Trend in neonatal mortality and preventable neonatal deaths: a time series analysis, Bahia, 2010-2020.

Objective: To analyze the temporal trend of neonatal mortality rates and preventable neonatal deaths in Bahia.

Methods: This was a time series study of neonatal deaths in Bahia from 2010 to 2020. Neonatal mortality rates and their components were calculated and analyzed according to sociodemographic, obstetric, and newborn characteristics, as well as causes of death. Joinpoint regression analyses were used to estimate trends, annual percentage change (APC), and 95% confidence intervals (95%CI).

Results: A total of 26,661 neonatal deaths were identified. A decreasing trend was observed for neonatal mortality (APC -1.9; 95%CI -2.4; -1.5) and early neonatal mortality (APC -2.2; 95%CI -2.6; -1.8), while late neonatal mortality showed a stationary trend (APC -0.7; 95%CI -2.1; 0.7). Higher frequencies of neonatal deaths were observed among children born to mothers aged 20 to 34 years, with 8 to 11 years of schooling, single pregnancies, preterm births, vaginal deliveries, male newborns, low birth weight, and those with certain conditions originating in the perinatal period and congenital malformations. A decreasing trend was found in neonatal mortality due to preventable causes through adequate care during pregnancy and childbirth. However, an upward trend was identified for some preventable causes of neonatal death, such as congenital syphilis.

Conclusion: The decline in neonatal mortality rates indicated progress in prenatal and childbirth care. Differences in trends of preventable deaths emphasized the need to expand and improve health services through public policies that address regional inequalities and strengthen comprehensive maternal and child health care.