scholarly journals Low birthweight and preterm birth: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

2018 ◽  
Vol 48 (Supplement_1) ◽  
pp. i46-i53 ◽  
Author(s):  
Mariangela F Silveira ◽  
Cesar G Victora ◽  
Bernardo L Horta ◽  
Bruna G C da Silva ◽  
Alicia Matijasevich ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Low Income ◽  
Low Birthweight ◽  
Family Income ◽  
Preterm Births ◽  
Population Based ◽  
Skin Colour ◽  
Birth Cohorts ◽  
Maternal Risk

Abstract 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.

scholarly journals Determinants of preterm birth: Pelotas, Rio Grande do Sul State, Brazil, 2004 birth cohort

2010 ◽  
Vol 26 (1) ◽  
pp. 185-194 ◽  
Author(s):  
Mariângela F. Silveira ◽  
Cesar G. Victora ◽  
Aluísio J. D. Barros ◽  
Iná S. Santos ◽  
Alicia Matijasevich ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Birth Cohort ◽  
Low Income ◽  
Family Income ◽  
Preterm Births ◽  
Rio Grande ◽  
Low Income Countries ◽  
Rio Grande Do Sul ◽  
Vaginal Deliveries

Prematurity is a leading cause of neonatal mortality and a global health problem that affects high, middle and low-income countries. Several factors may increase the risk of preterm birth. In this article, we test the hypothesis that different risk factors determine preterm birth in different income groups by investigating whether risk factors for preterm deliveries in the 2004 Pelotas (Rio Grande do Sul State, Brazil) birth cohort vary among those groups. A total of 4,142 women were included in the analysis. Preterm births were equally common among women who had spontaneous vaginal deliveries as for those with induced or operative births. In the multivariate analysis the factors that remained significantly associated with preterm birth were black skin color, low education, poverty, young maternal age, primiparity, previous preterm birth, inadequacy of prenatal care and reported hypertension. In the analyses repeated after stratification by family income terciles, there was no evidence of effect modification by income and no clear difference between the socioeconomic groups. No association between cesarean section and preterm delivery was found. Further studies are required to understand the causes of the epidemic of preterm births in Brazil.

scholarly journals Time trends and sociodemographic determinants of preterm births in pregnancy cohorts in Matlab, Bangladesh, 1990–2014

2019 ◽  
Vol 4 (4) ◽  
pp. e001462 ◽  
Author(s):  
Anisur Rahman ◽  
Monjur Rahman ◽  
Jesmin Pervin ◽  
Abdur Razzaque ◽  
Shaki Aktar ◽  
...  
Keyword(s):  
Seasonal Variation ◽  
Preterm Birth ◽  
Low Income ◽  
Time Trends ◽  
Maternal Education ◽  
Preterm Births ◽  
Population Based ◽  
Low Income Countries ◽  
Sociodemographic Determinants ◽  
Gestational Age At Birth

IntroductionPreterm birth is the major cause of under-five mortality. Population-based data on determinants and proportions of children born preterm are limited, especially from low-income countries. This study aimed at assessing time trends and social, reproductive and environmental determinants of preterm births based on a population-based pregnancy cohort over 25 years in rural Bangladesh.MethodsIn this cohort study in Matlab, a rural area in Bangladesh, we used data from the Health and Demographic Surveillance System from 1990 to 2014. Gestational age at birth was based on the reported last menstrual period and verified by ultrasound assessments. Preterm birth proportions were assessed within strata of social and reproductive characteristics, and time series analysis was performed with decomposition for trend and seasonality. We also determined the prevented fractions of preterm birth reduction associated with social and demographic changes during the follow-up period.ResultsAnalyses were based on 63 063 live births. Preterm birth decreased from 29% (95% CI 28.6 to 30.1) in 1990–1994 to 11% (95% CI 10.5 to 11.6) in 2010–2014. Low education, older age and multi-parity were associated with higher proportions of preterm births across the study period. Preterm births had a marked seasonal variation. A rapid increase in women’s educational level and decrease in parity were associated with the decline in preterm births, and 27% of the reduction observed from 1990 to 2014 could be attributed to these educational and reproductive changes.ConclusionThe reduction in preterm birth was to a large extent associated with the sociodemographic transition, especially changes in maternal education and parity. The persistent seasonal variation in the proportion of preterm birth may reflect the environmental stressors for pregnant women across the study period. Continued investments in girls’ education and family planning programmes may contribute to further reduction of preterm births in Bangladesh.

scholarly journals Maternal reproductive history: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

2019 ◽  
Vol 48 (Supplement_1) ◽  
pp. i16-i25 ◽  
Author(s):  
Alicia Matijasevich ◽  
Cesar G Victora ◽  
Mariangela F Silveira ◽  
Fernando C Wehrmeister ◽  
Bernardo L Horta ◽  
...  
Keyword(s):  
Low Birthweight ◽  
White Women ◽  
Family Income ◽  
Population Based ◽  
Reproductive History ◽  
Multiple Births ◽  
Birth Cohorts ◽  
Birth Intervals ◽  
Ethnic Inequalities ◽  
Over Time

Abstract 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.

Maternal risk factors for preterm birth and low birthweight in Cape Verde

1996 ◽  
Vol 75 (4) ◽  
pp. 360-366 ◽  
Author(s):  
Hans Wessel ◽  
Sven Cnattingius ◽  
Staffan Bergstrom ◽  
Alice Dupret ◽  
Pitt Reitmaier
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Low Birthweight ◽  
Cape Verde ◽  
Maternal Risk Factors ◽  
Maternal Risk

scholarly journals Infant nutrition and growth: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

2019 ◽  
Vol 48 (Supplement_1) ◽  
pp. i80-i88 ◽  
Author(s):  
Helen Gonçalves ◽  
Fernando C Barros ◽  
Romina Buffarini ◽  
Bernardo L Horta ◽  
Ana M B Menezes ◽  
...  
Keyword(s):  
Family Income ◽  
Infant Nutrition ◽  
Nutrition Transition ◽  
Population Based ◽  
Overweight And Obesity ◽  
World Health ◽  
Skin Colour ◽  
Birth Cohorts ◽  
Growth Standards ◽  
Z Scores

Abstract Background Levels of child undernutrition have declined in many middle-income countries, whereas overweight and obesity have increased. We describe time trends in nutritional indicators at age 1 year in the 1982, 1993, 2004 and 2015 Pelotas (Brazil) Birth Cohorts. Methods Each study included all children born in the urban area of the city, with over 4 200 births in each cohort. Children were measured at approximately 12 months of age. Anthropometric indicators were calculated according to World Health Organization Growth Standards. Stunting and wasting were defined as <-2 Z scores for length for age and weight for length, and overweight as >2 Z scores for weight for length. Prevalence was stratified by sex, maternal skin colour and family income. Results The prevalence of stunting declined by 53% (from 8.3% to 3.9%) from 1982 to 2015. Wasting prevalence remained stable at low levels (1.8% in 1982 and 1.7% in 2015), whereas overweight increased by 88% (6.5% to 12.2%). Undernutrition was more common among boys, those born to mothers with brown or black skin colour and in the poorest quintile of families. Socioeconomic inequalities in undernutrition decreased markedly over time. Overweight was markedly more common among the rich in 1982, but fast increase among the poor eliminated socioeconomic differences by 2015, when all groups showed similar prevalence. Conclusions Our results confirm the rapid nutrition transition in Brazil, with marked reduction in levels and inequalities in undernutrition in parallel with a rapid increase in overweight, which became the main nutritional problem for children.

scholarly journals Socioeconomic Risk Factors for Hospital-based Neonatal Death: A Population-based Study

2021 ◽  
Vol 2 (3) ◽  
pp. 72-79
Author(s):  
Ibrahim AS ◽  
Salama H ◽  
Al-Obiedly S ◽  
Al-Rifai H ◽  
Al-Qubaisi M
Keyword(s):  
Preterm Birth ◽  
Antenatal Care ◽  
Low Income ◽  
Neonatal Death ◽  
Family Income ◽  
Negative Impact ◽  
Family Members ◽  
Population Based ◽  
P Value ◽  
Assisted Conception

Introduction: The aim of this study to review the socioeconomic determinants of neonatal death compared to living infants in a multinational’s population. Methods: A retrospective data analysis of 58,990 births. Population-based Cohort study retrieved from the perinatal registry for the 4 years period. We compared socio-economic factors in cases of neonatal death [NND] who died in the hospital with infants who have discharged alive from the hospital [AL]. Socioeconomic factors including nationality, religion, marital status, level of education, parents’ occupation, family income, consanguinity, early childbearing, smoking, assisted conception, antenatal care, and place of delivery. Results: There were 336 cases of ND and 58,654 of AL. The prevalence of NND was 5.7/1000 births. There were more neonatal deaths among uneducated mothers with P-value < 0.0003, and OR=2.0, mothers with low income (P=0.0008, CI=1.34-3.16, OR=2.07), families living in a shared houses (P=0.008, CI=1.23-3.19, OR=1.34), consanguinity (P=0.005, CI=1.13-2.0, OR=1.5), unemployed father (P=0.027, CI=1.24-4.28, OR=2.4), father’s education (P=0.017, CI=1.065-1.92, OR=1.4), assisted conception (P= 0.0001, CI=2.99-5.46, OR=4.04) and those mothers with no antenatal care (P=0.0001, CI=2.54-4.48, OR=3.37). Preterm birth in a referral/tertiary hospital was significantly high. There was no negative impact of nationality, mother’s occupation, maternal age, gravidity, or smoking. Comparing means among maternal and neonatal outcome categories showed no negative impact of crowding index (family members/number of rooms), number of rooms, number of family members, number of children in the house, or number of parties. Conclusion: In this study, antenatal care, parent’s education, father’s unemployment, low income of the mother, poor housing, consanguinity, assisted conception, and preterm birth were all associated with in-hospital neonatal death.

scholarly journals Risk factors for preterm births in São Luís, Maranhão, Brazil

2004 ◽  
Vol 20 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Vânia Maria de Farias Aragão ◽  
Antônio Augusto Moura da Silva ◽  
Lívia Farias de Aragão ◽  
Marco Antônio Barbieri ◽  
Heloísa Bettiol ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Prenatal Care ◽  
Maternal Age ◽  
Family Income ◽  
Preterm Births ◽  
Neonatal Morbidity ◽  
Public And Private ◽  
Public And Private Hospitals ◽  
Hospital Births

Preterm birth continues to be one of the main causes of neonatal morbidity and mortality. The objective of the present study was to identify risk factors for preterm birth in São Luís, Maranhão, Brazil. The sample consisted of hospital births at 10 public and private hospitals from March 1, 1997 to February 28, 1998. A total of 2,443 live births were randomly selected, excluding multiple deliveries and stillbirths. Preterm birth rate in São Luís was 12.7%. Risk factors for preterm delivery were maternal age below 18 years, family income equal to or less than one minimum wage/ month, primiparity, vaginal delivery at a public hospital, single mothers (or living without a partner), and absence of prenatal care. The following factors remained associated with preterm birth after multivariate analysis to control for confounding: maternal age below 18 years (OR = 1.9), primiparity (OR = 1.5), and failure to appear for scheduled prenatal care visits (OR = 1.5).

scholarly journals Preterm Delivery; Who Is at Risk?

2021 ◽  
Vol 10 (11) ◽  
pp. 2279
Author(s):  
Dvora Kluwgant ◽  
Tamar Wainstock ◽  
Eyal Sheiner ◽  
Gali Pariente
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Prenatal Care ◽  
Recurrent Pregnancy Loss ◽  
Placental Abruption ◽  
Placenta Previa ◽  
Population Based ◽  
Perinatal Morbidity ◽  
Multiple Gestations ◽  
Extremely Preterm

Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality. Adverse effects of preterm birth have a direct correlation with the degree of prematurity, in which infants who are born extremely preterm (24–28 weeks gestation) have the worst outcomes. We sought to determine prominent risk factors for extreme PTB and whether these factors varied between various sub-populations with known risk factors such as previous PTB and multiple gestations. A population-based retrospective cohort study was conducted. Risk factors were examined in cases of extreme PTB in the general population, as well as various sub-groups: singleton and multiple gestations, women with a previous PTB, and women with indicated or induced PTB. A total of 334,415 deliveries were included, of which 1155 (0.35%) were in the extreme PTB group. Placenta previa (OR = 5.8, 95%CI 4.14–8.34, p < 0.001), multiple gestations (OR = 7.7, 95% CI 6.58–9.04, p < 0.001), and placental abruption (OR = 20.6, 95%CI 17.00–24.96, p < 0.001) were the strongest risk factors for extreme PTB. In sub-populations (multiple gestations, women with previous PTB and indicated PTBs), risk factors included placental abruption and previa, lack of prenatal care, and recurrent pregnancy loss. Singleton extreme PTB risk factors included nulliparity, lack of prenatal care, and placental abruption. Placental abruption was the strongest risk factor for extreme preterm birth in all groups, and risk factors did not differ significantly between sub-populations.

scholarly journals Magnitude of spontaneous preterm birth and its associated factors among preterm birth in NICU wards in Asella Teaching and Referral Hospital, Asella, Oromia, Ethiopia

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110346
Author(s):  
Techane Sisay Tuji ◽  
Addisu Dabi Wake ◽  
Gezahegn Badeg Adere ◽  
Aselefu Beka Wedajo ◽  
Batu Dekeba Obole ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Healthcare Providers ◽  
Preterm Births ◽  
Cross Sectional Study ◽  
Spontaneous Preterm Birth ◽  
Related Factors ◽  
Cross Sectional ◽  
Bivariate Logistic Regression ◽  
Associated Risk Factors

Objective To assess the prevalence of spontaneous preterm births and to identify the associated risk factors. Methods This single-centre cross-sectional study enrolled women that experienced a preterm birth as registered on the neonatal log-book between 30 December 2019 and 30 December 2020. A pre-tested structured checklist was used to collect data (sociodemographic characteristics; obstetric-related factors; medical history; and pregnancy-related factors). Bivariate logistic regression analyses were applied to identify factors associated with spontaneous preterm birth. A multivariate model identified significant independent risk factors. Results A total of 310 patients participated in the study. The prevalence of spontaneous preterm birth in this population was 67.1% (208 of 310; 95% confidence interval [CI] 61.5, 71.9). Patients without a partner (adjusted odds ratio [AOR] = 1.470, 95% CI 1.23, 4.42), patients residing in a rural area (AOR = 2.51, 95% CI 1.123, 5.513) and those with a history of PIH during their current pregnancy (AOR = 0.104, 95% CI 0.053, 0.014) were significantly more likely to have a spontaneous preterm birth. Conclusion The prevalence of spontaneous preterm birth in in this study was high. Healthcare providers and all stakeholders should focus on screening pregnant women at the risk of spontaneous preterm birth.

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