Risk Factors for Neonatal Depression in a Regional Public Hospital, Santos, Brazil, 2013

Neonatal depression leads to severe neurological sequelae with important impacts on quality of life. Most risk factors are sensitive to primary care actions, and this should be considered when developing prevention strategies. The aim was to identify the incidence and risk factors associated with neonatal depression in newborns at a Brazilian regional public hospital. A cross-sectional study of 784 live births with gestational ages of 22 weeks or more and without any major congenital anomalies was performed. Neonatal depression was defined as an Apgar score lower than seven at five minutes. Chi-square tests (p<0.05) were used for the analysis of associations, and a logistic regression model was run to control the confounding factors. The neonatal depression rate was 2.2%. Multivariate logistic regression revealed that the presence of foul-smelling amniotic fluid (OR=14.2, p=0.029), prematurity (gestational age less than 37 weeks) (OR=37.5, p<0.001) and the time of rupture of larger membranes (OR=8.7, p=0.005) were independently associated with neonatal depression. Risk conditions for perinatal infection and prematurity increase the likelihood of neonatal depression. Adequate prenatal care and guaranteed access to delivery services may reduce the occurrence of these neonatal depression risks and, consequently, may reduce infant morbidity and mortality.