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Low birthweight and preterm birth: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982-2015.

Abstract：

BACKGROUND:Despite positive changes in most maternal risk factors in Brazil, previous studies did not show reductions in preterm birth and low birthweight. We analysed trends and inequalities in these outcomes over a 33-year period in a Brazilian city. METHODS:Four population-based birth cohort studies were carried out in the city of Pelotas in 1982, 1993, 2004 and 2015, with samples ranging from 4231 to 5914 liveborn children. Low birthweight (LBW) was defined as <2500 g, and preterm birth as less than 37 weeks of gestation. Information was collected on family income, maternal skin colour and other risk factors for low birthweight. Multivariable linear regression was used to estimate the contribution of risk factors to time trends in birthweight. RESULTS:Preterm births increased from 5.8% (1982) to 13.8% (2015), and LBW prevalence increased from 9.0% to 10.1%, being higher for boys and for children born to mothers with low income and brown or black skin colour. Mean birthweight remained stable, around 3200 g, but increased from 3058 to 3146 g in the poorest quintile and decreased from 3307 to 3227 g in the richest quintile. After adjustment for risk factors for LBW, mean birthweight was estimated to have declined by 160 g over 1982-2015 (reductions of 103 g in the poorest and 213 g in the richest quintiles). CONCLUSIONS:Data from four birth cohorts show that preterm births increased markedly. Mean birthweights remained stable over a 33-year period. Increased prevalence of preterm and early term births, associated with high levels of obstetric interventions, has offset the expected improvements due to reduction in risk factors for low birthweight.

journal_name

Int J Epidemiol

journal_title

International journal of epidemiology

authors

Silveira MF,Victora CG,Horta BL,da Silva BGC,Matijasevich A,Barros FC,Pelotas Cohorts Study Group.

doi

10.1093/ije/dyy106

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

i46-i53

issue

Suppl 1

eissn

0300-5771

issn

1464-3685

pii

5042986

journal_volume

48

pub_type

杂志文章

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