Which factors could explain the low birth weight paradox?

Revista de Saúde Pública

Antônio Augusto Moura Da Silva²  Heloisa Bettiol¹  Marco Antonio Barbieri¹  Luiz Gustavo Oliveira Brito²  Márcio Mendes Pereira²  Vânia Maria Farias De Aragão¹  Valdinar Sousa Ribeiro¹ 

[1] ,Universidade Federal do Maranhão Departamento de Saúde Pública São Luís MA ,Brasil

关键词: Infant;    Prevalence;    Risk factors;    Confounders;    Socioeconomic factors;    Maternal age;    Smoking;    Cesarean section;    Recém-nascido de baixo peso;    Prevalência;    Fatores de risco;    Fatores de confusão;    Fatores socioeconômicos;    Idade materna;    Tabagismo;    Cesárea;   

DOI  :  10.1590/S0034-89102006000500014

来源: SciELO

【 摘 要 】

OBJECTIVE: Low birth weight children are unusual among well-off families. However, in Brazil, low birth weight rate was higher in a more developed city than in a less developed one. The study objective was to find out the reasons to explain this paradox. METHODS: A study was carried out in two municipalities, Ribeirão Preto (Southeastern Brazil) and São Luís (Northeastern Brazil), which low birth weight rates were 10.7% and 7.6% respectively. Data from two birth cohorts were analyzed: 2,839 newborns in Ribeirão Preto in 1994 and 2,439 births in São Luís in 1997-1998. Multiple logistic regression analysis was performed, adjusted for confounders. RESULTS: Low birth weight risk factors in São Luís were primiparity, maternal smoking and maternal age less than 18 years. In Ribeirão Preto, the associated variables were family income between one and three minimum wages, maternal age less than 18 and equal to or more than 35 years, maternal smoking and cesarean section. In a combined model including both cohorts, Ribeirão Preto presented a 45% higher risk of low birth weight than São Luís. When adjusted for maternal smoking habit, the excess risk for low birth weight in Ribeirão Preto compared to São Luís was reduced by 49%, but the confidence interval was marginally significant. Differences in cesarean section rates between both cities contributed to partially explain the paradox. CONCLUSIONS: Maternal smoking was the most important risk factor for explaining the difference in low birth weight between both cities. The other factors contributed little to explain the difference in low birth weight rates.

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