Prenatal care and preterm birth in the Western Brazilian Amazon: A population-based study

ABSTRACT

Brazil is among the top ten countries in preterm delivery worldwide. This study assesses the factors associated with preterm birth in the Western Brazilian Amazon. A population-based cross-sectional study was held between July 2015 to June 2016 in Cruzeiro do Sul, Brazilian Amazon. A total of 1525 births were included in this analysis. Preterm birth was defined as births at gestational age < 37 weeks. A stepwise multiple logistic regression was used to identify factors associated with preterm delivery. The prevalence rate of preterm birth was 7.9% (n = 120; 95% CI: 6.5–9.3). After adjusting for confounding factors, a positive association with preterm birth was observed for pregnant women who completed less than six antenatal care visits (OR: 2.93; 95% CI: 1.89–4.56), who had a birth interval of < 18 months (OR: 2.65; 95% CI: 1.04–6.75), and who experienced bleeding (OR: 2.17; 95% CI: 1.39–3.38) and hypertension during pregnancy (OR: 1.74; 95% CI: 1.07–2.82). Factors associated with preterm birth in the Western Brazilian Amazon were mostly related to the aspects of health care provided to women, and thus could be prevented. Proper, timely, and regular antenatal care visits can help reduce adverse outcomes, such as hypertension and bleeding.

KEYWORDS:

• Preterm birth
• pregnancy
• prenatal care
• gestational age
• Brazilian Amazon

Acknowledgments

We are thankful to all participants and professional health workers involved in this study, to the State Health Secretariat of Acre, and to the Municipal Health Secretariat, the Primary Health Care Units, and the maternity hospital of Cruzeiro do Sul. The authors declare no conflicts of interest. Members of the MINA-Brazil Study Group: Alicia Matijasevich Manitto, Bárbara Hatzlhoffer Lourenço, Maíra Barreto Malta, Marly Augusto Cardoso, Paulo Augusto Ribeiro Neves (University of São Paulo, São Paulo, Brazil); Bruno Pereira da Silva, Rodrigo Medeiros de Souza (Federal University of Acre, Cruzeiro do Sul, Brazil); Marcia Caldas de Castro (Harvard T.H. Chan School of Public Health, Boston, USA).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Brazilian National Council for Scientific and Technological Development, Brasília, Brazil (CNPq, grant number 407.255/2013-3), and the Maria Cecilia Souto Vidigal Foundation, São Paulo, Brazil, and the São Paulo Research Foundation, FAPESP (grant number 2016/00270-6). CVRO received scholarships from the Brazilian Federal Agency for Support and Evaluation of Graduate Education, Brasília, Brazil; CAPES - Brazilian Federal Agency for Support and Evaluation of Graduate Education (CAPES, grant number PDSE - 88881.132683/2016-01). The funders had no role in the design of the study, the data collection and analyses, the interpretation of the data, the preparation and review of the manuscript, or the decision to submit it.