Perfil das gestantes atendidas na maternidade escola Assis Chateaubriand e associação entre idade materna e baixo peso ao nascer

Abstract

Introduction: There is a considerable debate in the specialized literature regarding pregnancy during adolescence. This situation is attracting attention of the scientific community and the media due to the impact in the lives of these young women. However, there is no consensus in the literature if earlier pregnancies bring organic prejudice to the adolescent woman or to her newborn. Moreover, problems of social nature such as abandon of study life, work, lack of opportunities, familiar disorders, anticipated (and precipitated) marital arrangements, discrimination, occurrence of new pregnancy; and some of psychological nature such as sadness, melancholy, depression, rejection of the baby, psychosis, besides the contribution to the general fecundity level of the population, seem to be issues to be considered by the majority of the governments in developed and developing countries. Pregnancy during adolescence can be a disaster in some scenarios, but also could be a positive outcome in the life of some families. To understand the health conditions of these families, we proceeded a survey with adolescents attended at Maternidade-Escola Assis Chateaubriand, the Maternity associated to the Ceara State Federal University Hospital. General Objective: To describe social, demographic and familiars characteristics of adolescent pregnancy and non-adolescents that delivered their babies in Maternidade-Escola Assis Chateaubriand, and verify the association between maternal age and the occurrence of low birthweight infant. Specific Objectives: 1. To analyze and compare, by mother age, the occurrence of good-quality antenatal care; complications related to gynecologic age; type of delivery. 2. To analyze and compare, by groups of newborns of adolescents and non-adolescents, the occurrence of low birthweight and insufficient birthweight; prematurity. 3. To analyze the occurrence of low birthweight by mother age and by other socio-demographic variables and reproductive health issues, using multivariate analysis. Study Design: Transversal study. Setting: Maternidade-Escola Assis Chateaubriand (MEAC), Ceara State Federal University. Population under study: Patients interviewed at the Maternity after delivery, adolescents and non-adolescents. Study Variables: Maternal age, level of education, smoke habits, presence of partner (husband), maternal nutrition / subnutrition level, gynecologic age, antenatal care, number of pregnancies, type of delivery, prematurity, low birthweight and insufficient birthweight. Results: Five hundred and fifty three women (553) that delivered their babies at MEAC during the period of study were interviewed and their medical records were reviewed. This sample represents 340 patients over twenty years old and 213 patients under twenty years old. After univariate analysis of variables, it is clearly revealed that the majority of conditions generated by the pregnancy are unfavorable to the adolescents. Among women in this age, the occurrence of subnutrition is higher, the absence of a partner is higher (29.6% in adolescents versus 18.9% in adult women; p=.003); illiteracy (14.6% versus 24%; p=.004); good-quality antenatal care (21.1% versus 29.9%; p=.002); smoking (12.7% versus 14.5%; p=.54); precocious menarche (in average 12.5 years old in adolescent women versus 13.1 years old in adult women); prematurity (21.6% in adolescents versus 15.4% in adults; p=.06); low birthweight (24.4% versus 16.6%; p=.02) and insufficient birthweight (21.6% versus 18%, p=.30). An association statistically significant between low birthweight and low maternal age (OR=1.64 [1.04-2.57]). In stratified analysis of selected variables — prematurity, number of pregnancies, level of education, antenatal care, presence of a partner/husband, level of nutrition of the mother at the beginning of pregnancy — no confounding factors were observed in that association. However, in multivariate analysis of the occurrence of low birthweight and after the design of models for logistic regression, the results did not evidenced that maternal age alone could be responsible for the selected conditions listed above. Conclusions: 1. A good-quality antenatal care is very low in this study. 2. The low maternal age, in this sample, constitute a protection factor front surgical delivery. 3. The gynecological age above two years shows a tendency to insufficient and low birth weight, but the number of adolescents studied in this condition is small, without expression value. 4. There is a tendency to prematurely occurrence in adolescent women. However, the oddis ratio doesn’t have significant statistics value. 5. There is an association between low birth weight and low maternal age when desfavorable conditions like maternal desnutricion and anafalbetism are presents.