Oliveira Elaine Fernandes Viellas de, Gama Silvana Granado Nogueira da, Silva Cosme Marcelo Furtado Passos da
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2010 Mar;26(3):567-78. doi: 10.1590/s0102-311x2010000300014.
This article analyzes teenage pregnancy and other risk factors for fetal and infant mortality in the city of Rio de Janeiro, Brazil. The study included a sample of births in Rio de Janeiro, and exposure variables were organized hierarchically. For fetal death, the results showed the protective effect of adequate prenatal care, while maternal morbidity increased the risk. For neonatal death, adequate prenatal care and female gender in the newborn were protective factors, while black or brown maternal skin color, history of stillbirth, maternal morbidity, and physical aggression during the index pregnancy increased the risk. Low birth weight and prematurity were corroborated as determinants of fetal and neonatal death. Risk of post-neonatal death was highest with increased parity, intra-gestational morbidity, and low birth weight. Teenage pregnancy itself was an independent factor for post-neonatal death. The findings reaffirm the relevance of social and health policies targeting adolescents, as well as improvements in prenatal care.
本文分析了巴西里约热内卢市青少年怀孕以及胎儿和婴儿死亡的其他风险因素。该研究纳入了里约热内卢市的出生样本，暴露变量按层次结构进行组织。对于胎儿死亡，结果显示充分的产前护理具有保护作用，而孕产妇发病则增加了风险。对于新生儿死亡，充分的产前护理和新生儿为女性是保护因素，而黑人或棕色人种的孕产妇肤色、死产史、孕产妇发病以及本次妊娠期间遭受身体攻击则增加了风险。低出生体重和早产被确认为胎儿和新生儿死亡的决定因素。产后死亡风险在多胎妊娠、孕期发病以及低出生体重增加时最高。青少年怀孕本身是产后死亡的一个独立因素。研究结果再次证实了针对青少年的社会和健康政策以及改善产前护理的重要性。
