scholarly journals The epidemiologic paradox of low birth weight in Brazil

2010 ◽  
Vol 44 (5) ◽  
pp. 767-775 ◽  
Author(s):  
Antônio Augusto Moura da Silva ◽  
Leopoldo Muniz da Silva ◽  
Marco Antonio Barbieri ◽  
Heloísa Bettiol ◽  
Luciana Mendes de Carvalho ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Census Data ◽  
Perinatal Care ◽  
Rank Correlation ◽  
Live Births ◽  
Care Services ◽  
The North ◽  
Spearman’S Rank Correlation

OBJECTIVE: To examine whether the low birth weight (LBW) paradox exists in Brazil. METHODS: LBW and cesarean section rates between 1995 and 2007 were estimated based on data from SINASC (Brazilian Live Births Database). Infant mortality rates (IMRs) were obtained using an indirect method that correct for underreporting. Schooling information was obtained from census data. Trends in LBW rate were assessed using joinpoint regression models. The correlations between LBW rate and other indicators were graphically assessed by lowess regression and tested using Spearman's rank correlation. RESULTS: In Brazil, LBW rate trends were non-linear and non-significant: the rate dropped from 7.9% in 1995 to 7.7% in 2000, then increased to 8.2% in 2003 and remained nearly steady thereafter at 8.2% in 2007. However, trends varied among Brazilian regions: there were significant increases in the North from 1999 to 2003 (2.7% per year), and in the South (1.0% per year) and Central-West regions (0.6% per year) from 1995 to 2007. For the entire period studied, higher LBW and lower IMRs were seen in more developed compared to less developed regions. In Brazilian States, in 2005, the higher the IMR rate, the lower the LBW rate (p=0.009); the lower the low schooling rate, the lower the LBW rate (p=0.007); the higher the number of neonatal intensive care beds per 1,000 live births, the higher the LBW rate (p=0.036). CONCLUSIONS: The low birth weight paradox was seen in Brazil. LBW rate is increasing in some Brazilian regions. Regional differences in LBW rate seem to be more associated to availability of perinatal care services than underlying social conditions.

scholarly journals STATUS OF MEDICAL CARE FOR NEWBORNS IN UKRAINE

2020 ◽  
Vol 10 (4(38)) ◽  
pp. 5-24
Author(s):  
Y. Antypkin ◽  
T. Znamenska ◽  
R. Marushko ◽  
E. Dudina ◽  
V. Lapshin ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Medical Care ◽  
Neonatal Mortality ◽  
Perinatal Care ◽  
Neonatal Care ◽  
Postpartum Woman ◽  
Ministry Of Health ◽  
Live Births ◽  
Early Neonatal Mortality

Introduction. In the context of continuing depopulation, and low birth rate, the formation and preservation of newborn generations’ health is the most important medical and social task and one of the main activities of the Ministry of Health of Ukraine and local health care institutions. The aim of the study was to analyze and evaluate the effectiveness of medical care for newborns in Ukraine and its impact on the main indicators of newborns’ health. Materials and research methods. A retrospective analysis and assessment of the dynamics of neonatal care in Ukraine was carried out according to state and industry statistics, perinatal audit according to the method of WHO “MATRIX - BABIES” for the period 2001-2019, monitoring and evaluation of the regionalization of perinatal care (for 2014-2017). Methods of a systematic approach, bibliographic, statistical data processing, and graphic representation were applied. Results of the study: the study showed that during the period of the research a  number of newborns born in the facilities of the Ministry of Health of Ukraine decreased from 387900 in 2000 to 294100 in 2019, with a negative trend in the generalized objective criterion of the generation’s health and socio-economic well-being of the population - frequency of premature newborns with low birth weight  including those with extremely low birth weight. At the same time, the frequency of newborns with congenital diseases or those who got sick after birth, decreased from 280.8 per 1000 live births in 2000 to 172.14 in 2019 with the wave-like nature of its dynamics. The existing state system of three-level neonatal care integrated into the perinatal service makes it possible to provide basic, qualified and highly qualified specialized medical care for newborns at all stages of its provision. During the observation period, the provision of newborns with pediatrician-neonatologists increased from 4.58 per 1000 live births to 5.34, and with hospital beds for premature and sick newborns - from 5.62 to 6.91, respectively. A slight increasing trend of significant criterion of newborns’ health condition was achieved (99.36% in 2001 vs 99.7% in 2019) along with the activities of the neonatological service in survival of newborns in the first 168 hours of life mainly due to a 2.6-fold increase in the survival of newborns with a birth weight of 500-999g. Sufficient efficiency of medical care for newborns was confirmed by a positive trend in early neonatal mortality from 4.71 ‰ in 2000 to 3.04 ‰ in 2019 and neonatal mortality from 6.65 ‰ to 4.57 ‰, respectively. At the same time, the increase of newborns’ incidence with diseases that have a direct impact on the development of chronic and disabling diseases is a cause for concern: cases of congenital pneumonia increased from 3.18 ‰ in 2000 to 5.46 ‰ in 2019, of neonatal sepsis - from 0.09 ‰ to 0.74 ‰, respectively. Also other disorders of newborns’ cerebral status increased from 18.5 ‰ in 2010 to 28.5 ‰, and neonatal jaundice -  from 31.11 ‰ in 2015 to 43.65 ‰. An excess in 1.5 times of the standard recommended by the WHO of the proportional indicator of early neonatal mortality was revealed among infants weighing more than 1500 g. The excess of the real indicator of early neonatal mortality over the actual one was 2.2-2.3 times, which meant underestimation of the total rate of neonatal and infant mortality. Conclusions. Further improvement of the effectiveness of neonatal care and the decrease of early neonatal and neonatal mortality levels requires continued regionalization of perinatal care, completion of the perinatal care centers of the third level, revision and provision of patient routes, development and provision of state-guaranteed medical services/standards (such as a standard of child’s safety, safety of pregnant and postpartum woman), the reliability of determining body weight at birth, criteria for live birth and stillbirth, the introduction of follow-up monitoring of low-birth-weight newborns, the formation of a unified system for monitoring the activities of the maternal and child health services.

scholarly journals Infant mortality and low birth weight in cities of Northeastern and Southeastern Brazil

2003 ◽  
Vol 37 (6) ◽  
pp. 693-698 ◽  
Author(s):  
Antônio Augusto Moura da Silva ◽  
Heloísa Bettiol ◽  
Marco Antônio Barbieri ◽  
Valdinar Sousa Ribeiro ◽  
Vânia Maria de Farias Aragão ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Infant Mortality ◽  
Low Birth Weight ◽  
Perinatal Care ◽  
Northeastern Brazil ◽  
Southeastern Brazil ◽  
Systematic Sampling ◽  
Birth Cohorts ◽  
Live Births

OBJECTIVE: To compare estimates of low birth weight (LBW), preterm birth, small for gestational age (SGA), and infant mortality in two birth cohorts in Brazil. METHODS: The two cohorts were performed during the 1990s, in São Luís, located in a less developed area in Northeastern Brazil, and Ribeirão Preto, situated in a more developed region in Southeastern Brazil. Data from one-third of all live births in Ribeirão Preto in 1994 were collected (2,839 single deliveries). In São Luís, systematic sampling of deliveries stratified by maternity hospital was performed from 1997 to 1998 (2,439 single deliveries). The chi-squared (for categories and trends) and Student t tests were used in the statistical analyses. RESULTS: The LBW rate was lower in São Luís, thus presenting an epidemiological paradox. The preterm birth rates were similar, although expected to be higher in Ribeirão Preto because of the direct relationship between preterm birth and LBW. Dissociation between LBW and infant mortality was observed, since São Luís showed a lower LBW rate and higher infant mortality, while the opposite occurred in Ribeirão Preto. CONCLUSIONS: Higher prevalence of maternal smoking and better access to and quality of perinatal care, thereby leading to earlier medical interventions (cesarean section and induced preterm births) that resulted in more low weight live births than stillbirths in Ribeirão Preto, may explain these paradoxes. The ecological dissociation observed between LBW and infant mortality indicates that the LBW rate should no longer be systematically considered as an indicator of social development.

scholarly journals Factors associated with low birth weight at term: a population-based linkage study of the 100 million Brazilian cohort

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ila R. Falcão ◽  
Rita de Cássia Ribeiro-Silva ◽  
Marcia F. de Almeida ◽  
Rosemeire L. Fiaccone ◽  
Aline dos S. Rocha ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Population Based ◽  
Linkage Study ◽  
Live Births ◽  
Factors Associated ◽  
The North ◽  
Socioeconomic Data ◽  
Brazilian Cohort ◽  
Brazilian Populations

Abstract Background Factors associated with low birth weight at term (TLBW), a proxy for intrauterine growth restriction (IUGR), are not well-elucidated in socioeconomically vulnerable populations. This study aimed to identify the factors associated with TLBW in impoverished Brazilian women. Methods Records in the 100 Million Brazilian Cohort database were linked to those in the National System of Information on Live Births (SINASC) to obtain obstetric, maternal, birth and socioeconomic data between 2001 and 2015. Multivariate logistic regression was performed to investigate associations between variables of exposure and TLBW. Results Of 8,768,930 term live births analyzed, 3.7% presented TLBW. The highest odds of TLBW were associated with female newborns (OR: 1.49; 95% CI: 1.47–1.50), whose mothers were black (OR: 1.20; 95% CI: 1.18–1.22), had a low educational level (OR: 1.57; 95% CI: 1.53–1.62), were aged ≥35 years (OR: 1.44; 95% CI: 1.43–1.46), had a low number of prenatal care visits (OR: 2.48; 95% CI: 2.42–2.54) and were primiparous (OR: 1.62; 95% CI: 1.60–1.64). Lower odds of TLBW were found among infants whose mothers lived in the North, Northeast and Center-West regions of Brazil compared to those in the South. Conclusion Multiple aspects were associated with TLBW, highlighting the need to comprehensively examine the mechanisms underlying these factors, especially in more vulnerable Brazilian populations, in order to contribute to the elaboration of health policies and promote better conditions of life for poor and extremely poor mothers and children.

Mothers of Infants With Congenital Diaphragmatic Hernia Describe “Breastfeeding” in the Neonatal Intensive Care Unit: “As Long as It’s My Milk, I’m Happy”

2017 ◽  
Vol 33 (3) ◽  
pp. 524-532 ◽  
Author(s):  
Elizabeth B. Froh ◽  
Janet A. Deatrick ◽  
Martha A. Q. Curley ◽  
Diane L. Spatz
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Neonatal Intensive Care ◽  
Safety Net ◽  
Prospective Longitudinal

Background: Very little is known about the breastfeeding experience of mothers of infants born with congenital anomalies and cared for in the neonatal intensive care unit (NICU). Often, studies related to breastfeeding and lactation in the NICU setting are focused on the mothers of late preterm, preterm, low-birth-weight, and very-low-birth-weight infants. Congenital diaphragmatic hernia (CDH) is an anatomic malformation of the diaphragm and affects 1 in every 2,000 to 4,000 live births. Currently, there are no studies examining the health outcomes of infants with CDH and the effect of human milk. Research aim: This study aimed to describe the breastfeeding experience of mothers of infants with CDH cared for in the NICU. Methods: A prospective, longitudinal qualitative descriptive design was used. Phased interviews were conducted with a purposive sample of 11 CDH infant–mother dyads from a level 3 NICU in a children’s hospital. Results: Six themes emerged from the data: (a) hopeful for breastfeeding, (b) latching on . . . to the pump, (c) we’ve already worked so hard, (d) getting the hang of it—it’s getting easier, (e) a good safety net, and (f) finding a way that works for us. Conclusion: For this population of CDH infant–mother dyads, the term breastfeeding is not exclusive to direct feeding at the breast and the mothers emphasized the significance of providing their own mother’s milk through a combination of feeding mechanisms to their infants with CDH.

Evaluation of Morbidities and Complications of Neonatal İntensive Care Unit Patients with Respiratory Disorders at Different Gestational Ages

2021 ◽  
Author(s):  
Erbu Yarci ◽  
Fuat E. Canpolat
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Respiratory Diseases ◽  
Respiratory Disorders ◽  
Live Births

Objective Respiratory distress presented within the first few days of life is life-threatening and common problem in the neonatal period. The aim of this study is to estimate (1) the incidence of respiratory diseases in newborns and related mortality; (2) the relationship between acute neonatal respiratory disorders rates and gestational age, birth weight, and gender; and (3) the incidence of complications associated with respiratory disturbances. Study Design Only inborn patients with gestational age between 230/7 and 416/7 weeks having respiratory distress were included in the study. The data were collected from the medical records and gestational age was based on the menstrual dating. Results There were 8,474 live births between January 1, 2013 and June 30, 2013 in our hospital. A total of 1,367 newborns were hospitalized and oxygen therapy was applied in 903 of them because of respiratory distress. An acute respiratory disorder was found to be in 10.6% (903/8,474) among all live births. Mortality was 0.76% (66/8,474). The incidence of respiratory distress syndrome was 2.8% (n = 242). The occurrence of transient tachypnea of newborn was 3.1% (n = 270). Meconium aspiration syndrome, pneumonia, congenital diaphragmatic hernia, and pulmonary maladaptation and primary persistent pulmonary hypertension rates were 0.1, 0.7, 2.2, and 0%, respectively. Overall, 553 (61%) of the 903 newborns having respiratory diseases had complications. The occurrence of necrotizing enterocolitis, patent ductus arteriosus, bronchopulmonary dysplasia, intraventricular hemorrhage and air leak was 6.8, 19.8, 4.7, 24.9, and 5%, respectively. Conclusion This study offers an epidemiological perspective for respiratory disorders from a single-center level-III neonatal intensive care unit. Although number of births, premature newborns, extremely low birth weight/very low birth weight infants, and complicated pregnancies increase in years, decreasing rates of mortality and complications are very promising. As perinatal and neonatal cares are getting better in every day, we think that more promising results can be achieved over the coming years. Key Points

scholarly journals Pregnancy Outcome during the First COVID 19 Lockdown in Vienna, Austria

2021 ◽  
Vol 18 (7) ◽  
pp. 3782
Author(s):  
Sylvia Kirchengast ◽  
Beda Hartmann
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Negative Effects ◽  
Gestational Length ◽  
Live Births

The COVID 19 pandemic represents a major stress factor for non-infected pregnant women. Although maternal stress during pregnancy increases the risk of preterm birth and intrauterine growth restriction, an increasing number of studies yielded no negative effects of COVID 19 lockdowns on pregnancy outcome. The present study focused on pregnancy outcome during the first COVID 19 lockdown phase in Austria. In particular, it was hypothesized that the national lockdown had no negative effects on birth weight, low birth weight rate and preterm birth rate. In a retrospective medical record-based single center study, the outcome of 669 singleton live births in Vienna Austria during the lockdown phase between March and July 2020 was compared with the pregnancy outcome of 277 live births at the same hospital during the pre-lockdown months of January and February 2020 and, in addition, with the outcome of 28,807 live births between 2005 and 2019. The rate of very low gestational age was significantly lower during the lockdown phase than during the pre-lockdown phase. The rate of low gestational age, however, was slightly higher during the lockdown phase. Mean birth weight was significantly higher during the lockdown phase; the rates of low birth weight, very low birth weight and extremely low birth weight were significantly lower during the lockdown phase. In contrast, maternal gestational weight gain was significantly higher during the lockdown phase. The stressful lockdown phase in Austria seems to have no negative affect on gestational length and newborn weight among non-infected mothers.

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