Breastfeeding during the first hour of life and neonatal mortality

Boccolini, Cristiano Siqueira; de Carvalho, Márcia Lazaro; de Oliveira, Maria Inês Couto; Pérez-Escamilla, Rafael

doi:10.1016/j.jped.2013.03.005

Article information

Statistics

Abstract

Objective

To analyze the correlation between breastfeeding in the first hour of life with neonatal mortality rates.

Methods

The present study used secondary data from 67 countries, obtained from the Demographic and Health Surveys. Initially, for data analysis, Spearman Correlation (95% CI) and Kernel graphical analysis were employed, followed by a Negative Binomial Pois- son regression model, adjusted for potential confounders.

Results

Breastfeeding within the first hour of life was negatively correlated with neo- natal mortality (Spearman's Rho = −0.245, p = 0.046), and this correlation was stronger among countries with more than 29 neonatal deaths per 1000 newborns (Spearman's Rho = −0.327, p = 0.048). According to the statistical model, countries with the lowest breastfeeding tertiles had 24% higher neonatal mortality rates (Rate ratio = 1.24, 95% CI = 1.07-1.44, p < 0.05), even when adjusted for potential confounders.

Conclusion

The protective effect of breastfeeding during the first hour of life on neo- natal mortality in this ecological study is consistent with findings from previous observa- tional studies, indicating the importance of adopting breastfeeding within the first hour as a routine neonatal care practice.

Keywords:

Maternal and child health

Breastfeeding

Child mortality

Epidemiologic measurements

Resumo

Objetivo

Analisar a correlação entre o percentual de amamentação na primeira hora de vida e as taxas de mortalidade neonatal.

Métodos

Foram utilizados dados secundários de 67 países obtidos das pesquisas realizadas com a metodologia do Demographic and Health Surveys. Inicialmente, para a análise dos dados, foram empregadas a Correlação de Spearman (IC 95%) e a análise gráfica com modificação de Kernel, seguidas de regressão de Poisson Binomial Negativa, ajustando para possíveis fatores de confundimento.

Resultados

O percentual de aleitamento materno na primeira hora de vida esteve negativamente associado com as taxas de mortalidade neonatal (Rho = −0,245, p = 0,046), e esta correlação foi mais forte entre os países com mortalidade neonatal superior a 29 mortes/1.000 nascidos vivos (Rho = −0,327, p = 0,048). Os países com os menores tercis de aleitamento materno na primeira hora de vida tiveram uma taxa 24% maior de mortalidade neonatal (razão de taxa = 1,24, IC 95% = 1,07-1,44), mesmo ajustando para fatores de confundimento.

Conclusão

O efeito protetor da amamentação na primeira hora de vida sobre a mortalidade neonatal encontrado nesse estudo ecológico é consistente com o de estudos observacionais, e aponta para a importância de se adotar a amamentação na primeira hora de vida como prática de atenção neonatal.

Palavras-chave:

Saúde materno- infantil

Aleitamento materno

Mortalidade infantil

Medidas em epidemiologia

Lactente

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*

Please, cite this article as: Boccolin CS, de Carvalho ML, de Oliveira MI, Pérez-Escamilla R. Breastfeeding during the first hour of life and neonatal mortality. J Pediatr (Rio J). 2013;89:131−6.

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