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SECULAR TREND OF VERY LOW BIRTH WEIGHT RATE IN PORTO ALEGRE, SOUTHERN BRAZIL

Published online by Cambridge University Press:  26 October 2009

CLÉCIO HOMRICH DA SILVA ,
MARILYN AGRANONIK ,
ANTÔNIO AUGUSTO MOURA DA SILVA ,
HELOISA BETTIOL ,
MARCO ANTONIO BARBIERI  and
MARCELO ZUBARAN GOLDANI
CLÉCIO HOMRICH DA SILVA
Affiliation:
Department of Paediatrics and Puericulture, Faculty of Medicine, Federal University of Rio Grande do Sul. Hospital de Clìnicas de Porto Alegre, Porto Alegre, Brazil
MARILYN AGRANONIK
Affiliation:
Graduate Program in Epidemiology, Federal University of Rio Grande do Sul. Porto Alegre, Brazil
ANTÔNIO AUGUSTO MOURA DA SILVA
Affiliation:
Public Health Department, Federal University of Maranhão. São Luìs, Brazil
HELOISA BETTIOL
Affiliation:
Department of Paediatrics and Puericulture, Faculty of Medicine (Ribeirão Preto), Federal University of São Paulo, Ribeirão Preto, Brazil
MARCO ANTONIO BARBIERI
Affiliation:
Department of Paediatrics and Puericulture, Faculty of Medicine (Ribeirão Preto), Federal University of São Paulo, Ribeirão Preto, Brazil
MARCELO ZUBARAN GOLDANI
Affiliation:
Department of Paediatrics and Puericulture, Faculty of Medicine, Federal University of Rio Grande do Sul. Hospital de Clìnicas de Porto Alegre, Porto Alegre, Brazil
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Summary

The strong association of very low birth weight (VLBW; <1500 g) with infant mortality is well known. There are no data related to VLBW trends in Brazil although findings from some large surveys carried out in small- and medium-sized cities have demonstrated an increase in low birth weight (LBW; <2500 g) rates over the last 30 years. The aim of this study was to evaluate the secular trend of VLBW in the city of Porto Alegre, a large city in a developed area in southern Brazil, and the potential determinants of this trend during the 1990s and early 2000s. This is a registry-based study. Data were obtained from birth certificates of all live births in the city from 1994 to 2005. The variables analysed were: VLBW as the dependent variable and maternal age and schooling, type of delivery, type of hospital, number of live births, gestational age, newborn gender and unemployment rate. The incidence ratio rate (IRR) using Poisson regression was calculated to identify possible trends in VLBW rates. Poisson regressions were performed in order to assess the influence of some independent variables on VLBW. A total of 257,740 singleton newborns were delivered in the city during the period, with a steady reduction in the total number of live births per year from 23,296 in 1994 to 18,325 in 2005. The results showed a small but significant increase in VLBW (p for trend=0.049). There was a significant trend towards adequacy for gestational age per birth weight, suggesting a reduction in rates of intrauterine growth restriction (IUGR) (p<0.001). The findings showed a significant increase of 1% per year in the probability of VLBW. The main risk factors were related to VLBW mothers with low levels of schooling, public hospitals and multiparity and nulliparity. After adjustment, nulliparity remained as a significant risk factor. The interaction between type of hospital and type of delivery indicated that the probability for VLBW was 3.6 times higher (p<0.001) among those born in public hospitals by Caesarean section than those born in private hospitals by vaginal delivery. The results show that southern Brazil is going through a demographic transition characterized by a significant decrease in number of live births associated with a small increase in VLBW rates, a decrease in IUGR rates and stabilization of LBW.

Type
Research Article
Information
Journal of Biosocial Science , Volume 42 , Issue 2 , March 2010 , pp. 243 - 253
Copyright
Copyright © Cambridge University Press 2009

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