Survival estimate and geographic trajectory in the antepartum period of preterm infants with neonatal death outcome

Abstract The objective of this study was to analyze the estimated survival of preterm infants with a neonatal death outcome and the geographical trajectory traveled in the antepartum period between municipalities in the state of Pernambuco. This is a cohort study with survival and ecological analysis, using flow analysis, with 4,643 premature infants who did not survive the neonatal period from 2013 to 2019. Multivariate analysis was used using a generalized linear model. To analyze the geographic trajectory traveled by preterm infants in the antepartum period, a spatial flow pattern was used using the K-means method. Preterm birth survival was two days and 34% lived less than one day. Survival time decreased by 16% when the mothers’ race/color were mixed race. With regard to the spatial pattern of flows between home and place of birth, routes between 0 and 61.3km and between 61.3km and 163.5km were responsible for 74.7% and 17.5% of deaths, respectively. There were differences in survival times in the state’s different mesoregions. Many women still had to travel long distances to give birth to their children, which was associated with shorter neonatal survival times, especially in areas further away.