Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas, Universidade Estaudual de Campinas, Campinas, SP, Brazil.
Department of Obstetrics and Gynecology, Faculdade de Medicina de Jundiaí, Jundiaí, SP, Brazil.
Rev Bras Ginecol Obstet. 2021 Nov;43(11):811-819. doi: 10.1055/s-0041-1739492. Epub 2021 Dec 6.
To investigate the characteristics of women who had preterm birth (PTB) and related outcomes according to ethnicity.
A secondary analysis of a multicenter cross-sectional study conducted in Brazil. Women who had PTB were classified by self-report as white and non-white. Clinical, pregnancy, and maternal data were collected through postpartum interviews and reviews of medical charts. The sociodemographic, obstetric and clinical characteristics of the women, as well as the mode of delivery and the neonatal outcomes among different ethnic groups were compared through a bivariate analysis.
Of the 4,150 women who had PTB, 2,317 (55.8%) were non-white, who were more likely: to be younger than 19 years of age (prevalence ratio [PR]: 1.05; 95% confidence interval [95%CI]: 1.01-1.09); to be without a partner; to live on low income; to have lower levels of schooling; to have ≥ 2 children; to perform strenuous work; to be from the Northeastern region of Brazil rather than the from Southern region; to have a history of ≥ 3 deliveries; to have an interpregnancy interval < 12 months; to have pregnancy complications such as abortion, PTB, preterm premature rupture of membranes (pPROM), and low birth weight; to initiate antenatal care (ANC) visits in the second or third trimesters; to have have an inadequate number of ANC visits; to be under continuous overexertion; to smoke in the first and second or third trimesters; and to have anemia and gestational hypertension. The maternal and neonatal outcomes did not differ between the groups, except for the higher rate of low birth weight (73.7% versus 69.0%) in infants born to non-white women, and the higher rate of seizures (4.05% versus 6.29%) in infants born to white women.
Unfavorable conditions were more common in non-whites than in whites. Proper policies are required to decrease inequalities, especially in the context of prematurity, when women and their neonates have specific needs.
根据种族调查有早产（PTB）史的女性的特征及其相关结局。
这是一项在巴西进行的多中心横断面研究的二次分析。通过自我报告，将有 PTB 史的女性分为白人和非白人。通过产后访谈和病历回顾收集临床、妊娠和产妇数据。通过双变量分析比较不同种族群体的社会人口学、产科和临床特征、分娩方式和新生儿结局。
在 4150 名有 PTB 史的女性中，2317 名（55.8%）是非白人，她们更可能：年龄小于 19 岁（比值比 [PR]：1.05；95%置信区间 [95%CI]：1.01-1.09）；没有伴侣；收入低；受教育程度低；有≥2个孩子；从事重体力劳动；来自巴西东北部而不是南部地区；有≥3次分娩史；两次妊娠间隔时间<12 个月；有流产、PTB、早产胎膜早破（pPROM）和低出生体重等妊娠并发症；在妊娠第二个或第三个月开始接受产前保健（ANC）就诊；ANC 就诊次数不足；过度劳累；在第一个和第二个或第三个月吸烟；以及贫血和妊娠期高血压。两组的母婴结局没有差异，但非白人女性的新生儿出生体重较低（73.7%对 69.0%），白人女性的新生儿癫痫发作率较高（4.05%对 6.29%）。
非白人比白人更常见不利条件。需要制定适当的政策来减少不平等，特别是在早产的背景下，此时女性及其新生儿有特定的需求。
