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Isolation of Leukocytes from the Murine Tissues at the Maternal-Fetal Interface
Published on: May 21, 2015
Fetal and maternal factors are associated with mortality due to circulatory system disorders in children
Thais Rocha Salim1,2, Gabriel Porto Soares1,2, Carlos Henrique Klein1,3
1Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Instituto do Coração Edson Saad. Rio de Janeiro, RJ, Brasil.
Insights
Birth characteristics like low weight, asphyxia, and prematurity, along with maternal factors such as advanced age and lower education, significantly increase the risk of circulatory system diseases and malformations in children.
Area of Science:
- Pediatrics
- Public Health
- Cardiovascular Epidemiology
Background:
- Circulatory system diseases and malformations are significant causes of mortality in children.
- Understanding the impact of birth characteristics and maternal factors on pediatric cardiovascular mortality is crucial for public health interventions.
Purpose of the Study:
- To investigate the association between birth characteristics (weight, asphyxia, gestation duration) and maternal factors (age, education) with mortality from circulatory system diseases and malformations in children under 18.
- To quantify the risk associated with specific adverse birth and maternal conditions.
Main Methods:
- A longitudinal cohort analysis was performed by linking the Brazilian Information System on Live Births and Information System on Mortality databases.
- Independent variables included birth weight, occurrence of asphyxia, gestation duration, maternal age, and education level.
- Dependent variables were deaths from circulatory system diseases or malformations in children under 18, with relative risks estimated and adjusted.
Main Results:
- Low birth weight, asphyxia at 1 and 5 minutes, prematurity, advanced maternal age (≥40 years), and low maternal education level were associated with increased probability of death from circulatory system diseases.
- These factors showed a similar but more intense association with mortality due to malformations of the circulatory system.
Conclusions:
- Fetal and maternal factors are significantly associated with increased mortality from circulatory system diseases and malformations in children.
- Interventions targeting these factors, improving diagnosis, and treatment access can reduce pediatric cardiovascular mortality.
- Environmental influences during gestation and birth, potentially influenced by genetic factors, warrant careful consideration in risk assessment.
Objective:
To analyze the association of characteristics recorded at the time of birth, including weight, occurrence of asphyxia, gestation duration, maternal age and education level, with death from diseases or malformations of the circulatory system in children under 18 years of age.
Methods:
The Brazilian Information System on Live Births and Information System on Mortality databases were linked and evaluated following a longitudinal cohort analysis strategy. The following independent variables were evaluated: characteristics recorded at the time of birth, including weight, occurrence of asphyxia, gestation duration, maternal age and education level. Dependent variables were death from diseases or malformations of the circulatory system in children under 18 years of age. Crude relative risks were estimated and relative risks were adjusted for the variables.
Results:
6,380 deaths were linked to 4,282,260 birth records, yielding 5,062 pairs considered as true. Low birth weight (RR = 2.26), asphyxia at 1 (RR = 1.72) and 5 minutes (RR = 1.51), prematurity (RR = 1.50), maternal age ≥ 40 years (RR = 2.06), and low maternal education level (RR = 1.45) increased the probability of death caused by circulatory system diseases. In the association with death by malformations of the circulatory system, the predictive variables showed the same association profile, but with greater intensity.
Conclusions:
Fetal and maternal factors are associated with increased mortality due to diseases and malformations of the circulatory system. Measures to control these factors and improve access to their diagnosis and treatment would contribute to reducing the number of deaths caused by diseases and malformations of the circulatory system. However, the identification of environmental influences during gestation and birth on the risk of death should be carefully considered due to being influenced by genetic factors.
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