Is a higher altitude associated with shorter survival among at-risk neonates?
<h4>Introduction</h4>We hypothesize that high altitudes could have an adverse effect on neonatal health outcomes, especially among at-risk neonates. The current study aims to assess the association between higher altitudes on survival time among at-risk neonates.<h4>Methods</h4&...
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Public Library of Science (PLoS)
2021
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oai:doaj.org-article:0c5d3a91a9bb4996988ac5fada25f80f2021-12-02T20:05:03ZIs a higher altitude associated with shorter survival among at-risk neonates?1932-620310.1371/journal.pone.0253413https://doaj.org/article/0c5d3a91a9bb4996988ac5fada25f80f2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253413https://doaj.org/toc/1932-6203<h4>Introduction</h4>We hypothesize that high altitudes could have an adverse effect on neonatal health outcomes, especially among at-risk neonates. The current study aims to assess the association between higher altitudes on survival time among at-risk neonates.<h4>Methods</h4>Retrospective survival analysis. Setting: Ecuadorian neonates who died at ≤28 days of life. Patients: We analyzed the nationwide dataset of neonatal deaths from the Surveillance System of Neonatal Mortality of the Ministry of Public Health of Ecuador, registered from 126 public and private health care facilities, between January 2014 to September 2017. Main outcome measures: We retrospectively reviewed 3016 patients. We performed a survival analysis by setting the survival time in days as the primary outcome and fixed and mixed-effects Cox proportional hazards models to estimate hazard ratios (HR) for each altitude stratum of each one of the health care facilities in which those neonates were attended, adjusting by individual variables (i.e., birth weight, gestational age at birth, Apgar scale at 5 minutes, and comorbidities); and contextual variables (i.e., administrative planning areas, type of health care facility, and level of care).<h4>Results</h4>Altitudes of health care facilities ranging from 80 to <2500 m, 2500 to <2750m, and ≥2750 m were associated respectively with 20% (95% CI: 1% to 44%), 32% (95% CI:<1% to 79%) and 37% (95% CI: 8% to 75%) increased HR; compared with altitudes at <80 m.<h4>Conclusion</h4>Higher altitudes are independently associated with shorter survival time, as measured by days among at-risk neonates. Altitude should be considered when assessing the risk of having negative health outcomes during neonatal period.Iván Dueñas-EspínLuciana Armijos-AcurioEstefanía EspínFernando Espinosa-HerreraRuth JimboÁngela León-CáceresRaif Nasre-NasserMaría F RivadeneiraDavid Rojas-RuedaLaura Ruiz-CedeñoBetzabé TelloDaniela Vásconez-RomeroPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253413 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
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Medicine R Science Q Iván Dueñas-Espín Luciana Armijos-Acurio Estefanía Espín Fernando Espinosa-Herrera Ruth Jimbo Ángela León-Cáceres Raif Nasre-Nasser María F Rivadeneira David Rojas-Rueda Laura Ruiz-Cedeño Betzabé Tello Daniela Vásconez-Romero Is a higher altitude associated with shorter survival among at-risk neonates? |
| description |
<h4>Introduction</h4>We hypothesize that high altitudes could have an adverse effect on neonatal health outcomes, especially among at-risk neonates. The current study aims to assess the association between higher altitudes on survival time among at-risk neonates.<h4>Methods</h4>Retrospective survival analysis. Setting: Ecuadorian neonates who died at ≤28 days of life. Patients: We analyzed the nationwide dataset of neonatal deaths from the Surveillance System of Neonatal Mortality of the Ministry of Public Health of Ecuador, registered from 126 public and private health care facilities, between January 2014 to September 2017. Main outcome measures: We retrospectively reviewed 3016 patients. We performed a survival analysis by setting the survival time in days as the primary outcome and fixed and mixed-effects Cox proportional hazards models to estimate hazard ratios (HR) for each altitude stratum of each one of the health care facilities in which those neonates were attended, adjusting by individual variables (i.e., birth weight, gestational age at birth, Apgar scale at 5 minutes, and comorbidities); and contextual variables (i.e., administrative planning areas, type of health care facility, and level of care).<h4>Results</h4>Altitudes of health care facilities ranging from 80 to <2500 m, 2500 to <2750m, and ≥2750 m were associated respectively with 20% (95% CI: 1% to 44%), 32% (95% CI:<1% to 79%) and 37% (95% CI: 8% to 75%) increased HR; compared with altitudes at <80 m.<h4>Conclusion</h4>Higher altitudes are independently associated with shorter survival time, as measured by days among at-risk neonates. Altitude should be considered when assessing the risk of having negative health outcomes during neonatal period. |
| format |
article |
| author |
Iván Dueñas-Espín Luciana Armijos-Acurio Estefanía Espín Fernando Espinosa-Herrera Ruth Jimbo Ángela León-Cáceres Raif Nasre-Nasser María F Rivadeneira David Rojas-Rueda Laura Ruiz-Cedeño Betzabé Tello Daniela Vásconez-Romero |
| author_facet |
Iván Dueñas-Espín Luciana Armijos-Acurio Estefanía Espín Fernando Espinosa-Herrera Ruth Jimbo Ángela León-Cáceres Raif Nasre-Nasser María F Rivadeneira David Rojas-Rueda Laura Ruiz-Cedeño Betzabé Tello Daniela Vásconez-Romero |
| author_sort |
Iván Dueñas-Espín |
| title |
Is a higher altitude associated with shorter survival among at-risk neonates? |
| title_short |
Is a higher altitude associated with shorter survival among at-risk neonates? |
| title_full |
Is a higher altitude associated with shorter survival among at-risk neonates? |
| title_fullStr |
Is a higher altitude associated with shorter survival among at-risk neonates? |
| title_full_unstemmed |
Is a higher altitude associated with shorter survival among at-risk neonates? |
| title_sort |
is a higher altitude associated with shorter survival among at-risk neonates? |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/0c5d3a91a9bb4996988ac5fada25f80f |
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