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The epidemiologic paradox of low birth weight in Brazil.
MedLine Citation:
PMID:  20835496     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To examine whether the low birth weight (LBW) paradox exists in Brazil.
METHODS: LBW and cesarean section rates between 1995 and 2007 were estimated based on data from SINASC (Brazilian Live Births Database). Infant mortality rates (IMRs) were obtained using an indirect method that correct for underreporting. Schooling information was obtained from census data. Trends in LBW rate were assessed using joinpoint regression models. The correlations between LBW rate and other indicators were graphically assessed by lowess regression and tested using Spearman's rank correlation.
RESULTS: In Brazil, LBW rate trends were non-linear and non-significant: the rate dropped from 7.9% in 1995 to 7.7% in 2000, then increased to 8.2% in 2003 and remained nearly steady thereafter at 8.2% in 2007. However, trends varied among Brazilian regions: there were significant increases in the North from 1999 to 2003 (2.7% per year), and in the South (1.0% per year) and Central-West regions (0.6% per year) from 1995 to 2007. For the entire period studied, higher LBW and lower IMRs were seen in more developed compared to less developed regions. In Brazilian States, in 2005, the higher the IMR rate, the lower the LBW rate (p=0.009); the lower the low schooling rate, the lower the LBW rate (p=0.007); the higher the number of neonatal intensive care beds per 1,000 live births, the higher the LBW rate (p=0.036).
CONCLUSIONS: The low birth weight paradox was seen in Brazil. LBW rate is increasing in some Brazilian regions. Regional differences in LBW rate seem to be more associated to availability of perinatal care services than underlying social conditions.
Authors:
Antônio Augusto Moura da Silva; Leopoldo Muniz da Silva; Marco Antonio Barbieri; Heloísa Bettiol; Luciana Mendes de Carvalho; Valdinar Sousa Ribeiro; Marcelo Zubaran Goldani
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-08
Journal Detail:
Title:  Revista de saúde pública     Volume:  44     ISSN:  1518-8787     ISO Abbreviation:  Rev Saude Publica     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0135043     Medline TA:  Rev Saude Publica     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  767-75     Citation Subset:  IM    
Affiliation:
Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil. aasilva@elo.com.br
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