Risk factors for low birthweight in north‐east Brazil: the role of caesarean section

Abstract

Caesarean section (CS) delivery is associated with low birthweight (LBW) in south-east Brazil. A hospital-based study was conducted on singleton infants from mothers residing in São Luís, to assess if an association between CS and LBW was found in the northern part of the country, where the CS rate is lower than in the south-east. A standardised questionnaire was administered to a sample of 2541 mothers in 10 hospitals, representing 94% of all deliveries, from March 1997 to February 1998. In a logistic model, type of delivery was the independent variable, the other variables were treated as confounders, and interaction terms were added between type of delivery and all other factors. LBW was associated with low maternal height, maternal smoking, primiparity, previous LBW, public insurance, preterm birth and CS. The CS rate was 33.7%. The risk of CS was higher for primiparous and married mothers, those with high level of schooling and attended by the same physician during prenatal and delivery care, deliveries held in private hospitals, daylight hours or evenings, and for those mothers who had adequate prenatal care. Because it appears unlikely that only medical reasons are operative, it is a possibility that CS could cause LBW, reflecting abusive indications for elective CS.

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

“…One explanation is the higher percentage of cesarean sections in Ribeirão Preto in comparison with São Luís (51.1 vs 33.2%). Previous studies 15,17 have shown an association between LBW and cesarean section rate in the two cities, with the population-attributable risk of cesarean section, in relation to LBW, being higher in Ribeirão Preto than in São Luís (20 vs 10.9%).…”

“…Its perinatal health situation has been assessed in some epidemiological studies using representative samples of the birth population. 2,3,6,7,[15][16][17] These studies employed systematic methodology and were representative of the towns where the studies were carried out.…”

Imbalance of naive and memory T lymphocytes with sustained high cellular activation during the first year of life from uninfected children born to HIV-1-infected mothers on HAART

“…In HIV-exposed uninfected neonates, lower birth weight and smaller gestational age could be related to the higher rates of elective cesarean section in this group (9,10). However, anti-retroviral drugs prescribed to the mothers might have also contributed.…”

Significant differences in cesarean section rates between a private and a public hospital in Brazil

“…The greater proportion of adolescent mothers observed at the public maternity agrees with published data, with a higher frequency of births among adolescents of less privileged classes 17 . The absence of an association between cesarean section and maternal schooling may be related to the low variability of schooling among mothers from the two groups, since this association has been well documented in Brazil, where only 13% of uneducated women have a history of cesarean delivery compared to 81% of women with higher education 18,19 .…”