{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:41:53Z","timestamp":1792827713472,"version":"4.5.0"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"S 01","license":[{"start":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T00:00:00Z","timestamp":1660608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003This article aimed to report a temporal series of respiratory distress syndrome (RDS)-associated neonatal mortality rates in preterm live births in S\u00e3o Paulo state, Brazil, and to identify social, maternal, and neonatal characteristics associated with these deaths.<\/jats:p><jats:p>\n            Study Design\u2003This is a population-based study of all live births with gestational age (GA) between 22 and 36 weeks, birth weight \u2265400\u2009g, without congenital anomalies from mothers living in S\u00e3o Paulo state during 2004 to 2015. RDS-associated neonatal mortality was defined as death up to 27 days after birth with ICD-10 codes P22.0 or P28.0. RDS-associated neonatal mortality rate (annual percent change [APC] with 95% confidence intervals [95% CIs]) was analyzed by Prais\u2013Winsten. Kaplan\u2013Meier estimator identified the time after birth that the RDS-associated neonatal death occurred. Poisson's regression model compared social maternal and neonatal characteristics between preterm live births that survived the neonatal period and those with RDS-associated neonatal deaths, with results expressed in incidence rate ratio and 95% CI.<\/jats:p><jats:p>\n            Results\u2003A total of 645,276 preterm live births were included in the study, of which 612,110 survived and 11,078 had RDS-associated neonatal deaths. RDS-associated neonatal mortality rate was 17.17 per thousand preterm live births, with a decreasing annual trend (APC: \u22126.50%; 95% CI: \u22129.11 to \u22123.82%). The median time of these deaths was 48\u2009hours after birth. The following risk factors for RDS-associated neonatal death were identified: maternal schooling \u22647 years (1.18; 1.09\u20131.29), zero to three prenatal care visits (1.25; 1.18\u20131.32), multiple pregnancy (1.24; 1.16\u20131.33), vaginal delivery (1.29; 1.22\u20131.36), GA 22 to 27 weeks (106.35; 98.36\u2013114.98), GA 28 to 31 weeks (20.12; 18.62\u201321.73), male sex (1.16; 1.10\u20131.22), and 5-minute Apgar scores of 0 to 3 (6.74; 6.08\u20137.47) and 4 to 6 (3.97; 3.72\u20134.23).<\/jats:p><jats:p>\n            Conclusion\u2003During the study period, RDS-associated neonatal mortality rates showed significant reduction. The relationship between RDS-associated neonatal deaths and social, maternal, and neonatal factors suggests the need for perinatal strategies to reduce prematurity and to improve the initial management of preterm infants.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0042-1754410","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T00:50:52Z","timestamp":1660697452000},"page":"e298-e304","source":"Crossref","is-referenced-by-count":6,"special_numbering":"S","title":["Temporal Trend and Risk Factors for Respiratory Distress Syndrome\u2013Associated Neonatal Mortality in Preterm Infants: A Population-Based Study in a Middle-Income Country"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9845-6097","authenticated-orcid":false,"given":"Ana S\u00edlvia Scavacini","family":"Marinonio","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), Vila Clementino, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Testoni","family":"Costa-Nobre","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), Vila Clementino, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Sanudo","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), Vila Clementino, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milton Harumi","family":"Miyoshi","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), Vila Clementino, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsy Catherina Nema","family":"Areco","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), Vila Clementino, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandira Daripa","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), Vila Clementino, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita de Cassia","family":"Xavier","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), Vila Clementino, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tulio","family":"Konstantyner","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), Vila Clementino, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo","family":"Bandiera-Paiva","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), Vila Clementino, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Maria Vieira de","family":"Freitas","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Sistema Estadual de An\u00e1lise de Dados (SEADE Foundation), S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian Cristina Correia","family":"Morais","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Sistema Estadual de An\u00e1lise de Dados (SEADE Foundation), S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f4nica La Porte","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o 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