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Maternal reproductive history: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982-2015.

ABSTRACT: BACKGROUND:Brazil experienced important progress in maternal and child health in recent decades. We aimed at describing secular trends as well as socioeconomic and ethnic inequalities in reproductive history indicators (birth spacing, previous adverse perinatal outcome, parity and multiple births) over a 33-year span. METHODS:Four population-based birth cohort studies included all hospital births in 1982, 1993, 2004 and 2015 in Pelotas, Southern Brazil. Information on reproductive history was collected through interviews. Indicators were stratified by family income quintiles and skin colour. Absolute and relative measures of inequality were calculated. RESULTS:From 1982 to 2015, the proportion of primiparae increased from 39.2% to 49.6%, and median birth interval increased by 23.2?months. Poor women were more likely to report short intervals and higher parity, although reductions were observed in all income and ethnic groups. History of previous low birthweight was inversely related to income and increased by 7.7% points (pp) over time-more rapidly in the richest (12.1 pp) than in the poorest quintile (0.4 pp). Multiple births increased from 1.7% to 2.7%, with the highest increase observed among the richest quintile and for white women (220% and 70% increase, respectively). Absolute and relative income and ethnic-related inequalities for short birth intervals increased, whereas inequalities for previous low birthweight decreased over time. CONCLUSIONS:In this 33-year period there were increases in birth intervals, multiple births and reports of previous low-birthweight infants. These trends may be explained by increased family planning coverage, assisted reproduction and a rise in preterm births, respectively. Our results show that socioeconomic and ethnic inequalities in health are dynamic and vary over time, within the same location.

SUBMITTER: Matijasevich A

PROVIDER: S-EPMC6422066 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Maternal reproductive history: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982-2015.

Matijasevich Alicia A Victora Cesar G CG Silveira Mariangela F MF Wehrmeister Fernando C FC Horta Bernardo L BL Barros Fernando C FC

International journal of epidemiology 20190401 Suppl 1

<h4>Background</h4>Brazil experienced important progress in maternal and child health in recent decades. We aimed at describing secular trends as well as socioeconomic and ethnic inequalities in reproductive history indicators (birth spacing, previous adverse perinatal outcome, parity and multiple births) over a 33-year span.<h4>Methods</h4>Four population-based birth cohort studies included all hospital births in 1982, 1993, 2004 and 2015 in Pelotas, Southern Brazil. Information on reproductive ...[more]

PMID: 30883655

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Project description:BackgroundWe aimed to investigate the association between preterm birth and body composition at 6, 18, and 30 years of age using data from three population-based birth cohort studies.MethodsGestational age (GA), defined by the date of the last menstrual period (categorized in ≤33, 34-36, and ≥ 37 weeks), was gathered in the first 24-h after delivery for all live births occurring in the city of Pelotas, Brazil, in 2004, 1993 and 1982. Body composition was assessed by air-displacement plethysmography. Outcomes included fat mass (FM, kg), percent FM (%FM), FM index (FMI, kg/m2), fat-free mass (FFM, kg); percent FFM (%FFM), FFM index (FFMI, kg/m2), body mass index (BMI, kg/m2 at 18 years in the 1993 cohort and 30 years in the 1982 cohort), and BMI Z-score (at 6 years in the 2004 cohort). We further explored the association of birth weight for GA with body composition indicators and BMI. Crude and adjusted linear regressions provided beta coefficients with 95% confidence intervals (95%CI).ResultsA total of 3036, 3027, and 3369 participants, respectively, from the 2004, 1993, and 1982 cohorts were analyzed. At 6 years, preterm boys (born at 34-36 weeks) presented lower adjusted mean of FM (β = - 0.80 kg, - 1.45;-0.16, p = 0.046), %FM (β = - 2.39%, - 3.90;-0.88, p = 0.008), FMI (β = - 0.70 kg/m2, - 1.13;-0.27, p = 0.004) as well as lower FFM (β = - 0.4 kg, - 0.77; - 0.12, p = 0.010) and FFMI (β = - 0.3 kg/m2, - 0.46;-0.10, p < 0.001), and BMI Z-score (β = - 0.69,; - 0.99;-0.40, p < 0.001); but higher %FFM (β = 2.4%, 0.87;-3.90, p = 0.008), when compared to boys born at term (≥37). At 30 years, FM (15.7 kg, 0.25;31.1, p = 0.102) was higher among males born at ≤33 weeks. No association was observed for females from the three cohorts and for 18-year-old males. The association of birth weight for GA with body composition and BMI was not significant in any cohort. At 6 years, SGA boys had lower FFMI than boys AGA.ConclusionsOur results suggest that preterm birth is associated with decreased body fat and fat-free mass in childhood but higher fat mass in adulthood. Nevertheless, results were only significant for males. SGA boys also showed lower FFMI.

Dataset Information

Maternal reproductive history: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982-2015.

Publications

Maternal reproductive history: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982-2015.

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