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Desfechos perinatais/infantis constituem as principais causas de morbi-mortalidade infantil em países em desenvolvimento como o Brasil. Dentre os fatores de risco, está a presença de transtornos mentais maternos. Foi realizado um estudo longitudinal retrospectivo baseado no seguimento passivo por meio do método de linkage probabilístico para verificar a prevalência de desfechos perinatais/infantis em pacientes internadas em um hospital psiquiátrico público do Rio de Janeiro, Brasil, que tiveram partos durante o período de 1999 a 2009. As prevalências encontradas foram: baixo peso ao nascer (27,6%), prematuridade (17,4%), malformações (2,5%), óbitos fetais (4,8%) e neonatais (3,7%), sendo fatores associados o cuidado pré-natal insatisfatório, a presença de esquizofrenia e a baixa renda familiar. Os resultados reforçam que a prevalência de desfechos perinatais/infantis é elevada em mães com transtornos mentais maiores, sendo fundamental o rastreamento de sintomas psiquiátricos e o acompanhamento especializado por profissionais da saúde mental durante a assistência pré e pós-parto.

Rev. Bras. Saúde Matern. Infant., Recife, 13 (3): 237-246 jul. / set., 2013 237 ARTIGOS ORIGINAIS / ORIGINAL ARTICLES Infant mortality in a very low birth weight cohort from a public hospital in Rio de Janeiro, RJ, Brazil Mortalidade infantil em coorte de muito baixo peso ao nascer de um hospital público no Rio de Janeiro, RJ, BrasilAbstractObjectives: to evaluate infant mortality in very low birth weight newborns from a public hospital in Rio de Janeiro, Brazil (2002-2006.Methods: a retrospective cohort study was performed using the probabilistic linkage method to identify infant mortality. Mortality proportions were calculated according to birth weight intervals and period of death. The Kaplan-Meier method was used to estimate overall cumulative survival probability. The association between maternal schooling and survival of very low birth weight infants was evaluated by means of Cox proportional hazard models adjusted for: prenatal care, birth weight, and gestational age.Results: the study included 782 very low birth weight newborns. Of these, (28.6%) died before one year of age. Neonatal mortality was 19.5%, and early neonatal mortality was 14.9%. Mortality was highest in the lowest weight group (71.6%). Newborns whose mothers had less than four years of schooling had 2.5 times higher risk of death than those whose mothers had eight years of schooling or more, even after adjusting for intermediate factors.Conclusions: the results showed higher mortality among very low birth weight infants. Low schooling was an independent predictor of infant death in this low-income population sample.

ObjectivesTo estimate the effect of short interdelivery interval between the first and second pregnancies in adolescence on low birth weight. ApproachA non-concurrent cohort study was carried out employing a probabilistic duplicate detection technique of the Brazilian Live Birth Information System (N=2,774,373 records). We evaluated 3,146 linked records of singleton live-born infants delivered between 1999 and 2009 in Rio de Janeiro City (Brazil), who were the second child of teenage mothers born in 1989. We estimated the association between short interdelivery interval (less than 24 months) and low birth weight (<2,500 g) using a logistic regression model, adjusting for low birth weight on the first pregnancy, adequacy of prenatal on the first pregnancy, mother's age and schooling. Covariates were assessed for inclusion using a directed acyclic graph. ResultsBy the time of the second birth, the mothers' median age was 18 years (interquartile range 17-19 years). Almost half of the second children born to these teenage mothers (N=1,481; 47.1%) were born within less than 24 months of a previous birth. The prevalence of low birth weight in this group was 9.1% (confidence interval [CI] 95% 7.6 to 10.5), whereas in the group of children born within 24 months or more of a previous birth the prevalence was 6.5% (CI 95% 5.3 to 7.7) (adjusted odds ratio=1.4; CI 95% 1.1 to 1.9). ConclusionThis study suggests that a short interdelivery interval between the first and second pregnancies in adolescence has an independent effect on low birth weight.