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与足月低出生体重相关的因素:1 亿巴西队列的基于人群的关联研究。

Factors associated with low birth weight at term: a population-based linkage study of the 100 million Brazilian cohort.

机构信息

School of Nutrition, Federal University of Bahia, Salvador, Brazil.

Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.

出版信息

BMC Pregnancy Childbirth. 2020 Sep 14;20(1):536. doi: 10.1186/s12884-020-03226-x.

Abstract

BACKGROUND

Factors associated with low birth weight at term (TLBW), a proxy for intrauterine growth restriction (IUGR), are not well-elucidated in socioeconomically vulnerable populations. This study aimed to identify the factors associated with TLBW in impoverished Brazilian women.

METHODS

Records in the 100 Million Brazilian Cohort database were linked to those in the National System of Information on Live Births (SINASC) to obtain obstetric, maternal, birth and socioeconomic data between 2001 and 2015. Multivariate logistic regression was performed to investigate associations between variables of exposure and TLBW.

RESULTS

Of 8,768,930 term live births analyzed, 3.7% presented TLBW. The highest odds of TLBW were associated with female newborns (OR: 1.49; 95% CI: 1.47-1.50), whose mothers were black (OR: 1.20; 95% CI: 1.18-1.22), had a low educational level (OR: 1.57; 95% CI: 1.53-1.62), were aged ≥35 years (OR: 1.44; 95% CI: 1.43-1.46), had a low number of prenatal care visits (OR: 2.48; 95% CI: 2.42-2.54) and were primiparous (OR: 1.62; 95% CI: 1.60-1.64). Lower odds of TLBW were found among infants whose mothers lived in the North, Northeast and Center-West regions of Brazil compared to those in the South.

CONCLUSION

Multiple aspects were associated with TLBW, highlighting the need to comprehensively examine the mechanisms underlying these factors, especially in more vulnerable Brazilian populations, in order to contribute to the elaboration of health policies and promote better conditions of life for poor and extremely poor mothers and children.

摘要

背景

在社会经济弱势群体中,与足月低体重(TLBW)相关的因素(宫内生长受限(IUGR)的替代指标)尚不清楚。本研究旨在确定与贫困巴西女性 TLBW 相关的因素。

方法

将 1000 万巴西队列数据库中的记录与国家活产信息系统(SINASC)中的记录相链接,以获取 2001 年至 2015 年期间的产科、产妇、分娩和社会经济数据。采用多变量逻辑回归分析暴露变量与 TLBW 之间的关联。

结果

在分析的 8768930 例足月活产中,有 3.7%出现 TLBW。TLBW 发生的最高几率与女婴有关(OR:1.49;95%CI:1.47-1.50),其母亲为黑人(OR:1.20;95%CI:1.18-1.22),教育程度较低(OR:1.57;95%CI:1.53-1.62),年龄≥35 岁(OR:1.44;95%CI:1.43-1.46),产前检查次数较少(OR:2.48;95%CI:2.42-2.54),初产妇(OR:1.62;95%CI:1.60-1.64)。与南部地区的婴儿相比,北部、东北部和中西部地区婴儿的 TLBW 几率较低。

结论

多个方面与 TLBW 相关,强调需要全面检查这些因素背后的机制,特别是在巴西较为脆弱的人群中,以促进卫生政策的制定,并为贫困和极度贫困的母亲和儿童创造更好的生活条件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/760b/7491100/a5eaa62d6350/12884_2020_3226_Fig1_HTML.jpg

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