0134/2018 - Tendência temporal do nascimento pré-termo e de seus determinantes em uma década. Temporal trends of preterm birth and of its determinants in one decade.
Objetivou-se analisar a frequência de nascimentos pré-termo, identificar fatores de risco e a evolução destes em uma década (2001-2005-2010) em município paulista. Estudo de série temporal realizado com dados do Sistema de Informações de Nascidos Vivos. Utilizou-se regressão logística univariada e múltipla para identificar fatores associados ao nascimento pré-termo e regressão linear para avaliar a tendência temporal destes no período. Para evitar subestimação, às frequências de nascimento pré-termo obtidas aplicou-se fator de correção. Houve discreto aumento da taxa de nascimento pré-termo: 12,5%, 12,0% e 13,2%. Após ajuste para confundidores, associaram-se com maior chance desse desfecho e aumentaram na década: idade materna igual ou superior a 35 anos e parto cesárea; diminuíram no período: nascimento em hospital de alto risco e menos de sete consultas pré-natais, permanecendo estável a gemelaridade. Comparando ao parto vaginal, nascer de cesariana dobrou a chance de nascimento pré-termo. Dentre os cinco fatores associados à prematuridade, três (parto cesárea, nascimento em hospital de alto risco e menos de sete consultas de pré-natais) são modificáveis por ações no âmbito dos serviços de saúde.
Palavras-chave:
Prematuro; Gravidez; Epidemiologia; Sistemas de Informação.
Abstract:
This study aimed at analyzing the frequency of preterm births and at identifying their risk factors and development in one decade (2001-2005-2010) in a city in São Paulo state. It is a time-series study using datathe Live Birth Information System. Univariate and multiple logistic regressions were used to identify factors associated with preterm births, and linear regression was utilized to evaluate the time tendency of such factors in the period. In order to prevent underestimation, a correction factor was applied to the preterm frequencies obtained. A discrete increase in preterm birth was observed: 12.5%, 12.0% and 13.2%. After adjusting for potential confounders, maternal age equal to or higher than 35 years and cesarean sections were associated with higher chances for such outcome and increased over the decade. The number of births at high-risk hospitals and of women with fewer than seven prenatal consultations decreased during that period while that of multiple pregnancies remained stable. As compared to vaginal births, cesarean sections doubled the chance of preterm birth. Among the five factors associated with preterm birth, three (cesarean sections, births at high-risk hospitals and fewer than seven prenatal consultations) are modifiable by actions taken by health care services.
Keywords:
Premature; Pregnancy; Epidemiology; Information Systems.
Temporal trends of preterm birth and of its determinants in one decade.
Resumo (abstract):
This study aimed at analyzing the frequency of preterm births and at identifying their risk factors and development in one decade (2001-2005-2010) in a city in São Paulo state. It is a time-series study using datathe Live Birth Information System. Univariate and multiple logistic regressions were used to identify factors associated with preterm births, and linear regression was utilized to evaluate the time tendency of such factors in the period. In order to prevent underestimation, a correction factor was applied to the preterm frequencies obtained. A discrete increase in preterm birth was observed: 12.5%, 12.0% and 13.2%. After adjusting for potential confounders, maternal age equal to or higher than 35 years and cesarean sections were associated with higher chances for such outcome and increased over the decade. The number of births at high-risk hospitals and of women with fewer than seven prenatal consultations decreased during that period while that of multiple pregnancies remained stable. As compared to vaginal births, cesarean sections doubled the chance of preterm birth. Among the five factors associated with preterm birth, three (cesarean sections, births at high-risk hospitals and fewer than seven prenatal consultations) are modifiable by actions taken by health care services.
Palavras-chave (keywords):
Premature; Pregnancy; Epidemiology; Information Systems.
Balbi, B, Carvalhaes, MABL, Parada, C.M.G.L.. Tendência temporal do nascimento pré-termo e de seus determinantes em uma década.. Cien Saude Colet [periódico na internet] (2018/mar). [Citado em 24/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/tendencia-temporal-do-nascimento-pretermo-e-de-seus-determinantes-em-uma-decada/16667?id=16667&id=16667
