المؤلفون: Silveira, Mariangela F¹ (AUTHOR) mariangelafreitassilveira@gmail.com, Victora, Cesar G² (AUTHOR), Horta, Bernardo L² (AUTHOR), Silva, Bruna G C da² (AUTHOR), Matijasevich, Alicia³ (AUTHOR), Barros, Fernando C⁴ (AUTHOR), da Silva, Bruna G C² (AUTHOR), Pelotas Cohorts Study Group (CORPORATE AUTHOR)

المصدر: International Journal of Epidemiology. 2019 Supplement 1, Vol. 48, pi46-i53. 8p.

مصطلحات موضوعية: *PREMATURE labor, *BIRTH weight, *CHILDBIRTH, *MOTHER-child relationship, *INCOME, *FETAL macrosomia

مصطلحات جغرافية: BRAZIL

مستخلص: Background: Despite positive changes in most maternal risk factors in Brazil, previous studies did not show reductions in preterm birth and low birthweight. We analysed trends and inequalities in these outcomes over a 33-year period in a Brazilian city.Methods: Four population-based birth cohort studies were carried out in the city of Pelotas in 1982, 1993, 2004 and 2015, with samples ranging from 4231 to 5914 liveborn children. Low birthweight (LBW) was defined as <2500 g, and preterm birth as less than 37 weeks of gestation. Information was collected on family income, maternal skin colour and other risk factors for low birthweight. Multivariable linear regression was used to estimate the contribution of risk factors to time trends in birthweight.Results: Preterm births increased from 5.8% (1982) to 13.8% (2015), and LBW prevalence increased from 9.0% to 10.1%, being higher for boys and for children born to mothers with low income and brown or black skin colour. Mean birthweight remained stable, around 3200 g, but increased from 3058 to 3146 g in the poorest quintile and decreased from 3307 to 3227 g in the richest quintile. After adjustment for risk factors for LBW, mean birthweight was estimated to have declined by 160 g over 1982-2015 (reductions of 103 g in the poorest and 213 g in the richest quintiles).Conclusions: Data from four birth cohorts show that preterm births increased markedly. Mean birthweights remained stable over a 33-year period. Increased prevalence of preterm and early term births, associated with high levels of obstetric interventions, has offset the expected improvements due to reduction in risk factors for low birthweight. [ABSTRACT FROM AUTHOR]

المؤلفون: Passini Jr, Renato¹ passini@caism.unicamp.br, Cecatti, Jose G.^1,2, Lajos, Giuliane J.¹, Tedesco, Ricardo P.^1,3, Nomura, Marcelo L.¹, Dias, Tabata Z.¹, Haddad, Samira M.¹, Rehder, Patricia M.¹, Pacagnella, Rodolfo C.¹, Costa, Maria L.¹, Sousa, Maria H.²

المصدر: PLoS ONE. Oct2014, Vol. 9 Issue 10, p1-12. 12p.

مصطلحات موضوعية: *PREMATURE infants, *PREMATURE labor, *CHILDBIRTH, *HEALTH facilities, *MULTIPLE pregnancy

مصطلحات جغرافية: BRAZIL

مستخلص: Background: Preterm birth rate is increasing and is currently a worldwide concern. The purpose of this study was to estimate the prevalence of preterm birth in a sample of health facilities in Brazil and to identify the main risk factors associated with spontaneous preterm births. Methods and Findings: This was a multicentre cross sectional study on preterm births in 20 referral obstetric hospitals with a case-control component to identify factors associated with spontaneous preterm birth. Surveillance was implemented at all centres to identify preterm births. For eligible consenting women, data were collected through a post-delivery questionnaire completed with information from all mother-newborn medical records until death or discharge or at a maximum of 60 days post-delivery, whichever came first. The risk of spontaneous preterm birth was estimated with OR and 95%CI for several predictors. A non-conditional logistic regression analysis was then performed to identify independently associated factors. The overall prevalence of preterm birth was 12.3%. Among them, 64.6% were spontaneous and 35.4% therapeutic. In the case-control component, 2,682 spontaneous preterm births were compared to a sample of 1,146 term births. Multivariate analyses identified the following as risk factors for spontaneous preterm birth among women with at least one previous birth: a previous preterm birth (ORadj = 3.19, 2.30–4.43), multiple pregnancy (ORadj = 29.06, 8.43–100.2), cervical insufficiency (ORadj = 2.93, 1.07–8.05), foetal malformation (ORadj = 2.63, 1.43–4.85), polyhydramnios (ORadj = 2.30, 1.17–4.54), vaginal bleeding (ORadj = 2.16, 1.50–3.11), and previous abortion (ORadj = 1.39, 1.08–1.78). High BMI (ORadj = 0.94, 0.91–0.97) and weight gain during gestation (ORadj = 0.92, 0.89–0.95) were found to be protective factors. Conclusions: The preterm birth rate in these health facilities in Brazil is high and spontaneous preterm births account for two thirds of them. A better understanding of the factors associated with spontaneous preterm birth is of utmost importance for planning effective measures to reduce the burden of its increasing rates. [ABSTRACT FROM AUTHOR]

المؤلفون: Matijasevich, Alicia, Victora, Cesar G, Silveira, Mariangela F, Wehrmeister, Fernando C, Horta, Bernardo L, Barros, Fernando C, Pelotas Cohorts Study Group

المصدر: International Journal of Epidemiology; 2019 Supplement 1, Vol. 48, pi16-i25, 10p

مصطلحات موضوعية: REPRODUCTIVE history, MULTIPLE birth, BIRTH intervals, CHILDBIRTH, PREMATURE labor, COLOR vision

مصطلحات جغرافية: BRAZIL

مستخلص: Background: Brazil experienced important progress in maternal and child health in recent decades. We aimed at describing secular trends as well as socioeconomic and ethnic inequalities in reproductive history indicators (birth spacing, previous adverse perinatal outcome, parity and multiple births) over a 33-year span.Methods: Four population-based birth cohort studies included all hospital births in 1982, 1993, 2004 and 2015 in Pelotas, Southern Brazil. Information on reproductive history was collected through interviews. Indicators were stratified by family income quintiles and skin colour. Absolute and relative measures of inequality were calculated.Results: From 1982 to 2015, the proportion of primiparae increased from 39.2% to 49.6%, and median birth interval increased by 23.2 months. Poor women were more likely to report short intervals and higher parity, although reductions were observed in all income and ethnic groups. History of previous low birthweight was inversely related to income and increased by 7.7% points (pp) over time-more rapidly in the richest (12.1 pp) than in the poorest quintile (0.4 pp). Multiple births increased from 1.7% to 2.7%, with the highest increase observed among the richest quintile and for white women (220% and 70% increase, respectively). Absolute and relative income and ethnic-related inequalities for short birth intervals increased, whereas inequalities for previous low birthweight decreased over time.Conclusions: In this 33-year period there were increases in birth intervals, multiple births and reports of previous low-birthweight infants. These trends may be explained by increased family planning coverage, assisted reproduction and a rise in preterm births, respectively. Our results show that socioeconomic and ethnic inequalities in health are dynamic and vary over time, within the same location. [ABSTRACT FROM AUTHOR]

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المؤلفون: Lansky, Sônia¹ (AUTHOR), Oliveira, Bernardo J.² (AUTHOR) bjo@ufmg.br, Peixoto, Eliane R.M.³ (AUTHOR), Souza, Kleyde V.⁴ (AUTHOR), Fernandes, Luísa M.M.⁵ (AUTHOR), Friche, Amélia A.L.⁴ (AUTHOR)

المصدر: International Journal of Gynecology & Obstetrics. Apr2019, Vol. 145 Issue 1, p91-100. 10p.

مصطلحات موضوعية: *CHILDBIRTH, *PREGNANT women, *PREMATURE labor

مصطلحات جغرافية: BRAZIL

مستخلص: Objective: To increase knowledge and promote cultural change toward valuing normal birth, and to lower rates of cesarean and unnecessary interventions during childbirth in Brazil via the Senses of Birth (SoB) exhibition.Methods: The SoB intervention targeted 22 621 participants in three Brazilian cities in 2015. The effects of the exhibition in knowledge, perceptions, and preferences regarding childbirth were analyzed in a multi-method study. Pre- and post-exhibition survey responses of 17 501 (77.0%) visitors, 1947 (8.6%) non-pregnant women, and all pregnant women (n=1287) were collected at the exhibition. A follow-up survey was completed by 555 (43.0%) postpartum women who had participated at SoB while pregnant. Univariate analyses were used to compare before and after changes.Results: There was a significant increase in knowledge about normal birth, varying from 10.0% to 25.0% among general visitors (P<0.001) and 27.3% to 42.0% among pregnant women (P<0.001). Perceptions and preferences for normal birth also changed, reaching 83.0% of general visitors and 87.4% of pregnant women.Conclusion: SoB was found to effectively improve knowledge about and preference for normal birth. Scaling-up the intervention might contribute to cultural change toward valuing normal birth, and might decrease the rate of unnecessary cesarean and premature birth in Brazil. [ABSTRACT FROM AUTHOR]

المؤلفون: Machado Cruz Shibukawa, Bianca¹ bih.cruuz@gmail.com, Patricio Rissi, Gabrieli¹, Ieda Harumi Higarashi¹, Rosseto de Oliveira, Rosana¹

المصدر: Brazilian Journal of Mother & Child Health (BJMCH) / Revista Brasileira de Saude Materno Infantil (RBSMI). Sep-Dic2019, Vol. 19 Issue 4, p947-956. 10p.

مصطلحات موضوعية: *CLEFT lip, *CLEFT palate, *NEONATAL mortality, *CHILDBIRTH, *PREMATURE labor, *HEALTH care networks

مصطلحات جغرافية: BRAZIL

مستخلص: Objectives: to analyze the trend and the associated factors with the presence of cleft lip and/or cleft palate in Brazilian newborns, in order to verify possible associations with maternal care and newborn factors. Methods: a cross-sectional and ecological study, involving all live births in Brazil, recorded in the Information System on Live Births from 2005 to 2016. Maternal and infant information were evaluated using trend analysis and odds ratio, with a 95% confidence interval. The analyses were performed using SPSS software. Results: we analyzed 17,800 live births with presence of cleft lip and/or cleft palate. The Brazilian prevalence rate was 0.51 /1000 live births, with South and Southeast Regions registering higher rates than the national rate. There was an association with maternal age above 35 years old, with no partner, less than seven prenatal consultations, premature birth and cesarean section. About the factors of the newborn, being male, Apgar less than seven in the 1st and 5th minutes of life, low birth weight and white color were associated. Conclusions: Brazil has an increasing tendency for cleft lip and/or cleft palate (p=0.019), reinforcing the need to strengthen health care networks, providing adequate support for newborn with cleft lip and/or cleft palate and their families. [ABSTRACT FROM AUTHOR]

المؤلفون: Carvalho-Sauer, Rita¹ (AUTHOR) ritacarvalhosauer@gmail.com, Costa, Maria da Conceição Nascimento² (AUTHOR) mcncosta@ufba.br, Barreto, Florisneide R.² (AUTHOR) florisneide@gmail.com, Teixeira, Maria Gloria^1,2 (AUTHOR) magloria@ufba.br

المصدر: International Journal of Infectious Diseases. May2019, Vol. 82, p44-50. 7p.

مصطلحات موضوعية: *LOW birth weight, *ZIKA virus infections, *CESAREAN section, *CHILDBIRTH, *PREMATURE labor

مصطلحات جغرافية: BAHIA (Brazil : State), BRAZIL

مستخلص: • Low Birth Weight in children with CZS is 4 times higher than in those without CZS. • The prevalence of Low Birth Weight among children with CZS is very high, regardless of the duration of gestation. • Prematurity and caesarean birth are associated with Low Birth Weight in CSZ children. • Most of the children with CZS have mother of brown color, single and of low schooling. The clinical manifestations of Congenital Zika Syndrome (CZS) are not fully known, for example its effect on birth weight. This study estimated the prevalence of low birth weight (LBW) among children with CZS, and identified associated factors. Cross-sectional study involving 393 children with CZS living in Bahia, Brazil, in 2015–2017. Official Information Systems were the data sources. We calculated LBW prevalence and applied Logistic Regression to assess associated factors. Prevalence of LBW among children with CZS was 37.2%. Excluding pre-term births the proportion was 29.9%. This prevalence was 81.0% and 28.0% among children born pre-term and term/post term, respectively. There was a higher proportion (53.2%) in female children, and in those delivered by cesarean section (51.4%). Most mothers were single/separated (62.1%) and had a low level of schooling (70.0%). In the model adjusted for type of delivery, preterm births presented a 10.8 times greater chance of presenting LBW than term/post-term ones. However, the Confidence Interval was very wide. Adjusting for gestation duration, children born by cesarean section had a 1.63 higher probability of presenting LBW than those born by vaginal delivery (OR = 1,63; CI 95% 1.01, 2.63). The prevalence of LBW among children with CZS was very elevated, both preterm and term/post-term live births. This can contribute to increasing their risk for morbimortality. The association of LBW with prematurity and cesarean deliveries is known, but in children with CZS, it has not been clarified whether or not this is related to pathological conditions caused by fetal infection by the Zika virus. [ABSTRACT FROM AUTHOR]