Prevalence, mortality and risk factors associated with very low birth weight preterm infants: an analysis of 33 years

Julia Damiani Victora , Mariangela Freitas Silveira , Cristian Tedesco Tonial , Cesar Gomes Victora , Fernando Celso Barros , Bernardo Lessa Horta , Iná Silva dos Santos , Diego Garcia Bassani , Pedro Celiny R. Garcia , Marola Scheeren , Humberto H. Fiori , Pelotas Cohorts Study Group, Alicia Matijasevich, Aluísio J.D. Barros, Andréa Damaso Bertoldi, Fernando C. Wehrmeister, Helen Gonçalves, Joseph Murray, Luciana Tovo Rodrigues, Maria Cecília Assumpção, Pedro Rodrigues Curi Hallal
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Abstract

Objective

To assess the prevalence, mortality and risk factors associated with the birth of very low birth weight preterm infants over a period of 33 years.

Methods

Four cross‐sectional studies were analyzed, using data from perinatal interviews of birth cohorts in the city of Pelotas collected in 1982, 1993, 2004, and 2015. Based on perinatal questionnaires, anthropometric measurements of newborns and death certificates were analyzed to obtain the prevalence rate, neonatal mortality, and risk factors (maternal age, income and type of delivery) for very low birth weight.

Results

A total of 19,625 newborns were included in the study. In the years 1982, 1993, 2004, and 2015, there were, respectively, 5909, 5232, 4226, and 4258 births. The prevalence of very low birth weight was, respectively, 1.1% (n = 64), 0.9% (n = 46), 1.4% (n = 61), and 1.3% (n = 54). There was no statistical evidence of an increasing trend over time (p = 0.11). Among the risk factors, family income in the three poorest quintiles was associated with prevalence rates that were approximately twice as high as in the richest quintile (p = 0.003). Mortality per 1000 live births for neonates weighing <1500 g decreased from 688 to 259 per thousand from 1982 to 2015 (p < 0.001), but still represented 61% of neonatal deaths in the latter year.

Conclusion

Although mortality in very low birth weight decreased by more than 60% in recent years, this group still contributes with more than half of neonatal deaths. Low family income remains an important risk factor in this scenario.

极低出生体重早产儿的患病率、死亡率和相关危险因素:33年的分析
目的评价33年来极低出生体重早产儿的患病率、死亡率及相关危险因素。方法采用1982年、1993年、2004年和2015年收集的佩洛塔斯市出生队列围产期访谈数据,对四项横断面研究进行分析。根据围产期问卷,对新生儿的人体测量值和死亡证明进行分析,以获得极低出生体重的患病率、新生儿死亡率和危险因素(产妇年龄、收入和分娩类型)。结果共19625例新生儿纳入研究。1982年、1993年、2004年和2015年的出生人数分别为5909人、5232人、4226人和4258人。极低出生体重的患病率分别为1.1% (n = 64)、0.9% (n = 46)、1.4% (n = 61)和1.3% (n = 54)。随着时间的推移,没有统计学上的增加趋势(p = 0.11)。在风险因素中,三个最贫穷五分之一的家庭收入与患病率相关,患病率大约是最富裕五分之一的两倍(p = 0.003)。1982年至2015年,体重1500克的新生儿死亡率从688‰降至259‰(p <0.001),但仍占后一年新生儿死亡的61%。结论虽然近年来极低出生体重儿死亡率下降了60%以上,但仍占新生儿死亡的一半以上。在这种情况下,家庭收入低仍然是一个重要的风险因素。
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