title: Changes in perinatal health in two birth cohorts (1997/1998 and 2010) in São Luís, Maranhão State, Brazil.
abstract: The objective of this study was to analyze changes in perinatal health in two birth cohorts started in 1997/1998 and 2010, respectively, in São Luís, Maranhão State, Brazil. A total of 2,493 live born infants were included in 1997/1998 and 5,166 in 2010. Low birth weight (LBW) rate did not change (8.5% in 1997/1998 and 8.6% in 2010). Preterm birth (PTB) rate also remained stable (13.2% in 1997/1998 and 13% in 2010). Teenage deliveries and births to single mothers decreased. Maternal schooling and prenatal care coverage increased. Intrauterine growth restriction (IUGR) decreased from 13.3% to 10.6% (p < 0.001). The perinatal mortality rate decreased from 36.6 to 20.7 per 1,000 (p < 0.001) and the infant mortality rate (IMR) dropped from 28.5 to 12.8 per 1,000 (p < 0.001). The cesarean rate increased from 34.1% to 47.5% (p < 0.001). In conclusion, despite favorable changes in socio-demographic, behavioral, and health service factors and decreasing rates of IUGR and perinatal and infant mortality, LBW and PTB remained stable, while the cesarean rate increased.
authors.affiliation: Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil.
authors.forename: Antônio Augusto Moura da
authors.initials: AA
authors.lastname: Silva
authors.affiliation: Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil.
authors.forename: Rosângela Fernandes Lucena
authors.initials: RF
authors.lastname: Batista
authors.affiliation: Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil.
authors.forename: Vanda Maria Ferreira
authors.initials: VM
authors.lastname: Simões
authors.affiliation: Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil.
authors.forename: Erika Barbara Abreu Fonseca
authors.initials: EB
authors.lastname: Thomaz
authors.affiliation: Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil.
authors.forename: Cecília Cláudia Costa
authors.initials: CC
authors.lastname: Ribeiro
authors.affiliation: Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lamy-Filho
authors.affiliation: Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil.
authors.forename: Zeni Carvalho
authors.initials: ZC
authors.lastname: Lamy
authors.affiliation: Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil.
authors.forename: Maria Teresa Seabra Soares de Britto e
authors.initials: MT
authors.lastname: Alves
authors.affiliation: Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil.
authors.forename: Flávia Helen Furtado
authors.initials: FH
authors.lastname: Loureiro
authors.affiliation: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil.
authors.forename: Viviane Cunha
authors.initials: VC
authors.lastname: Cardoso
authors.affiliation: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil.
authors.forename: Heloisa
authors.initials: H
authors.lastname: Bettiol
authors.affiliation: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil.
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Barbieri
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D009313:National Health Programs; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000401:mortality; D011256:Pregnancy Outcome; D012959:Socioeconomic Factors