Adverse neonatal outcomes: a hospital-based study

Introduction: Unfavorable neonatal outcomes in newborns have been associated with excessive medicalization in prenatal care, delivery and birth. Objective: to analyze unfavorable neonatal outcomes in live births in a Brazilian municipality. Methods: cohort study, carried out in public and private maternity hospitals. The sample consisted of live births. The occurrence of prematurity, low birth weight, neonatal resuscitation, use of oxygen, mechanical ventilation, use of antibiotics, admission to the Intensive Care Unit and death were included as unfavorable outcomes. Explanatory models were extracted using logistic regression. Results: 1088 newborns were evaluated, of which 32.7% had some unfavorable neonatal outcome, the most frequent being: resuscitation maneuvers, use of oxygen and prematurity. In the unfavorable neonatal outcome model, it was a risk factor, presenting clinical intercurrence during pregnancy, and protective factors, like having a health plan and prenatal card. In the model for neonatal death, the variables that expressed a significant association were gestational age, Apgar score below 7 at the 5th minute and location of prenatal care. Conclusion: the high occurrence of unfavorable neonatal outcomes is a challenge to be overcome and its prevention involves actions in the process of pregnancy and childbirth.