- Neonatal near miss affected 12.5% of singleton live births in the Southeast Brazil Born in Brazil II cohort (2021-2023).
- Higher NMN odds associated with clinical conditions and inadequate care: syphilis, pre-gestational diabetes, hypertensive syndromes, less than 50% prenatal visits, forceps or vacuum delivery.
- Findings highlight sociodemographic inequalities and the need to strengthen integrated maternal and neonatal care policies to improve prenatal and intrapartum care.
Cien Saude Colet. 2026 Aug;31(8):e06572026. doi: 10.1590/1413-81232026318.06572026. Epub 2026 Apr 29.
ABSTRACT
This article aims to analyze the factors associated with neonatal near miss (NMN) in public and private hospitals in the Southeast region of Brazil. A prospective cohort study with 7,552 live births from singleton pregnancies from the “Born in Brazil II” study (2021-2023). NMN was defined according to the criteria of Pileggi-Castro et al. (2014), and the independent variables were organized in a hierarchical model: distal level (sociodemographic characteristics), intermediate level (maternal conditions and prenatal care), and proximal level (obstetric complications, type of delivery, and sex of the newborn). Neonatal mortality (NMN) occurred in 12.5% of live births. After adjustment, the following were associated with the outcome: urban residence (OR=1.75), absence of a partner (OR=1.36), hypertensive syndromes of pregnancy, pre-gestational diabetes (OR=2.76), syphilis (OR=5.44), less than 50% of prenatal visits (OR=2.14), alcoholism (OR=1.50), severe maternal morbidity (OR=1.96), forceps/vacuum delivery (OR=2.39), and male sex (OR=1.23). NMN was associated with clinical, sociodemographic, and care determinants, highlighting persistent inequalities in prenatal and intrapartum care and the need to strengthen integrated maternal and neonatal care policies.
PMID:42615715 | DOI:10.1590/1413-81232026318.06572026
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