Prevalence and correlates of preterm labor among young parturient women attending public hospitals in Brazil / Prevalencia y factores correlativos del parto prematuro en las jóvenes parturientas que acuden a los hospitales públicos del Brasil

Objective. To determine the prevalence of and risk factors for preterm labor (< 37 weeks of gestation) among young pregnant women in Brazil. Methods. A national cross-sectional study was conducted among parturient women aged 15–24 years attending Brazilian public maternities in 2009. Questionnaires were administered by interviewers during parturient admission to the maternity clinic (or soon after delivery, if survey participants were in too much pain to respond during labor). The questionnaires collected demographic, behavioral, and clinical data. Results. A total of 2 071 (86.3%) of the 2 400 parturient women invited to participate were included in the study. Mean age was 20.2 years (standard deviation [SD]: 2.7) and mean years of formal education was 8 (SD: 2.4). Preterm labor occurred in 450 women (21.7%). The highest proportion of premature labor (36.1%) was found in the North region and the lowest proportion (6.9%) was found in the South region. In the final multivariate logistic regression model, living in the North region (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.28– 1.59); having monthly income less than twice the Brazilian minimum wage (OR: 1.27, 95% CI: 1.01–1.60); having suffered domestic violence (OR: 2.27, 95% CI: 1.23–4.18); and having had inadequate prenatal care (OR: 3.17, 95% CI: 2.54–3.97) remained significant correlates of preterm labor in this population. Conclusions. Results show a high prevalence of preterm labor among young women in Brazil. Preterm labor has multifactorial etiologies. More public health resources must be directed toward accelerating understanding of this complex process.

Objetivo. Determinar la prevalencia y los factores de riesgo de parto prematuro (menos de 37 semanas de gestación) en las jóvenes embarazadas del Brasil. Métodos. Se llevó a cabo un estudio transversal a escala nacional en jóvenes parturientas de 15 a 24 años de edad que acudieron a las maternidades públicas brasileñas en el 2009. Los entrevistadores administraron cuestionarios al ingresar la parturienta en la maternidad (o poco después de parto, si las mujeres participantes tenían demasiado dolor como para responder durante el trabajo del parto). Las participantes respondieron a un cuestionario que recopilaba datos demográficos, conductuales y clínicos. Resultados. Se incluyeron en el estudio un total de 2 071 (86,3%) parturientas de las 2 400 invitadas a participar. La media de edad fue de 20,2 años (desviación estándar [SD]: 2,7) y el promedio de años de enseñanza escolar fue de 8 (SD: 2,4). Se produjo un parto prematuro en 450 mujeres (21,7%). La proporción más alta de parto prematuro (36,1%) se observó en la región del Norte y la proporción más baja (6,9%) en la región del Sur. En el modelo final de regresión logística con variables múltiples, el vivir en la región del Norte (razón de posibilidades [OR]: 1,43; intervalo de confianza [IC] de 95%: 1,28–1,59); el tener ingresos mensuales inferiores a dos veces el salario mínimo brasileño (OR: 1,27, IC de 95%: 1,01–1,60); el haber sido víctima de violencia doméstica (OR: 2,27, IC de 95%: 1,23–4,18); y el haber recibido una atención prenatal inadecuada (OR: 3,17, IC de 95%: 2,54–3,97) seguían siendo factores correlativos significativos de parto prematuro en esta población. Conclusiones. Los resultados muestran una alta prevalencia del parto prematuro en las mujeres jóvenes del Brasil. El parto prematuro presenta una etiología multifactorial. Se deben destinar más recursos de salud pública para acelerar el conocimiento de este complejo proceso.

Prevalence and correlates of preterm labor among young parturient women attending public hospitals in Brazil.

OBJECTIVE: To determine the prevalence of and risk factors for preterm labor (< 37 weeks of gestation) among young pregnant women in Brazil. METHODS: A national cross-sectional study was conducted among parturient women aged 15-24 years attending Brazilian public maternities in 2009. Questionnaires were administered by interviewers during parturient admission to the maternity clinic (or soon after delivery, if survey participants were in too much pain to respond during labor). The questionnaires collected demographic, behavioral, and clinical data. RESULTS: A total of 2 071 (86.3%) of the 2 400 parturient women invited to participate were included in the study. Mean age was 20.2 years (standard deviation [SD]: 2.7) and mean years of formal education was 8 (SD: 2.4). Preterm labor occurred in 450 women (21.7%). The highest proportion of premature labor (36.1%) was found in the North region and the lowest proportion (6.9%) was found in the South region. In the final multivariate logistic regression model, living in the North region (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.28-1.59); having monthly income less than twice the Brazilian minimum wage (OR: 1.27, 95% CI: 1.01-1.60); having suffered domestic violence (OR: 2.27, 95% CI: 1.23-4.18); and having had inadequate prenatal care (OR: 3.17, 95% CI: 2.54-3.97) remained significant correlates of preterm labor in this population. CONCLUSIONS: Results show a high prevalence of preterm labor among young women in Brazil. Preterm labor has multifactorial etiologies. More public health resources must be directed toward accelerating understanding of this complex process.