Evaluation of risk for pregnancy adverse outcomes in Baixada Santista – São Paulo State, Brazil

Abstract Background Brazil has the fifth biggest territory in the world, and the eighth economy. In the Brazilian Health System, universal health coverage has been the target to be pursuit. However, there are many obstacles to assured this right to the entire population. Even in São Paulo, the state with the biggest part of Brazilian GDP, there are regions with serious economic problems impacting negatively health coverage, education programs and urban infrastructure. The metropolitan region of Baixada Santista includes nine cities with different socioeconomic status and a well-known history of environmental contamination. These environmental and economic stressors are risk factors that can impact pregnants and their offspring. In 2018 the infant mortality in the region was 14.02 for each one thousand newborns while in the São Paulo State it was 10.7 and in Brazil 12.4. The aim of this study was to investigate risk factors associated to adverse pregnancy outcomes in the Metropolitan Region of Baixada Santista. Methods We adopted a crossectional design using data from the Born Alive Information System (Brazilian Health Ministry) from 2006 to 2016. Low birth weight, malformation, low Apgar score and prematurity were assumed as dependent variables in specific single e multiple logistic regression models. Results Besides the effects of risk factors already seeing in other investigations on adverse pregnancy outcomes, as maternal age and years of study, we found prematurity associated with living in Guarujá (OR = 1,37; 95% CI 1,25 - 1,51) and inadequacy of pre-natal (OR 2,9; 95% CI 2,74 - 3,11). Also, low birth weight was associated with living in Cubatão (OR 1,88; 95% CI1,67 - 2,12) or São Vicente (OR 1,80; 95% CI 1,62 - 2,01), and inadequacy of pre-natal (OR 2,96; 95% CI 2,62 - 3,24). Conclusions Differences on primary health care structure and medical coverage, by city, may contribute to increase the risk of pregnancy adverse outcomes. Key messages Improvements have to be implemented in municipal health structure to minimize the risk of pregnancy adverse outcomes. Preventing evitable factors for adverse birth outcomes costs less than treating the consequences of a them.

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The relationship between low birth weight and exposure to inhalable particulate matter

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2013000600007 ◽

2013 ◽

Vol 29 (6) ◽

pp. 1101-1108 ◽

Cited By ~ 15

Author(s):

Rodrigo Romão ◽

Luiz Alberto Amador Pereira ◽

Paulo Hilário Nascimento Saldiva ◽

Patricia Matias Pinheiro ◽

Alfésio Luiz Ferreira Braga ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Public Health Problem ◽

Sao Paulo ◽

São Paulo ◽

Global Public Health ◽

Paulo State ◽

São Paulo State ◽

Adverse Pregnancy ◽

The Relationship

Atmospheric pollution is a global public health problem. The adverse effects of air pollution are strongly associated with respiratory and cardiovascular diseases and, to a lesser extent, with adverse pregnancy outcomes. This study analyzes the relationship between exposure to PM10 and low birth weight in the city of Santo André, São Paulo State, Brazil. We included babies born to mothers resident in Santo André between 2000 and 2006. Data on daily PM10 levels was obtained from the São Paulo State Environmental Agency. We performed descriptive analysis and logistic regressions. The prevalence rate of low birth weight was 5.9%. There was a dose-response relationship between PM10 concentrations and low birth weight. Exposure to the highest quartile of PM10 (37,50µg/m³) in the third trimester of pregnancy increased the risk of low birth weight by 26% (OR: 1.26; 95%CI: 1.14-1.40) when compared to the first quartile. The same effect was observed in the remaining trimesters. This effect was observed for ambient particle concentrations that met the current air quality standards.

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Seroprevalence of and risk factors for Toxoplasma gondii in sheep raised in the Jaboticabal microregion, São Paulo State, Brazil

Research in Veterinary Science ◽

10.1016/j.rvsc.2009.06.006 ◽

2010 ◽

Vol 88 (1) ◽

pp. 104-106 ◽

Cited By ~ 25

Author(s):

Welber Daniel Zanetti Lopes ◽

Thaís Rabelo dos Santos ◽

Ricardo dos Santos da Silva ◽

Walter Matheus Rossanese ◽

Fernando Augusto de Souza ◽

...

Keyword(s):

Risk Factors ◽

Toxoplasma Gondii ◽

Sao Paulo ◽

São Paulo ◽

Paulo State ◽

São Paulo State

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Anomalous scales of Tillandsia usneoides (L.) L. (Bromeliaceae) exposed in the Metropolitan Region of Campinas, SP, Brazil as air pollution markers

Hoehnea ◽

10.1590/2236-8906-18/rad/2015 ◽

2015 ◽

Vol 42 (4) ◽

pp. 749-757 ◽

Cited By ~ 4

Author(s):

Patrícia Giampaoli ◽

Natalie do Valle Capelli ◽

Armando Reis Tavares ◽

Francine Faia Fernandes ◽

Marisa Domingos ◽

...

Keyword(s):

Air Pollution ◽

Air Pollutants ◽

Sao Paulo ◽

Initial Evaluation ◽

Metropolitan Region ◽

São Paulo ◽

Paulo State ◽

Tillandsia Usneoides ◽

São Paulo State

Tillandsia usneoides is an epiphytic bromeliad that has been used as a universal bioindicator. The species accumulates metals and presents foliar scale variations when exposed to air pollutants. This study aimed to use the variations in foliar scales as microscopic markers of pollutant effects in the Metropolitan Region of Campinas (MRC), São Paulo State, Brazil. T. usneoides plants were exposed for 12 weeks during dry and wet seasons, totaling four exposures, at five sites in the MRC. Samples were selected before each exposure for initial evaluation of the plants (T0). Leaf fragments were fixed in glutaraldehyde and total scale density and anomalous scale percentage were evaluated. Plants exposed in the MRC showed anomalies and changes in number of subperipheral cells of leaf scales. When compared to T0, T. usneoides presented higher total scale density and anomalous scale percentage at disturbed sites, thus the species can be used as a pollution bioindicator for MRC.

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Impact of Wildfire Smoke on Adverse Pregnancy Outcomes in Colorado, 2007–2015

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16193720 ◽

2019 ◽

Vol 16 (19) ◽

pp. 3720 ◽

Cited By ~ 9

Author(s):

Mona Abdo ◽

Isabella Ward ◽

Katelyn O’Dell ◽

Bonne Ford ◽

Jeffrey Pierce ◽

...

Keyword(s):

Birth Weight ◽

Pregnancy Outcomes ◽

Gestational Hypertension ◽

Adverse Pregnancy Outcomes ◽

Adverse Outcomes ◽

Wildfire Smoke ◽

Secondary Outcomes ◽

Adverse Pregnancy ◽

The Impact ◽

Zip Code

Colorado is regularly impacted by long-range transport of wildfire smoke from upwind regions. This smoke is a major source of ambient PM2.5. Maternal exposure to total PM2.5 during pregnancy has been linked to decreased birth weight and other adverse outcomes, although the impact of wildfire smoke contribution has only recently been investigated. The objective of this study was to estimate associations between adverse pregnancy outcomes and ambient wildfire smoke PM2.5. Wildfire smoke PM2.5 exposures were estimated using a previously published method incorporating ground-based monitors and remote sensing data. Logistic regression models stratified by ZIP code and mixed models with random intercept by ZIP code were used to test for associations. The primary outcomes of interest were preterm birth and birth weight. Secondary outcomes included gestational hypertension, gestational diabetes, neonatal intensive care unit admission, assisted ventilation, small for gestational age, and low birth weight. Exposure to wildfire smoke PM2.5 over the full gestation and during the second trimester were positively associated with pre-term birth (OR = 1.076 (μg/m3)−1 [95% CI = 1.016, 1.139; p = 0.013] and 1.132 (μg/m3)−1 [95% CI = 1.088, 1.178]; p < 0.0001, respectively), while exposure during the first trimester was associated with decreased birth weight (−5.7 g/(μg/m3) [95% CI: −11.1, −0.4; p = 0.036]). Secondary outcomes were mixed.

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Evaluation of infections by Candida at a university hospital of Vale do Paraíba region, São Paulo State, Brazil: species distribution, colonization, risk factors and antifungal susceptibility

Revista Pan-Amazônica de Saúde ◽

10.5123/s2176-62232016000200006 ◽

2016 ◽

Vol 2 (7) ◽

pp. 1-2 ◽

Cited By ~ 1

Author(s):

Sonia Khouri ◽

Luciana da Silva Ruiz ◽

Marcos Ereno Auler ◽

Bosco Christiano Maciel da Silva ◽

Virgínia Bodelão Richini Pereira ◽

...

Keyword(s):

Risk Factors ◽

Species Distribution ◽

Antifungal Susceptibility ◽

Sao Paulo ◽

University Hospital ◽

São Paulo ◽

Paulo State ◽

São Paulo State

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Spatial Microsimulation Combined with Skater Regionalization Methods: A Study for the Paraíba Valley and North Coast Metropolitan Region Subregion 4 in the São Paulo State

Revista Brasileira de Cartografia ◽

10.14393/rbcv72n4-53160 ◽

2020 ◽

Vol 72 (4) ◽

pp. 713-726

Author(s):

Gabriela Carvalho de Oliveira ◽

Tathiane Mayumi Anazawa ◽

Antonio Miguel Vieira Monteiro

Keyword(s):

Sao Paulo ◽

Metropolitan Region ◽

North Coast ◽

São Paulo ◽

Iterative Proportional Fitting ◽

Socioeconomic Groups ◽

Paulo State ◽

The Social ◽

Spatial Microsimulation ◽

São Paulo State

This study analyzes the socio-occupational distribution in the Paraíba Valley and North Coast Metropolitan Region (in Portuguese: Região Metropolitana do Vale do Paraíba e Litoral Norte – RMVPLN) Subregion 4 using spatial microsimulation techniques. To fulfill the proposed objective, the Iterative Proportional Fitting (IPF) technique was used to obtain spatial microdata in the territorial census tracts unit through the 2010 Brazilian Demographic Census. After the Skater regionalization technique was applied, eight homogeneous socio-occupational groups were found. Overall, the proposed socio-occupational categories, studied at an intra-urban scale, allowed for highlighting the social structure on a subregion of the newest Metropolitan space in the São Paulo state. Although this is a preliminary study, it is already capable to identify inequalities degrees that consistently spatially segregate and the less privileged population socioeconomic groups.

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Association Between Adverse Pregnancy Outcomes and Preceding Risk Factors: an Analytical Cross-Sectional Study

10.21203/rs.3.rs-403228/v1 ◽

2021 ◽

Author(s):

Prakash Prabhakarrao Doke ◽

Sonali Hemant Palkar ◽

Jayashree Sachin Gothankar ◽

Archana Vasantrao Patil ◽

Amruta Paresh Chutke ◽

...

Keyword(s):

Risk Factors ◽

Pregnancy Outcomes ◽

Significant Risk ◽

Tobacco Consumption ◽

Adverse Pregnancy Outcomes ◽

Adverse Outcomes ◽

Mountainous Area ◽

Cross Sectional ◽

Heavy Work ◽

Adverse Pregnancy

Abstract Background: The health of women during the preconception phase though critical, is a comparatively ignored part in her life cycle. The presence of health risks is judged as hazardous to the wellbeing of women and their forthcoming progeny. The study aimed to estimate the prevalence of various pregnancy outcomes and assess the association between various risk factors and adverse outcomes. Methods: It was a population-based cross-sectional analytical study. The study was carried out in Nashik District, having a large mountainous area. It included two randomly selected blocks, one tribal and one nontribal, in which interventions were planned in the later stage. For comparison, two adjacent blocks, one tribal and one nontribal, were also included. All women who had a pregnancy outcome in the preceding 12 months (01 April 2017 to 31 March 2018) were interviewed. Trained Accredited Social Health Activists under the direct supervision of Auxiliary Nurse Midwives and Medical Officers conducted the survey. Multivariate analysis was carried out to find the adjusted risk ratio of having a particular adverse outcome because of the specified potential risk factors.Results: A total of 9,307 women participated in the study. The prevalence of adverse pregnancy outcomes was abortion 4.1%; stillbirth 1.6%; preterm birth 4.1%; LBW 11.2%; congenital physical defect 2.6%. Prevalence of consanguineous marriage, heavy work during the last six months of pregnancy, pre-existing illness, tobacco consumption, direct exposure to pesticides and domestic violence during pregnancy was 17.6%; 16.9%; 2.2%; 5.6%; 2.3%; and 0.8%, respectively. Risk factors that were significantly associated with abortion include existing illness at the time of conception and performing heavy work in the last six months of pregnancy. Consanguinity, tobacco consumption during pregnancy and pre-existing illness were identified as risk factors for stillbirth. Significant risk factors of LBW were heavy work in the last six months of pregnancy, pre-existing illness and residence in a tribal area. Conclusion: The survey showed that risk factors differentially affect outcomes of pregnancy. Preconception and antenatal care should include counselling about consanguineous marriages, identifying and managing a pre-existing illness, avoiding tobacco consumption in the prenatal and natal period, and avoiding heavy work during pregnancy.

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Effects of sanitation practices on adverse pregnancy outcomes in India: a conducive finding from recent Indian demographic health survey

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2528-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Ratna Patel ◽

Ajay Gupta ◽

Shekhar Chauhan ◽

Dhananjay W. Bansod

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Pregnancy Outcome ◽

Health Survey ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcome ◽

Wealth Index ◽

Adverse Pregnancy Outcomes ◽

Adverse Outcomes ◽

Adverse Pregnancy

Abstract Background Several risk factors predisposing women and their live-borns to adverse outcomes during pregnancy have been documented. Little is known about sanitation being a factor contributing to adverse pregnancy outcomes in India. The role of sanitation in adverse pregnancy outcomes remains largely unexplored in the Indian context. This study is an attempt to bring the focus on sanitation as a factor in adverse pregnancy outcome. Along with the sanitation factors, few confounder variables have also been studied in order to understand the adverse pregnancy outcomes. Methods The study is based on the fourth round of National Family Health Survey (NFHS-IV) covering 26,972 married women in the age-group 15–49. The study variables include the mother’s age, Body Mass Index (BMI), education, anemia, and Antenatal care (ANC) visits during their last pregnancy. The household level variable includes place of residence, religion, caste, wealth index, access to toilet, type of toilet, availability of water within toilet premises, and facility of hand wash near the toilet. Children study variables include Low Birth Weight (LBW), the order of birth (Parity), and the death of the children of the women in the last 5 years. The target variable Adverse Pregnancy Outcome (APO) was constructed using children born with low birth weight or died during the last pregnancy. Results We calculated both adjusted as well as unadjusted odds ratios for a better understanding of the association between sanitation and adverse pregnancy outcomes. Findings from the study showed that women who did not have access to a toilet within the house had a higher risk of adverse pregnancy outcome. In the multivariable model, no association was observed for adverse pregnancy outcome among women who did not have access to toilet and women who used shared toilet. Teenage (15–19 years), uneducated, underweight and anemic mothers were more likely to face APO as compare to other mothers in similar characteristics group. Conclusions Our findings contribute to the decidedly less available literature on maternal sanitation behaviour and adverse pregnancy outcomes. Our results support that sanitation is a very significant aspect for women who are about to deliver a baby as there was an association between sanitation and adverse pregnancy outcome. Education on sanitation practices is the need of the hour as much as it needs to follow.

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Spatial analysis of the COVID-19 distribution pattern in São Paulo State, Brazil

Ciência & Saúde Coletiva ◽

10.1590/1413-81232020259.17082020 ◽

2020 ◽

Vol 25 (9) ◽

pp. 3377-3384

Author(s):

Franciel Eduardo Rex ◽

Cléber Augusto de Souza Borges ◽

Pâmela Suélen Käfer

Keyword(s):

Spatial Analysis ◽

Spatial Pattern ◽

Kernel Density ◽

Sao Paulo ◽

Control Measures ◽

Metropolitan Region ◽

São Paulo ◽

Paulo State ◽

First Case ◽

São Paulo State

Abstract At the end of 2019, the outbreak of COVID-19 was reported in Wuhan, China. The outbreak spread quickly to several countries, becoming a public health emergency of international interest. Without a vaccine or antiviral drugs, control measures are necessary to understand the evolution of cases. Here, we report through spatial analysis the spatial pattern of the COVID-19 outbreak. The study site was the State of São Paulo, Brazil, where the first case of the disease was confirmed. We applied the Kernel Density to generate surfaces that indicate where there is higher density of cases and, consequently, greater risk of confirming new cases. The spatial pattern of COVID-19 pandemic could be observed in São Paulo State, in which its metropolitan region standed out with the greatest cases, being classified as a hotspot. In addition, the main highways and airports that connect the capital to the cities with the highest population density were classified as medium density areas by the Kernel Density method.It indicates a gradual expansion from the capital to the interior. Therefore, spatial analyses are fundamental to understand the spread of the virus and its association with other spatial data can be essential to guide control measures.

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