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Impact of socioeconomic factors and health determinants on preterm birth in Brazil: a register-based study.

Publication ,  Journal Article
de Andrade, L; Kozhumam, AS; Rocha, TAH; de Almeida, DG; da Silva, NC; de Souza Queiroz, RC; Massago, M; Rent, S; Facchini, LA; da Silva, AAM ...
Published in: BMC Pregnancy Childbirth
November 24, 2022

BACKGROUND: More than 15 million children are born preterm annually. While preterm survival rates have increased in high-income countries. Low- and middle-income countries, like Brazil, continue to battle high neonatal mortality rates due to a lack of adequate postnatal care. Globally, neonatal mortality is higher for preterm infants compared to those born at term. Our study aims to map and analyze the spatial, socioeconomic, and health coverage determinants related to preterm birth in Brazil in order to understand how spatial variations in demographics and access to primary care may affect preterm birth occurrences.  METHODS: Using publicly available national-level data from the Brazilian health system for 2008-2017, we conducted an ecological study to visualize the spatial distributions of preterm birth along with socioeconomic status, the structure of health services, and primary care work process, each consisting of multiple variables reduced via principal component analysis. Regression models were created to determine predictive effects of numeric and spatial variation of these scores on preterm birth rates. RESULTS: In Brazil, preterm birth rates increased from 2008-2017, with small and rural municipalities frequently exhibiting higher rates than urban areas. Scores in socioeconomic status and work process were significant predictors of preterm birth rates, without taking into account spatial adjustment, with more positive scores in socioeconomic status predicting higher preterm birth rates (coefficient 0.001145) and higher scores in work process predicting lower preterm birth rates (coefficient -0.002416). Geographically weighted regression showed socioeconomic status to be a more significant predictor in the North, with the work process indicators being most significant in the Northeast. CONCLUSIONS: Results support that primary care work process indicators are more significant in estimating preterm birth rates than physical structures available for care. These results emphasize the importance of ensuring the presence of the minimum human resources needed, especially in the most deprived areas of Brazil. The association between social determinants of health and preterm birth rates raises questions regarding the importance of policies dedicated to foster equity in the accessibility of healthcare services, and improve income as protective proxies for preterm birth.

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Published In

BMC Pregnancy Childbirth

DOI

EISSN

1471-2393

Publication Date

November 24, 2022

Volume

22

Issue

1

Start / End Page

872

Location

England

Related Subject Headings

  • Socioeconomic Factors
  • Premature Birth
  • Obstetrics & Reproductive Medicine
  • Infant, Premature
  • Infant, Newborn
  • Infant Mortality
  • Infant
  • Humans
  • Female
  • Child
 

Citation

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de Andrade, L., Kozhumam, A. S., Rocha, T. A. H., de Almeida, D. G., da Silva, N. C., de Souza Queiroz, R. C., … Thomaz, E. B. A. F. (2022). Impact of socioeconomic factors and health determinants on preterm birth in Brazil: a register-based study. BMC Pregnancy Childbirth, 22(1), 872. https://doi.org/10.1186/s12884-022-05201-0
Andrade, Luciano de, Arthi S. Kozhumam, Thiago Augusto Hernandes Rocha, Dante Grapiuna de Almeida, Núbia Cristina da Silva, Rejane Christine de Souza Queiroz, Miyoko Massago, et al. “Impact of socioeconomic factors and health determinants on preterm birth in Brazil: a register-based study.BMC Pregnancy Childbirth 22, no. 1 (November 24, 2022): 872. https://doi.org/10.1186/s12884-022-05201-0.
de Andrade L, Kozhumam AS, Rocha TAH, de Almeida DG, da Silva NC, de Souza Queiroz RC, et al. Impact of socioeconomic factors and health determinants on preterm birth in Brazil: a register-based study. BMC Pregnancy Childbirth. 2022 Nov 24;22(1):872.
de Andrade, Luciano, et al. “Impact of socioeconomic factors and health determinants on preterm birth in Brazil: a register-based study.BMC Pregnancy Childbirth, vol. 22, no. 1, Nov. 2022, p. 872. Pubmed, doi:10.1186/s12884-022-05201-0.
de Andrade L, Kozhumam AS, Rocha TAH, de Almeida DG, da Silva NC, de Souza Queiroz RC, Massago M, Rent S, Facchini LA, da Silva AAM, Staton CA, Vissoci JRN, Thomaz EBAF. Impact of socioeconomic factors and health determinants on preterm birth in Brazil: a register-based study. BMC Pregnancy Childbirth. 2022 Nov 24;22(1):872.
Journal cover image

Published In

BMC Pregnancy Childbirth

DOI

EISSN

1471-2393

Publication Date

November 24, 2022

Volume

22

Issue

1

Start / End Page

872

Location

England

Related Subject Headings

  • Socioeconomic Factors
  • Premature Birth
  • Obstetrics & Reproductive Medicine
  • Infant, Premature
  • Infant, Newborn
  • Infant Mortality
  • Infant
  • Humans
  • Female
  • Child