DETERMINANTS OF INFANT MORTALITY IN CITIES OF THE JEQUITINHONHA VALLEY, MINAS GERAIS, BRAZIL DETERMINANTES DA MORTALIDADE INFANTIL EM MUNICÍPIOS DO VALE DO JEQUITINHONHA,

Objective: To analyze the determinants of infant mortality in Aracuai, Joaima, Jordânia, and Novo Cruzeiro, cities located in the Jequitinhonha Valley, Minas Gerais State, Brazil. Methods: This was a case-control study including 36 infant deaths that occurred in 2008 and 72 live births, which did not evolve to death, randomly selected in the same period as controls. Demographic and socioeconomic data, maternal obstetric history, prenatal and childbirth care, and biological conditions of mothers and newborns were obtained using a structured questionnaire. Multivariate analyses of hierarchical logistic regression were conducted to evaluate the association of infant death and the study variables. Results: Deaths in the neonatal period (55%) were predominant. Children from mothers with a history of stillbirth (p<0.001) and children who were born preterm (p=0.01), or with some type of malformation (p<0.001) remained independently associated with mortality. Children whose families did not receive government aid and resided in households with less favorable conditions had a higher chance to die in the first year of life. Conclusions: perinatal causes were important determinants of infant mortality in this study, although poor socioeconomic conditions also interfered significantly in the occurrence of deaths, indicating social problems and poor access to health services. The challenge of reducing infant deaths in the studied cities include the need for improvements in access and quality of maternal and child health care and demand for public policies that aimed at reducing socioeconomic inequalities.