute Apgar score ≥ 7. Survival in ICU was lower in newborns that were delivered via cesarean section.

Mortality prediction in women with corpus uteri cancer in Brazil: a 21-year analysis.

Mortality data obtained from the Mortality Information System identified a total of 19,499 deaths in women caused by corpus uteri cancer in Brazil. However, the association between mortality and sociodemographic factors in these women is not fully understood. A study based on the secondary data on deaths caused by corpus uteri cancer recorded in the SIM-DATASUS was conducted. Deaths reported from 1996 to 2016 in the health information system were included. Sociodemographic factors were analysed to determine their association with mortality. Low schooling is highly associated with mortality in all administrative regions. Advanced age, race and marital status have specific association with mortality for the different geographic regions. Black, Brown and Indigenous women with low schooling and of advanced age are highly associated with mortality. Brown, White and Black women of advanced age had the highest corpus uteri cancer related mortality rates. Women with low schooling who died of corpus uteri cancer were either single or widows. The marital status of Black, White and Brown women aged <59 years was single. The sociodemographic factors that predict mortality in women with corpus uteri cancer in Brazil were presented and can be used to guide public health.