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Published on: November 20, 2015
Maternal and neonatal factors related to prematurity
Laura Leismann de Oliveira1, Annelise de Carvalho Gonçalves2, Juvenal Soares Dias da Costa3,4
1Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
Insights
Maternal age, education, multiple pregnancies, and inadequate prenatal care are key factors linked to prematurity. Immediate consequences include low birth weight and poor Apgar scores, highlighting the need for targeted interventions.
Area of Science:
- Public Health
- Neonatal Research
- Epidemiology
Background:
- Prematurity is a significant global health concern with severe neonatal outcomes.
- Identifying associated maternal and neonatal factors is crucial for developing effective prevention strategies.
Purpose of the Study:
- To investigate maternal and neonatal factors associated with preterm birth in Porto Alegre.
- To understand the determinants of prematurity in a specific urban population.
Main Methods:
- Population-based case-control study involving 19,457 births in Porto Alegre (2012).
- Cases: newborns < 37 weeks gestation; Controls: newborns ≥ 37 weeks gestation.
- Logistic regression analysis applied to sociodemographic, reproductive history, and gestational/birth factors.
Main Results:
- Statistically significant associations found for: maternal age extremes ( <19 or >34 years), inadequate maternal education, multiple pregnancies, C-section, low birth weight (<2,500g), low Apgar scores (0-3 at 5 min), and inadequate prenatal care.
- Low birth weight (OR=4.04) and low Apgar scores (OR=1.47) were immediate neonatal consequences.
- Maternal age, education, multiple gestation, prenatal care, and C-section identified as potential distal determinants.
Conclusions:
- Prematurity is strongly associated with immediate adverse neonatal outcomes like low birth weight and poor Apgar scores.
- Maternal age, education, multiple gestation, inadequate prenatal care, and C-section are significant risk factors for prematurity.
- Findings underscore the importance of addressing these factors for preterm birth prevention.
Objective:
To identify maternal and neonatal factors associated with prematurity in the municipality of Porto Alegre.
Method:
This was a population-based case-control study. The cases were newborns under 37 weeks of gestation and the controls were newborns over 37 weeks. The data came from the records of 19,457 births in the city of Porto Alegre in the year 2012 from the Information System on Live Births of the Municipal Health Department. The analysis was carried outand adjusted by a Logistic Regression according to a hierarchical model. The variables studied were allocated into three hierarchy levels: sociodemographic variables; reproductive history; and gestational and birth factors.
Results:
There were 767 cases allocated and 1,534 controls in a design of a case for two controls (1:2) by simple randomization. In the final model, a statistically significant association was found for prematurity for the following variables: mother's age under 19 years old (OR=1.32; CI 95%: 1.02-1.71) or over 34 years old (OR=1.39; CI 95%: 1.12-1.72); inadequate maternal schooling for age (OR=2.11; CI 95%: 1.22-3.65); multiple pregnancies (OR=1.14; CI 95%: 1.01-1.29); C-section (OR=1.15; CI 95%: 1.03-1.29); birth weights under 2,500g (OR=4.04; CI 95%: 3.64-4.49); Apgar score at five minutes between zero and three (OR=1.47; CI 95%: 1.12-1.91); and inadequate prenatal care (OR=1.18; CI 95%: 1.02-1.36).
Conclusion:
The present study showed the most immediate consequence of prematurity for newborns by evidencing its association with worse Apgar scores and low birth weight. The following factors were also shown as possible more distal determinants of prematurity: mother's age; inadequate maternal education; multiple gestation; inadequate prenatal care; and C-section.
Objetivo:
Identificar fatores maternos e neonatais associados à prematuridade no município de Porto Alegre.
MéTodo:
Estudo do tipo caso-controle de base populacional. Os casos foram recém-nascidos com menos de 37 semanas de gestação, e os controles foram os recém-nascidos com 37 semanas ou mais. Os dados provieram dos registros de 19.457 nascimentos do município de Porto Alegre, no ano de 2012, no Sistema de Informações sobre Nascidos Vivos da Secretaria Municipal da Saúde. Foi realizada análise ajustada mediante Regressão Logística segundo modelo hierárquico. As variáveis estudadas foram alocadas em três níveis de hierarquia: variáveis sociodemográficas; história reprodutiva; fatores gestacionais e de nascimento.
Resultados:
Foram alocados 767 casos e 1.534 controles, em um desenho de um caso para dois controles (1:2), mediante randomização simples. No modelo final, foi encontrada associação estatisticamente significante para prematuridade para as seguintes variáveis: idade materna menor que 19 anos (OR=1,32; IC 95%: 1,02 - 1,71) e maior que 34 anos (OR=1,39; IC 95%: 1,12 - 1,72); escolaridade materna inadequada para a idade (OR=2,11; IC 95%: 1,22 - 3,65); gravidez múltipla (OR=1,14; IC 95%: 1,01 - 1,29); cesariana (OR=1,15; IC 95%: 1,03 - 1,29); peso ao nascer menor a 2.500g (OR=4,04; IC 95%: 3,64 - 4,49); Índice de Apgar no 5° minuto de zero a três (OR=1,47; IC 95%: 1,12 - 1,91) e pré-natal inadequado (OR=1,18; IC 95%: 1,02 - 1,36).
ConclusãO:
O presente estudo evidenciou as consequências mais imediatas da prematuridade para os recém-nascidos ao revelar sua associação com piores escores de Apgar e baixo peso ao nascimento. Mostrou como possíveis determinantes mais distais de prematuridade: idade materna, educação materna inadequada, gestação múltipla, pré-natal inadequado e realização de cesariana.
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