Perfil sociodemográfico e epidemiológico de gestantes e recém-nascidos e fatores determinantes do peso ao nascer: um estudo de usuários do SUS em Viçosa-MG / Socio-demographical and epidemiological profile of gestational women and newborn infants and determinant weight factors at birth: a SUS study in Viçosa-MG

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

This study aimed to study the profile of pregnant women and newborn infants attended by the national health system SUS in Viçosa-MG and microregion, as well as to evaluate the predicting factors of weight at birth and placental characteristics of this population. This was a cross-sectional study using 244 puerperium women, their newborn infants (NB) and respective placentas, from October 2005 to March 2006. Delivery type, sex of NB infant, anthropometric data of puerperium women and NB infant as well as placenta weight were verified. The puerperium mothers were classified according to the pre-gestational Body Mass Index as low weight, normal weight, overweight and obese, according to the Institute of Medicine IOM (1990). The NB infants were classified according to weight at birth and gestational age, according to the World Health Organization (WHO) (1995). The Röhrer Index was used to evaluate NB weight/length ratio. The placenta with the umbilical cord and membranes were weighed according to the method described by Margotto (1992), and the placenta index was calculated (placenta weight /fetus weight ratio). A mean pre-gestational Body Mass Index (BMI) of 22.05 was observed within the normality limits. However, an expressive number of gestational women with low pre-pregnancy BMI were confirmed. As for ponderal gain during the course of pregnancy, 43.8% gained weight below the recommended, which was associated with NB low weight. It was observed that the pregnant women from the rural area had 3.73 more chance to have low weight newborn infants and those with per capita income lower than 1/3 of the current minimum wage had 4.35 times more chance to give birth to low weight NB infants. The pregnant women that had less than six prenatal appointments had 7.87 times more chance of occurrence of low weight at birth and those with low weight in previous pregnancies had 4.47 times more chance to give birth to low weight NB infants during the current pregnancy. It was confirmed that 38.37% of the NB infants had weight below the adequate average. Out of these, 8.98% were low weight and the others were underweight. Low weight at birth percentage found did not differ from the national average. Although most the NB infants (61.63%) presented a favorable weight (above 3.000 g), there was a great difference in this indicator when compared to countries such as Sweden, where 88.88% of the NB infants presented favorable weight according to Puffer and Serrano (1988). No abnormality was confirmed for the other anthropometrical data. As for the Rohrer index, 86.5% of the NB infants were within the normalcy range. Such normalcy was also confirmed when placenta weight and placenta index were analyzed. In the case of gestational age, the majority was of term and in the case of the preterm births, all were low weight. It was observed that 14% of the NB infants were small for gestational age or SGA (34 NB infants); 5.4% were big for gestational age or BGA (13 NB infants) and 80.6% were adequate for gestational age or AGA (195 NB infants). Thus, it was confirmed that a significant proportion of SGA NB infants suffered restriction in their intrauterine growth, with a slight predominance of the SGA group over the preterm group in the category low weight at birth. Factors such as height and pre-gestational weight were only associated with the SGA group and not with the preterm group, as expected, since nutritional factors are more associated with uterine growth restriction than with pregnancy duration. Associations with lower maternal ponderal gain, shorter maternal height, lower pre-pregnancy weight, fewer prenatal appointments, lower Rohrer indices and lower placenta weights were observed in the SGA group. It can be inferred that the association between lower placenta weight and SGA occurrence is true, since no shorter pregnancy duration occurred as confusion factor as in the preterm infants case, what may indicate loss of placenta function in this group. It was concluded that the factors associated with low weight at birth in Viçosa-MG were ponderal gain below the recommended during pregnancy, fewer prenatal appointments, shorter pregnancy duration, lower placenta weight, lower per capita income, low schooling, and lower Rohrer and placenta indices.

ASSUNTO(S)

risk factors fatores de risco newborn peso ao nascer recém-nascido birth weight analise nutricional de populacao

ACESSO AO ARTIGO

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