Smoking and Adverse Maternal and Child Health Outcomes in Brazil

Abstract

The results show that over a 20-year period, during which Brazil implemented numerous effective tobacco control measures, the country experienced a dramatic decrease in both maternal smoking prevalence and smoking-attributable adverse MCH outcomes. Countries that implement effective tobacco control measures can expect to reduce both maternal smoking and adverse MCH outcomes, thereby improving the public health.

Update and extension of the Brazil SimSmoke model to estimate the health impact of cigarette smoking by pregnant women in Brazil

“…Our literature review 23 found that PTB tend to be underdiagnosed and underreported. However, their measurement improved in 2011, when gestational age began to be collected in exact weeks and not grouped into categories 24 .…”

“…To avoid overlap, we excluded PTB from LBW cases. Since reliable data for adverse MCHOs were not available before 2000, we estimated trends in years prior to 2000 from the published literature on an outcome-by-outcome basis 23 , yielding an increasing trend for PTB and a decreasing trend for SIDS between 1989 and 2000, but no trend for LBW and placenta praevia/placental abruption.…”

“…Since 2011 estimates were underestimated by at least 15% 24 , we adjusted all years by an additional 15% as our midrange estimate and by 30% as our upper bound. We also adjusted SIDS estimates upward by 100% for midrange and by 200% for the upper bound 23 . Rates after 2013 for all MCHOs were assumed to remain at their 2013 levels (cf.…”

Neonatal near miss and mortality: factors associated with life-threatening conditions in newborns at six public maternity hospitals in Southeast Brazil

“…Criteria for definition of life-threatening conditions, namely gestational age less than 32 weeks, birth weight less than 1,500g, or five-minute Apgar score less than seven (pragmatic criteria for definition of near miss 9 ), correspond to adverse perinatal outcomes and are associated with sociodemographic variables 13 reproductive history, risk behavior 1,18 , and prenatal, delivery, and neonatal care 2,9,19 . Our results corroborated previous studies on factors associated with adverse neonatal outcomes.…”

Suscetibilidade à prematuridade: investigação de fatores comportamentais, genéticos, médicos e sociodemográficos

“…Tal associação já foi verificada em coorte estadunidense ao se verificar associação entre IMC >30 kg/m² e os nascimentos prematuros por indicação médica, com OR de 1,4 nas gestações entre a 34ª e 36ª semana e de 1,7 nas anteriores à 34ª semana gestacional 16 . Em relação ao uso do tabaco, mesmo não se encontrando associação significativa com a prematuridade, é possível observar que há uma elevação na taxa de gestantes tabagistas no local de estudo (13,3% no grupo Caso) quando comparada à média nacional (7,7%) 17 . Ainda, é importante salientar a taxa de gestantes consideradas fumantes passivas (57%).…”