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Evolution of perinatal outcomes and sociodemographic variables in Chile (1996–2017)

Published online by Cambridge University Press:  04 December 2020

Francisco Mardones*
Affiliation:
Centro Latino Americano de Estudios Económicos y Sociales (Latin American Center for Economic and Social Studies), Pontificia Universidad Católica de Chile (CLAPES-PUC), Santiago, Chile
José Acuña
Affiliation:
Centro Latino Americano de Estudios Económicos y Sociales (Latin American Center for Economic and Social Studies), Pontificia Universidad Católica de Chile (CLAPES-PUC), Santiago, Chile
*
Address for correspondence: Francisco Mardones, Centro Latino Americano de Estudios Económicos y Sociales (Latin American Center for Economic and Social Studies), Pontificia Universidad Católica de Chile (CLAPES-PUC). Email: [email protected]

Abstract

The evolution of birth weight (BW), birth length (BL), and gestational age at delivery (GAD) and their correlation with various maternal sociodemographic variables were studied in Chilean newborns from years 1996 to 2017. A slight decrease in the mean values of these perinatal outcomes was observed; however, their risk sub-categories increased significantly, especially for GAD, indicating an important deterioration. GAD was strongly correlated with BW and BL. In the contingency tables, all sociodemographic variables, with the exemption of sex, had a higher proportion of early term 37–38-week and late pre-term 34–36-week newborns in women with a higher socioeconomic level; the strongest positive association was observed between mother’s years of education and the GAD risk category 37–38 weeks. Different maternal factors, such as a higher frequency of cesarean sections, including either obesity presence or smoking habit, could be influencing presented results.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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References

Victora, CG, Adair, L, Fall, C, et al. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008; 371(9609), 340357.CrossRefGoogle ScholarPubMed
Ngandu, CB, Momberg, D, Magan, A, et al. The association between household socioeconomic status, maternal sociodemographic characteristics, and adverse birth and infant growth outcomes in sub-Saharan Africa: a systematic review. J Dev Origins Health Dis. 2020; 11(4), 317334.CrossRefGoogle Scholar
Diet, nutrition and the prevention of chronic diseases. Report of the joint WHO/FAO expert consultation. In WHO Technical Report Series No. 916 (TRS 916), 2003. Retrieved June 15, 2020 from: https://www.who.int/dietphysicalactivity/publications/trs916/en/.Google Scholar
Barker, DJP. Past obstacles and future promises. In Developmental Origins of health and Disease (eds. Gluckman, P, Hanson, M), 2006; pp. 481495, Cambridge University Press, Cambridge.CrossRefGoogle Scholar
Roseboom, T, de Rooij, S, Painter, R. The Dutch famine and its long-term consequences for adult health. Early Hum Dev. 2006; 82, 485491.CrossRefGoogle ScholarPubMed
Prentice, A. Impact of early nutrition on later chronic disease outcomes epidemiological studies. In The Influence of Maternal, Foetal and Child Nutrition on the Development of Chronic Disease in Later Life (ed. Prentice, A ), 2011; pp. 57–59. Stationery Office Limited, London.Google Scholar
Gluckman, P, Hanson, M, Seng, CY, Bardsley, A. Pre-conception maternal body composition and gestational weight gain. In Nutrition & Lifestyle for Pregnancy and Breastfeeding (eds. Gluckman, P, Hanson, M, Seng, CY, Bardsley, A), 2014; pp. 216220. Oxford University Press, Oxford.Google Scholar
Hanson, MA, Bardsley, A, De-Regil, L-M, et al. International federation of gynecology and obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: “Think Nutrition First”. Int J Gynecol Obst. 2015; 131(S4), S213S225.Google Scholar
Eriksson, JG, Forsen, T, Toilets, J, Osmond, C, Barker, DJP. Early growth and coronary heart disease in later life: longitudinal study. Br Med J. 2001; 322 (7292), 949953.CrossRefGoogle ScholarPubMed
Araujo, CL, Hallal, PC, Nader, GA, Menezes, AMB, Victora, CG. Size at birth and height in early adolescence: a prospective birth cohort study. Eur J Clin Notre. 2009; 63 (5), 634639.CrossRefGoogle Scholar
Sørensen, HT, Sabroe, S, Rothman, KJ, et al. Birth weight and length as predictors for adult height. Am J Epidemiol. 1999; 149(8), 726729.CrossRefGoogle ScholarPubMed
Eide, MG, Øyen, N, Skjœrven, R, et al. Size at birth and gestational age as predictors of adult height and weight. Epidemiology. 2005; 16, 175181.CrossRefGoogle ScholarPubMed
Bosy-Westphal, A, Plachta-Danielzik, S, Dorhofer, RP, Muller, MJ. Short stature and obesity: positive association in adults but inverse association in children and adolescents. Br J Nutr. 2009; 102(3), 453461.CrossRefGoogle ScholarPubMed
Mardones, F, Villarroel, L, Karzulovic, L, et al. Association of perinatal factors and obesity in 6–8 years old Chilean children. Int J Epidemiol. 2008; 37, 902910.CrossRefGoogle ScholarPubMed
Mardones, F, Villarroel, L, Arnaiz, P, et al. Prenatal growth and metabolic syndrome components among Chilean children. J Dev Orig Health Dis. 2012; (3), 237244.CrossRefGoogle ScholarPubMed
Villarroel, L, Karzulovic, L, Manzi, J, Eriksson, JG, Mardones, F. Association of perinatal factors and school performance in primary school in Chilean children. J Dev Orig Health Dis. 2013; 4, 232238.CrossRefGoogle ScholarPubMed
Mardones, F, Arnaiz, P, Pacheco, P, et al. Associations of prenatal growth with metabolic syndrome, insulin resistance and nutritional status in Chilean children. BioMed Res Int. 2014: 8291. doi: 10.1155/2014/472017.CrossRefGoogle Scholar
Mittendorfer-Rutz, E, Rasmussen, F, Wasserman, D. Restricted fetal growth and adverse maternal psychosocial and socioeconomic conditions as risk factors for suicidal behaviour of offspring: a cohort study. Lancet. 2004; 364, 11351140.CrossRefGoogle ScholarPubMed
Dalziel, SR, Parag, V, Rodgers, A, Harding, JE. Cardiovascular risk factors at age 30 following pre-term birth. Int J Epidemiol. 2007; 36(4), 907915.CrossRefGoogle ScholarPubMed
World Health Organization & International Conference for the Ninth Revision of the International Classification of Diseases (1975). In: Manual of the international statistical classification of diseases, injuries, and causes of death: based on the recommendations of the ninth revision conference, 1975, and adopted by the Twenty-ninth World Health Assembly, 1975 revision, 1977. World Health Organization, Geneva. Retrieved June 20, 2020 from: https://apps.who.int/iris/handle/10665/40492 Google Scholar
Vogel, JP, Chawanpaiboon, S, Moller, A-B, et al. The global epidemiology of preterm birth. Best Pract Res Clin Obstet Gynaecol. 2018; 52, 312.CrossRefGoogle ScholarPubMed
Raju, TNK, Higgins, RD, Stark, AR, Leveno, KJ. Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development. Pediatrics. 2006; 118(3), 12071214.Google Scholar
Delnord, M, Zeitlin, J. Epidemiology of late preterm and early term births – An international perspective. Semin Fetal Neonatal Med. 2019; 24, 310.CrossRefGoogle ScholarPubMed
Kajantie, E, Strang-Karlsson, S, Evensen, KAI, Haaramo, P. Adult outcomes of being late preterm or early term – What do we know? Semin Fetal Neonatal Med. 2019; 24, 6683.CrossRefGoogle ScholarPubMed
Pan American Health Organization. In AIEPI Neonatal Interventions Based on Evidence, 2nd ed.) 2010. Pan American Health Organization, Washington, DC. Retrieved March 26, 2020 from: http://www.manuelosses.cl/BNN/AIEPI-Neonatal_intbasevid.pdf Google Scholar
Ministry of Health, Chile. Live births databases, year 2017. Retrieved January 14, 2020 from: http://deis.cl/bases-de-datos-nacimientos/.Google Scholar
Mardones, F, Marshall, G, Viviani, V, et al. Interactive effect of birth weight and gestational age on the individual probability of neonatal mortality. J Health Popul Nutr. 2008; 26(1), 5463.Google Scholar
Milad, M, Novoa, JM, Fabres, J, Samamé, M, Aspillaga, C. Recomendación sobre curvas de crecimiento intrauterino (Recomendations on intrauterine growth curves). Rev Chil Pediatr. 2010; 81(3), 264274.CrossRefGoogle Scholar
Ministry of Health, Chile. Guía perinatal 2015 (Perinatal guide 2015). Retrieved May 19, 2020 from: https://cedipcloud.wixsite.com/minsal-2015/cesrea.Google Scholar
Mardones, F, García-Huidobro, T, Ralph, C, et al. Influencia combinada del índice de masa corporal pregestacional y de la ganancia de peso en el embarazo sobre el crecimiento fetal (Combined influence of pregestational body mass index and weight gain during pregnancy on fetal growth). Rev Med Chile. 2011; 139, 710716.CrossRefGoogle Scholar
StataCorp. Stata Statistical Software: Release 16, 2019. StataCorp LLC, College Station, TX.Google Scholar
Ndirangu, J, Newell, ML, Bland, RM, Thorne, C. Maternal HIV infection associated with small-for-gestational age infants but not preterm births: evidence from rural South Africa. Hum Reprod. 2012; 27(6), 18461856.CrossRefGoogle Scholar
Blumenshine, P, Egerter, S, Barclay, CJ, et al. Socioeconomic disparities in adverse birth outcomes: a systematic review. Am J Prev Med. 2010; 39(3), 263272.CrossRefGoogle ScholarPubMed
Mardones, F. Algunos factores condicionantes del bajo peso de nacimiento [Some factors related to low birth weight (author’s transl)]. Rev Med Chile. 1980; 108(9), 830854.Google Scholar
Taucher, E, Jofré, I. Mortalidad infantil en Chile: el gran descenso [Infant mortality in Chile: the great descent]. Rev Med Chile. 1997; 125(10), 12251235.Google Scholar
Cabrera, R. Relaciones de la mortalidad infantil con la edad de la madre y número de orden del parto. Chile, 1969–1974 - 1979 [Relation of infant mortality to maternal age and birth order. Chile, 1969–1974 - 1979]. Rev Chil Obstet Ginecol. 1982; 47(5), 334349.Google Scholar
Fuentes, A, Sequeira, K, Tapia, A. Niveles socioeconómicos bajo y medio bajo comienzan a postergar la maternidad en Santiago de Chile [Delayed child bearing in a Chilean public hospital]. Rev Med Chile. 2019; 147(2), 168172. doi: 10.4067/s0034-98872019000200168.CrossRefGoogle Scholar
Potential impact of later childbearing on future population: United Nations. Department of Economic and Social Affairs. Population facts. 2019; No. 2019/5. Retrieved September 20, 2020 from: –https://www.un.org/en/development/desa/population//publications/pdf/popfacts/PopFacts_2019–5.pdf.Google Scholar
Kozuki, N, Lee, AC, Silveira, MF, et al. The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis. BMC Public Health. 2013; 13(Suppl 3), S2. doi: 10.1186/1471-2458-13-S3-S2.CrossRefGoogle ScholarPubMed
Nylander, PPS. The phenomenon of twinning. In Obstetrical Epidemiology (eds. Barron, SL, Thomson, AM), 1983; pp. 143165. Academic Press, London.Google Scholar
Shaver’s, VL. Measurement of socioeconomic status in health disparities research. J Natl Med Assoc. 2007; 99(9), 10131023.Google Scholar
Adler, NE, Newman, K. Socioeconomic disparities in health: pathways and policies. Health Aff. 2002; 21, 6076. 6.CrossRefGoogle ScholarPubMed
Fraser, D, Abu-Saad, K. Maternal nutrition and birth outcomes. Epidemiol Rev. 2010; 32(1), 525.Google Scholar
Chattrapiban, T, Smit, HA, Wijga, AH, et al. The joint effect of maternal smoking during pregnancy and maternal prepregnancy overweight on infant’s term birth weight. BMC Pregnancy and Childbirth. 2020; 20, 132.CrossRefGoogle Scholar
Ministry of Health, Chile. Encuesta Nacional de Salud (2016–2017) (National Health Survey). 2018. Retrieved May 7, 2020 from: https://www.minsal.cl/wp-content/uploads/2018/01/2-Resultados-ENS_MINSAL_31_01_2018.pdf Google Scholar
Mallol, J, Brandenburg, D, Madrid, R, et al. Prevalencia de tabaquismo durante el embarazo en mujeres chilenas de bajo nivel socioeconómico (Smoking prevalence during pregnancy in Chilean women of low socioeconomic status). Rev Chil Enf Respir. 2007; 23, 1722.Google Scholar
Abenheim, HA, Kinch, RA, Morin, L. Effect of prepregnancy body mass index categories on obstetrical and neonatal outcomes. Arch Gynecol Obstet. 2007; 275, 3943.CrossRefGoogle Scholar
Mardones, F, Rosso, P. A weight gain chart pregnant women designed in Chile. Matern Child Nutr. 2005; 1(2), 7790.CrossRefGoogle ScholarPubMed
Fraser, D, Abu-Saad, K. Maternal nutrition and birth outcomes. Epidemiol Rev. 2010; 32(1), 525.Google Scholar
Mardones, F, Rosso, P, Villarroel, L, et al. Pregnancy outcomes and the use of two standards to assess adequacy of maternal body mass index in early gestation. J Dev Orig Health Dis. 2016; 7(1), 8389. doi: 10.1017/S204017441500714X.CrossRefGoogle ScholarPubMed
Mardones, F, Rosso, P, Bacallao, J, et al. Comparación de dos patrones de evaluación nutricional del embarazo usando datos nacionales de Uruguay (Comparison of two maternal weight gain guidelines using national data from Uruguay). Arch Gyn Obst (AGO-URUGUAY). 2017; 55(2), 6372.Google Scholar
Mardones, F, Rosso, P, Villarroel, L, et al. Obesity and underweight diagnoses during pregnancy using two standards. Ann Obes Disord. 2018; 3(1), 1021.Google Scholar
Zhou, S, Rosenthal, DG, Sherman, S, et al. Physical, behavioral, and cognitive effects of prenatal tobacco and postnatal second hand smoke exposure. Curr Probl Pediatr Adolesc Health Care. 2014; 44(8), 219241.CrossRefGoogle Scholar
Bambs, C, Álcantara, J. Menos tabaco, más salud (Low smoking, better health). In Cómo vivir bien 100 años (How to reach 100 years of healthy life) (eds. Larraín, F, Martín, PP, Valenzuela, E), 2016; pp. 137–147. Ediciones Universidad Católica de Chile, Santiago, Chile.Google Scholar
Bachelet, VC, Lanas, F. Smoking and obesity in Chile’s Third National Health Survey: light and shade. Rev Panam Salud Publica. 2018; 42, e132. doi: 10.26633/RPSP.2018.132 CrossRefGoogle ScholarPubMed
Águila, C, Chamorro, H. Perfil actual de los programas de cesación de tabaquismo en Chile (Present information on Chilean programs for tobacco use cessation). Rev Chil Enferm Respir. 2019; 35(1). https://doi.org/10.4067/S0717-73482019000100043 CrossRefGoogle Scholar
Borrescio-Higa, F, Valdés, N. Publicly insured cesarean sections in private hospitals: a repeated cross-sectional analysis in Chile. British Med J Open. 2019; 9, e024241. doi: 10.1136/bmjopen-2018-02424146.Google ScholarPubMed
Murray, SF. Relation between private health insurance and high rates of caesarean section in Chile: qualitative and quantitative study. BMJ. 2000; 321, 15011505.CrossRefGoogle ScholarPubMed
Visser, GHA, Ayres-de-Campos, A, Shah, PK, et al. FIGO position paper: how to stop the cesarean section epidemic. Lancet. 2018; 392(10155), 12861287.CrossRefGoogle ScholarPubMed
Editorial. Stemming the global cesarean section epidemic. Lancet. 2018; 392(10155), 1270.Google Scholar
World Health Organization. WHO recommendations on non-clinical interventions to reduce unnecessary cesarean sections., 2018. Retrieved June 15, 2020 from: http://who.int/reproductivehealth/publications/non-clinical-interventions-to-reduce-cs/en/.Google Scholar
Mardones-Restat, F, de Azevedo, AC. The essential health reform in Chile; a reflection on the 1952 process. Salud Publica Mex. 2006; 48(6), 504511.CrossRefGoogle ScholarPubMed
Hevia, P. Vida y legado del Dr. Francisco Mardones Restat, 1919–2009 (Life and legacy of Dr. Francisco Mardones-Restat, 1919–2009). Rev Chil Nutr. 2009; 36(3), 285288.Google Scholar
Bossert, TJ, Leisewitz, T. Innovation and change in the Chilean health system. N Engl J Med. 2016; 374(1), 15.CrossRefGoogle ScholarPubMed
Ministry of Health, Chile. Estadísticas de natalidad 1994–2013 (Fertility statistics 1994–2013). Retrieved June 15, 2020 from: http://www.deis.cl/estadisticas-de-natalidad-2011/.Google Scholar