Departamento de Saúde, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil.
São Paulo, São Paulo, SP, Brasil.
Rev Saude Publica. 2020;54:88. doi: 10.11606/s1518-8787.2020054002098. Epub 2020 Aug 28.
In Brazil, the excess of interventions that anticipate childbirth, such as cesarean sections and labor inductions, has resulted in the shortening of pregnancy, with negative consequences on maternal-infant outcomes. This commentary presents a novel way to measure gestational age: the continuous variable "Potential pregnancy days lost." Using data from the Live Birth Information System (SINASC), we counted the missing days between the period until childbirth and the average duration of pregnancy (280 days), or the lost weeks. This measure can be used as an outcome variable (socioeconomic-demographic characteristics of the mother, type of childbirth, financing, etc.) or exposure variable (for neonatal, infant, and maternal outcomes). The indicator can be used in municipal and national cohorts and intervention studies to analyze hospitals and regions. We discuss the limits and scope of gestational age measures and, given their inaccuracies, the importance of studying their trends.
在巴西,过度的分娩干预措施,如剖宫产和引产,导致了妊娠时间缩短,对母婴结局产生了负面影响。本评论提出了一种新的衡量妊娠期的方法:连续变量“潜在妊娠天数损失”。我们使用来自活产信息系统(SINASC)的数据,计算了从分娩期到平均妊娠时间(280 天)之间缺失的天数,或者说损失的周数。该指标可用作结果变量(母亲的社会经济人口特征、分娩类型、融资等)或暴露变量(用于新生儿、婴儿和产妇结局)。该指标可用于市和县队列和干预研究,以分析医院和地区。我们讨论了妊娠期衡量指标的局限性和范围,鉴于其不准确性,研究其趋势非常重要。