Determinants of Preterm Delivery and Intrauterine Growth Retardation in North-East Brazil

Abstract

A case-control study was conducted in Natal, north-east Brazil to determine the risk factors for low birthweight (LBW). Cases were 429 preterm and 422 intrauterine growth retarded (IUGR) singleton infants. Controls were 2555 infants of normal birthweight and gestational age. The prevalence of LBW was 10% (5.1% preterm and 4.9% IUGR). Logistic regression was used to estimate the adjusted odds ratios of LBW, and attributable risk per cent (AR%) was used to estimate the proportion of LBW that might be prevented. The preventable determinants of preterm delivery were births to women less than 20, (AR = 7.1%), low maternal weight less than 50 kg (AR = 20.5%), smoking during pregnancy (AR = 14.6%) and infrequent antenatal visits (AR = 28.1%). Other important determinants of preterm delivery were prior LBW births, gestational illness and vaginal bleeding. The main preventable causes of IUGR were low maternal weight (AR = 17.8%), low maternal education (AR = 11.6%), smoking (AR = 14.8%), and inadequate antenatal care (AR = 11.6%). Other risk factors for IUGR include primiparity, prior LBW births, and illness during gestation. In this population, the focus of short-term preventive programme should be improvement in maternal nutrition, cessation of smoking, reduction of births to women under 20, and improved antenatal care.

Mortalidade infantil em duas coortes de base populacional no Sul do Brasil: tendências e diferenciais

“…Entre as crianças de baixo peso, as nascidas pré-termo apresentam risco substancialmente maior do que as com retardo de crescimento intra-uterino. Isto comprova a necessidade de intervenções pré-natais para prevenir os partos pré-termo, como o controle de infecções (Ferraz et al, 1990).…”

HIV status and sociodemographic correlates of maternal body size and wasting during pregnancy

“…Short maternal stature and low pre-pregnancy weight are associated with increased risk of low birth weight (LBW), intra-uterine growth retardation (IUGR;World Health Organization, 1995), and preterm delivery (Ferraz et al, 1990;Kramer et al, 1995). Short stature is also related to increased risk of cephalopelvic disproportion, assisted delivery (Everett, 1975;Sokal et al, 1991;Thomson, 1959), and increased perinatal and infant mortality (Liljestrand et al, 1985;Martorell et al, 1981).…”

Determinantes do hábito de fumar e de seu abandono durante a gestação em localidade urbana na região sul do Brasil

“…Os dados disponíveis na literatura tornam inequívocos os malefícios do hábito de fumar da mãe durante a gestação sobre a saúde fetal, aumentando o risco de ter um recém-nascido com baixo peso e/ou pequeno para a idade gestacional 5,13 , bem como de parto prematuro 2,3,5 e de mortalidade perinatal 12,14 .…”