Community diagnosis of maternal exposure to risk factors for congenital defects

This paper describes a community diagnosis of maternal exposure to risk factors for congenital defects in the population of Pelotas, RS, Brazil (400000 inhabitants). The authors investigated biological and demographic factors (maternal age, alcohol ingestion and smoking), social and economic factors (family income and type of work), and welfare factors (prenatal care, illnesses during pregnancy, drug therapy, and vaccinations). These factors were matched up with the Decalogue for Prevention of Congenital Defects recommended by the Latin American Collaborative Study of Congenital Malformations.

Data were collected in a population-based study in which mothers were interviewed in the hospitals of Pelotas, RS, during 1995. On each day, the first 3 women to give birth were interviewed in every city hospital. The sample resulted in a total of 3219 interviewed women.

Low-income groups are most exposed. They present the following potential risk factors: (a). outside the ideal age range for pregnancy; (b). fewer prenatal care appointments; (c). no prevention against rubella through vaccinations, and (d). more cigarette smoking. In the high-income groups, the potential risk factors were: (a). drug therapy (more common) and (b). more women working outside the home. We did not find any difference among social classes concerning: (a). illnesses during pregnancy and (b). ingestion of alcohol. When a general risk score was used, this figure was higher in the group of women who were not within ideal age for pregnancy. However, there was no difference among social classes. This has led us to conclude that delayed childbearing is a global risk whereas each social class has its own risks.