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Maternal factors associated with prematurity in public maternity hospitals at the Brazilian Western Amazon
Clisângela Lago Santos1, Kleynianne Medeiros de Mendonça Costa2, José Eduardo Cavalcante Dourado2
1Health Science and Sports Centre, Federal University of Acre, BR 364 Km 04, Distrito Industrial, Bloco Francisco Augusto Vieira Nunes, sala 214, Rio Branco, Acre, CEP: 69920-900 Brazil.
Objective:
To analyse maternal factors associated with prematurity in public maternity hospitals.
Design:
Retrospective unmatched case-control study on two public maternity hospitals in the State of Acre, Brazil.
Setting And Participants:
A sample of 341 newborn infants of premature birth (< 37 weeks; case group) and 388 newborn infants of term delivery (≥ 37 weeks; control group).
Methods:
A validated instrument was used for interviews, and information was collected from hospital records. The variables were divided into five blocks: (1) maternal sociodemographic and economic characteristics, (2) maternal biological and reproductive characteristics, (3) maternal habits, (4) pregnancy complications, and (5) neonatal characteristics. The hierarchical analysis was performed using multiple logistic regression.
Results:
The risk factors associated with premature birth were as follows: newborn infants of mothers who were born premature (p = 0.005), with low BMI (p = 0.006), history of a previous preterm child (p<0.003), who had stress (p = 0.020) and physical injury during pregnancy (p = 0.025), with quality of prenatal care classified as inadequate II (p = 0.001), which presented abnormal amniotic fluid volume (p<0.001), pre-eclampsia/eclampsia (p<0.001), bleeding (p = 0.013) and hospitalization during pregnancy (p = 0.001).
Conclusion:
The variables that were associated with premature birth were mother born preterm, low BMI, previous premature child, stress and physical injury during pregnancy, prenatal care inadequate II, bleeding, abnormal amniotic fluid volume, pre-eclampsia/eclampsia and hospitalization during pregnancy. It is important to properly perform prenatal care, having a multidisciplinary approach as support, with the objective of keep up with changes in nutritional classification and monitoring of adverse clinical conditions.
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