Birth weight intra-urban differentials in the city of São Paulo

• Autor(a) principal: Minuci, Elaine Garcia
• Data de Publicação: 2009
• Outros Autores: Almeida, Márcia Furquim de
• Tipo de documento: Artigo
• Idioma: por; eng
• Título da fonte: Revista de Saúde Pública
• Texto Completo: https://www.revistas.usp.br/rsp/article/view/32594
• topic: Recém-Nascido de Baixo Peso; Cuidado Pré-Natal; Fatores de Risco; Fatores Socioeconômicos; Vulnerabilidade em Saúde; Diferenciais intra-urbanos; Epidemiologia; Nascimento de pré-termo; Recién Nacido de Bajo Peso; Atención Prenatal; Factores de Riesgo; Factores Socioeconómicos; Vulnerabilidad en Salud; Diferenciais intra-urbanos; Epidemiología; Nacimiento Pré-termo; Infant; Low Birth Weight; Prenatal Care; Risk Factors; Socioeconomic Factors; Health Vulnerability; Urban Zones; Epidemiology; Preterm Birth

OBJECTIVE: To identify intra-urban differentials and risk factors in low birth weight prevalence. METHODS: Information was gathered in the live birth declarations made by mothers residing in the city of São Paulo (Southern Brazil), and obtained through the Live Birth Information System and the Seade Foundation, for the period between 2002 and 2003, totaling 388,980 live births. The addresses were georeferenced in census tracts and classified into six vulnerability groups according to the São Paulo State Social Vulnerability Index. To identify potential risk factor logistic regression analysis was performed. RESULTS: A positive growth trend was observed in the prevalence of low birth weight with an increase in the vulnerability rate (from 6.8% to 8.1%). There were significant differences among groups in terms of mothers' demographics, prenatal care and the proportion of non-preterm low weight births. In the low birth weight non-preterm group, a proxy measure to estimate intra-uterine growth delay, residing in vulnerable areas (1.29;1.17-1.43) and unfavorable mothers' demographics, such as teenage mothers (1.13;1.04-1.22), low schooling (1.26;1.17-1.35) and high number of children (1.10;1.01-1.20) were considered risk factors, as were older mothers (1.38;1.30-1.47), and single mothers (1.15;1.11-1.20). The lack of prenatal care produced the highest risk of low weight at birth in preterm (3.39;2.86-4.02) and non-preterm births (2.12;1.87-2.41). There was a decrease in the risk for low birth weight with an increase in prenatal care appointments in preterm and non-preterm births. CONCLUSIONS: There are low birth weight prevalence differences across vulnerability groups. Prenatal care proved to be unequal across vulnerability groups and its high risk in terms of low birth weight shows the importance of increasing the access to and the quality of healthcare services.