Salim Thais Rocha, Soares Gabriel Porto, Klein Carlos Henrique, Oliveira Gláucia Maria Moraes
Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Instituto do Coração Edson Saad. Rio de Janeiro, RJ, Brasil.
Universidade de Vassouras. Curso de Medicina. Vassouras, RJ, Brasil.
Rev Saude Publica. 2019 Apr 1;53:31. doi: 10.11606/S1518-8787.2019053000793.
To analyze the association of characteristics recorded at the time of birth, including weight, occurrence of asphyxia, gestation duration, maternal age and education level, with death from diseases or malformations of the circulatory system in children under 18 years of age.
The Brazilian Information System on Live Births and Information System on Mortality databases were linked and evaluated following a longitudinal cohort analysis strategy. The following independent variables were evaluated: characteristics recorded at the time of birth, including weight, occurrence of asphyxia, gestation duration, maternal age and education level. Dependent variables were death from diseases or malformations of the circulatory system in children under 18 years of age. Crude relative risks were estimated and relative risks were adjusted for the variables.
6,380 deaths were linked to 4,282,260 birth records, yielding 5,062 pairs considered as true. Low birth weight (RR = 2.26), asphyxia at 1 (RR = 1.72) and 5 minutes (RR = 1.51), prematurity (RR = 1.50), maternal age ≥ 40 years (RR = 2.06), and low maternal education level (RR = 1.45) increased the probability of death caused by circulatory system diseases. In the association with death by malformations of the circulatory system, the predictive variables showed the same association profile, but with greater intensity.
Fetal and maternal factors are associated with increased mortality due to diseases and malformations of the circulatory system. Measures to control these factors and improve access to their diagnosis and treatment would contribute to reducing the number of deaths caused by diseases and malformations of the circulatory system. However, the identification of environmental influences during gestation and birth on the risk of death should be carefully considered due to being influenced by genetic factors.
分析出生时记录的特征，包括体重、窒息发生情况、妊娠时长、产妇年龄和教育水平，与18岁以下儿童因循环系统疾病或畸形导致的死亡之间的关联。
按照纵向队列分析策略，将巴西活产信息系统和死亡信息系统数据库进行关联并评估。评估了以下自变量：出生时记录的特征，包括体重、窒息发生情况、妊娠时长、产妇年龄和教育水平。因变量为18岁以下儿童因循环系统疾病或畸形导致的死亡。估计了粗相对风险，并对变量进行了相对风险调整。
6380例死亡与4282260条出生记录相关联，产生了5062对被视为真实的记录。低出生体重（RR = 2.26）、1分钟（RR = 1.72）和5分钟时的窒息（RR = 1.51）、早产（RR = 1.50）、产妇年龄≥40岁（RR = 2.06）以及产妇教育水平低（RR = 1.45）增加了循环系统疾病导致死亡的可能性。在与循环系统畸形导致的死亡的关联中，预测变量显示出相同的关联模式，但强度更大。
胎儿和母亲因素与循环系统疾病和畸形导致的死亡率增加有关。控制这些因素并改善其诊断和治疗的可及性的措施将有助于减少循环系统疾病和畸形导致的死亡人数。然而，由于受遗传因素影响，应仔细考虑孕期和出生时环境影响对死亡风险的作用。
