title: Preterm births, low birth weight, and intrauterine growth restriction in three birth cohorts in Southern Brazil: 1982, 1993 and 2004.
abstract: Three birth cohort studies from 1982, 1993 and 2004, in Pelotas, Southern Brazil provided the data for this study of trends in preterm births, low birth weight, and intrauterine growth restriction. We found a slight increase in the period in the low birth weight prevalence from 9% to 10%. Intrauterine growth restriction decreased from 14.8% in 1982 to 9.4% in 1993, and subsequently increased to 12% in 2004, whereas preterm births increased markedly, from 6.3% in 1982 to 14.7% in 2004. This striking increment could not be explained by changes in maternal characteristics, as mothers in 2004 were heavier, smoked less during pregnancy and attended antenatal clinics more often and earlier than those of previous cohorts. However, pregnancy interruptions due either to caesarean sections or to inductions significantly increased. Caesareans increased from 28% in 1982 to 45% in 2004, and inductions were 2.5% in 1982 but 11.1% in 2004. The increase in preterms could be partially explained by the growing number of pregnancy interruptions, but there must be other causes since this increase was also observed among babies born by non-induced vaginal deliveries.
authors.affiliation: Programa de Pós-graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brasil. fcbarros.epi@gmail.com
authors.forename: Fernando C
authors.initials: FC
authors.lastname: Barros
authors.forename: Cesar G
authors.initials: CG
authors.lastname: Victora
authors.forename: Alicia
authors.initials: A
authors.lastname: Matijasevich
authors.forename: Iná S
authors.initials: IS
authors.lastname: Santos
authors.forename: Bernardo L
authors.initials: BL
authors.lastname: Horta
authors.forename: Mariângela F
authors.initials: MF
authors.lastname: Silveira
authors.forename: Aluísio J D
authors.initials: AJ
authors.lastname: Barros
mesh_terms: D001724:Birth Weight; D001938:Brazil / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D007182:Income; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors