Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil.
Rev Panam Salud Publica. 2012 Nov;32(5):330-4. doi: 10.1590/s1020-49892012001100002.
To determine the prevalence of and risk factors for preterm labor (< 37 weeks of gestation) among young pregnant women in Brazil.
A national cross-sectional study was conducted among parturient women aged 15-24 years attending Brazilian public maternities in 2009. Questionnaires were administered by interviewers during parturient admission to the maternity clinic (or soon after delivery, if survey participants were in too much pain to respond during labor). The questionnaires collected demographic, behavioral, and clinical data.
A total of 2 071 (86.3%) of the 2 400 parturient women invited to participate were included in the study. Mean age was 20.2 years (standard deviation [SD]: 2.7) and mean years of formal education was 8 (SD: 2.4). Preterm labor occurred in 450 women (21.7%). The highest proportion of premature labor (36.1%) was found in the North region and the lowest proportion (6.9%) was found in the South region. In the final multivariate logistic regression model, living in the North region (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.28-1.59); having monthly income less than twice the Brazilian minimum wage (OR: 1.27, 95% CI: 1.01-1.60); having suffered domestic violence (OR: 2.27, 95% CI: 1.23-4.18); and having had inadequate prenatal care (OR: 3.17, 95% CI: 2.54-3.97) remained significant correlates of preterm labor in this population.
Results show a high prevalence of preterm labor among young women in Brazil. Preterm labor has multifactorial etiologies. More public health resources must be directed toward accelerating understanding of this complex process.
确定巴西年轻孕妇早产(<37 周妊娠)的流行率和危险因素。
2009 年,对在巴西公立妇产医院就诊的 15-24 岁产妇进行了一项全国性的横断面研究。在产妇入住妇产科病房时(或如果调查参与者在分娩时疼痛太剧烈而无法回答问题,则在分娩后不久),由访谈员通过问卷调查收集人口统计学、行为和临床数据。
共邀请了 2400 名产妇中的 2071 名(86.3%)参加了研究。平均年龄为 20.2 岁(标准差 [SD]:2.7),平均受教育年限为 8 年(SD:2.4)。450 名妇女(21.7%)发生早产。早产比例最高的是北部地区(36.1%),最低的是南部地区(6.9%)。在最终的多变量逻辑回归模型中,生活在北部地区(优势比 [OR]:1.43,95%置信区间 [CI]:1.28-1.59);月收入低于巴西最低工资的两倍(OR:1.27,95% CI:1.01-1.60);遭受过家庭暴力(OR:2.27,95% CI:1.23-4.18);以及产前保健不足(OR:3.17,95% CI:2.54-3.97),这些因素在该人群中仍然是早产的显著相关因素。
结果表明,巴西年轻孕妇早产的发生率很高。早产有多种病因。必须投入更多的公共卫生资源,以加速对这一复杂过程的理解。