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Open Access 01-10-2016 | Research

Prevalence and risk factors related to preterm birth in Brazil

Authors: Maria do Carmo Leal, Ana Paula Esteves-Pereira, Marcos Nakamura-Pereira, Jacqueline Alves Torres, Mariza Theme-Filha, Rosa Maria Soares Madeira Domingues, Marcos Augusto Bastos Dias, Maria Elizabeth Moreira, Silvana Granado Gama

Published in: Reproductive Health | Special Issue 3/2016

Abstract

Background

The rate of preterm birth has been increasing worldwide, including in Brazil. This constitutes a significant public health challenge because of the higher levels of morbidity and mortality and long-term health effects associated with preterm birth. This study describes and quantifies factors affecting spontaneous and provider-initiated preterm birth in Brazil.

Methods

Data are from the 2011–2012 “Birth in Brazil” study, which used a national population-based sample of 23,940 women. We analyzed the variables following a three-level hierarchical methodology. For each level, we performed non-conditional multiple logistic regression for both spontaneous and provider-initiated preterm birth.

Results

The rate of preterm birth was 11.5 %, (95 % confidence 10.3 % to 12.9 %) 60.7 % spontaneous - with spontaneous onset of labor or premature preterm rupture of membranes - and 39.3 % provider-initiated, with more than 90 % of the last group being pre-labor cesarean deliveries. Socio-demographic factors associated with spontaneous preterm birth were adolescent pregnancy, low total years of schooling, and inadequate prenatal care. Other risk factors were previous preterm birth (OR 3.74; 95 % CI 2.92–4.79), multiple pregnancy (OR 16.42; 95 % CI 10.56–25.53), abruptio placentae (OR 2.38; 95 % CI 1.27–4.47) and infections (OR 4.89; 95 % CI 1.72–13.88). In contrast, provider-initiated preterm birth was associated with private childbirth healthcare (OR 1.47; 95 % CI 1.09–1.97), advanced-age pregnancy (OR 1.27; 95 % CI 1.01–1.59), two or more prior cesarean deliveries (OR 1.64; 95 % CI 1.19–2.26), multiple pregnancy (OR 20.29; 95 % CI 12.58–32.72) and any maternal or fetal pathology (OR 6.84; 95 % CI 5.56–8.42).

Conclusion

The high proportion of provider-initiated preterm birth and its association with prior cesarean deliveries and all of the studied maternal/fetal pathologies suggest that a reduction of this type of prematurity may be possible. The association of spontaneous preterm birth with socially-disadvantaged groups reaffirms that the reduction of social and health inequalities should continue to be a national priority.

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Title: Prevalence and risk factors related to preterm birth in Brazil
Authors: Maria do Carmo Leal
Ana Paula Esteves-Pereira
Marcos Nakamura-Pereira
Jacqueline Alves Torres
Mariza Theme-Filha
Rosa Maria Soares Madeira Domingues
Marcos Augusto Bastos Dias
Maria Elizabeth Moreira
Silvana Granado Gama
Publication date: 01-10-2016
Publisher: BioMed Central
Published in: Reproductive Health / Issue Special Issue 3/2016
Electronic ISSN: 1742-4755
DOI: https://doi.org/10.1186/s12978-016-0230-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prevalence and risk factors related to preterm birth in Brazil

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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