Early and late neonatal mortality: preventable causes and trends in Brazilian

Objective: To analyze the main causes and trends in preventable early and late neonatal mortality according to Brazilian regions. Methods: This is an ecological time series study carried out with records of neonatal deaths from 2000 to 2018 through the Mortality Information System. To classify the avoidable causes, the Unified Health System List of Preventable Causes of Death by Interventions (Lista de Causas de Mortes Evitaveis por Intervencoes do Sistema unico de Saude) was used. From mortality rates of early and late neonatal components, joinpoint regressions of the main causes were performed using the Annual Percentage Change and Average Annual Percentage Change.Results: The highest avoidable mortality rates were found in the early neonatal phase. The South had the lowest avoidable mortality rates. The main causes according to groups on the list were tetanus of newborns, respiratory distress syndrome, birth asphyxia, bacterial septicemia, pneumonia and sudden death syndrome. The reduction in early neonatal mortality was higher from 2000 to 2004 (4.19% per year, p<0.001) and lower between 2012 and 2018 (1.80% per year, p<0.001). Considering late neonatal mortality, there was an average annual reduction of 2.02% (p<0.001). The Northeast had more than one turning point in the trend of mortality due to respiratory distress and asphyxia at birth and stability due to septicemia. In the South, a downward trend was identified for all the preventable causes studied.Conclusion: There was a lower reduction in early neonatal mortality and inequalities in the trend of preventable neonatal mortality according to causes and regions of residence.