PDF(Pubmed)
Abstract：
Background/Objectives: Prematurity rates remain high and represent a challenge for the public health systems of any country, with a high impact on neonatal mortality. This study aimed to evaluate the frequency and environmental and maternal-fetal risk factors for premature birth in a cohort of parturient women, with their newborns monitored in a neonatal intensive care unit at a private reference hospital. Methods: A cohort was carried out between 2013 and 2018 among parturient women living in a capital city in the Northeast of Brazil whose newborns were admitted to the neonatal intensive care unit. This study was approved by the Research Ethics Committee of the University of Fortaleza. The information collected comprised data from both medical records and hydrosanitary data from maternal homes. Results: The prevalence of prematurity among live births (n = 9778) between 2013 and 2018 at this hospital was 23%. The frequency of prematurity among those eligible (n = 480) was 76.9%, and the frequency of eligible premature babies (n = 369) in relation to the total number of births in this period was 3.8%. In the multivariate analysis, the significant risk factors for prematurity were primigravida (RR = 1.104, 95%CI: 1.004-1.213) and hypertensive syndromes during pregnancy (RR = 1.262, 95%CI: 1.161-1.371), and the significant protective factor was the highest number of prenatal consultations (RR = 0.924, 95%CI: 0.901-0.947). Conclusions: This study contributes to providing greater visibility to prenatal care and the understanding of complications during pregnancy and childbirth care. These results indicate the need to implement public policies that promote improvements in the population\'s living conditions and care for pregnant women to reduce premature births and, consequently, neonatal and infant mortality.
摘要：
背景/目标：早产率仍然很高，对任何国家的公共卫生系统都是挑战，对新生儿死亡率有很大影响。本研究旨在评估一组产妇早产的频率和环境及母婴危险因素。他们的新生儿在一家私人参考医院的新生儿重症监护室接受监测。方法：在2013年至2018年期间，对居住在巴西东北部首都城市的产妇进行了队列研究，这些产妇的新生儿被送往新生儿重症监护病房。本研究得到福塔莱萨大学研究伦理委员会的批准。收集的信息包括来自医疗记录的数据和来自孕产妇家庭的水文卫生数据。结果：2013年至2018年，该医院活产（n=9778）的早产患病率为23％。符合条件的人(n=480)的早产频率为76.9%，在此期间，符合条件的早产儿（n=369）占分娩总数的频率为3.8％。在多变量分析中，早产的重要危险因素是初产妇（RR=1.104，95CI：1.004-1.213）和妊娠期高血压综合征（RR=1.262，95CI：1.161-1.371），且显著的保护因素是产前咨询次数最高(RR=0.924,95CI:0.901-0.947)。结论：这项研究有助于提高产前护理的知名度，以及对怀孕和分娩护理期间并发症的了解。这些结果表明，需要实施公共政策，促进改善人口的生活条件和照顾孕妇，以减少早产，因此,新生儿和婴儿死亡率。
