Prematuridade e baixo peso ao nascer: magnitude e fatores associados no município de Sobral, Ceará - 2007-2016

Abstract

Preterm birth and low birth weight are relevant indicators for determining vulnerability to survival risks, childhood infections, neurodevelopmental damage and learning disabilities, and stand out as the main predictors of neonatal mortality. The aims of this study were to: Characterize factors associated with premature birth and low birth weight in live births in Sobral, Ceará, from 2007 to 2016; characterize the sociodemographic and health profile of the women in the study; identify risk factors for premature birth in Sobral, Ceará, from 2007 to 2016; identify the risk factors for low birth weight in Sobral, Ceará, from 2007 to 2016 and characterize the magnitude of the association between adequate prenatal visits and premature birth and low birth weight, in Sobral. A cross-sectional study using the Trevo de Quatro Folhas database in the city of Sobral, from 2007 to 2016, with 30,385 women. To organize the independent variables, the hierarchical theoretical model was used for the outcomes preterm birth and low birth weight. The Poisson regression model with robust variance was used to analyze the data using STATA 13.0® software. The results showed a significant association with preterm birth in non-white women (RP=1.28, IC95%: 1.11 – 1.47); in the adolescent age group (RP=1.24, IC95%: 1.12 – 1.37); in rural areas (RP=0.89, IC95%: 0.81 – 0.98); antenatal visits (RP=2.44, IC95%: 2.24 – 2.66); high blood pressure (RP=1.92, IC95%1.54 – 2.40), diabetes (RP=2.12, IC95%: 1.75 – 2.58), transvaginal bleeding (RP=2.26, IC95%:2.32 – 3.20), and urinary infection (RP=0.84, IC95%: 0.76 – 0.96). With regard to low birth weight, there was a significant association between non-white women (RP=1.43, IC95%: 1.30 – 1.57); in the adolescent age group (RP=1.24, IC95%:1.12 – 1.37); smoking during pregnancy (RP=1.62, IC95%: 1.38 – 1.90); in antenatal visits (RP=2.37, IC95%:2.18 – 2.58); high blood pressure (RP=1.97, IC95%:1.59 – 2.45), diabetes (RP=1.61, IC95%:1.29 – 2.01), transvaginal bleeding (RP=2.40, IC95%:2.02 – 2.84), and urinary infection (RP=0.86, IC95%:0.78 – 0.95). The association between adequate prenatal care as an outcome and the variables premature birth and low birth weight was verified. It was observed that low birth weight had a more significant association with adequate prenatal care than premature birth. It was found that non-white women aged 35 and over were more likely to attend appointments properly than white women in other age groups. It was concluded that prenatal care is strongly associated with prematurity and low birth weight, as well as having a significant association with the risk factors for these health onditions.