Cumulative prevalence of biological and social risk factors at birth in a city in São Paulo

da Cruz, Aline Adryane Morishigue Bássiga; dos Santos, Lucas Cardoso; Minharro, Michelle Cristine de Oliveira; Aguiar Alencar, Rúbia

doi:10.1590/1980-220X-REEUSP-2021-0328

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 56 • 2022 • https://doi.org/10.1590/1980-220X-REEUSP-2021-0328 copy

Cumulative prevalence of biological and social risk factors at birth in a city in São Paulo

Prevalencia acumulada de factores de riesgo biológicos y sociales al nacer en una ciudad de São Paulo

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to identify the cumulative prevalence of biological and social risk factors at birth.

Method:

a cross-sectional study, with retrospective data collection, carried out with live births in a medium-sized city, from January 2018 to July 2020. A database was used with information aimed at identifying social and biological risks after birth, assessed descriptively.

Results:

the sample consisted of 4,480 newborns, of which 78.9% were classified as at usual risk, and 21.1% as at risk. The cumulative prevalence showed that most newborns had more than one risk factor, with biological risks being the most prominent: need for admission to Intensive Care Unit, birth with less than 37 weeks of gestation and weight less than 2,500 g. Among the social risks, the following stand out: newborns who had a dead sibling aged less than 5 years old; head of family without income; mothers under 16 years old and who did not undergo prenatal care. The biological risk rate was 7.39 times higher than the social risk rate.

Conclusion:

the cumulative prevalence of the risks found was significant, with a considerable part of the sample presenting some biological risk.

DESCRIPTORS
Primary Health Care; Infant, Postmature; Risk Factors

		n	%
Variables	Risk stratification
	Usual risk	3533	78.9
	At-risk newborn	947	21.1
	Compulsory notification disease
	No	4440	99.1
	Without the description of the reported disease	13	0.3
	Syphilis	19	0.4
	HIV	1	0.0
	HIV under investigation	1	0.0
	Toxoplasmosis	4	0.1
	Syphilis and Hepatitis C	1	0.0
	Gonorrhea and HPV	1	0.0
Biological risks	Death at birth
	No	4478	99.9
	Yes	2	0.044
	Weight < 2,500 g
	No	4089	91.3
	Yes	391	8.7
	Gestational age < 37 weeks
	No	4035	90.1
	Yes	445	9.9
	Major or multiple congenital malformation/genetic disease
	No	4427	98.8
	Yes	53	1.2
	Intensive Care Unit Admission
	No	3989	89.0
	Yes	491	11.0
	5-minute Apgar less than 7
	No	4431	98.9
	Yes	49	1.1
Social risks	Brother killed < 5 years
	No	4411	98.5
	Yes	69	1.5
	Maternal age under 16 years
	No	4449	99.3
	Yes	31	0.7
	Mother unable to care for child
	No	4470	99.8
	Yes	10	0.2
	Illiterate mother
	No	4477	99.9
	Yes	3	0.1
	Mother without a partner and without family support
	No	4464	99.6
	Yes	16	0.4
	No prenatal care follow-up
	No	4453	99.4
	Yes	27	0.6
	Head of family without income
	No	4417	98.6
	Yes	63	1.4

Health units	Total n° of NB	N° of NB–usual risk	N° of RNB	Cumulative risk*	Number of risks
Health units	Total n° of NB	N° of NB–usual risk	N° of RNB	Cumulative risk*	Biological risk mean ± SD (min–max)	Social risk mean ± SD (min–max)
1	338	277	61	100	0.26 ± 0.64 (0–4)	0.03 ± 0.19 (0–2)
2	417	337	80	130	0.27 ± 0.69 (0–4)	0.04 ± 0.19 (0–1)
3	1	0	1	1	1 ± (1–1)	0 ± (0–0)
4	406	317	89	145	0.29 ± 072 (0–4)	0.06 ± 0.24 (0–1)
5	240	188	52	98	0.35 ± 0.80 (0–4)	0.05 ± 0.29 (0–3)
6	197	162	35	68	0.28 ± 0.66 (0–3)	0.07 ± 0.52 (0–7)
7	207	162	45	91	0.39 ± 0.86 (0–5)	0.05 ± 0.21 (0–1)
8	97	71	26	40	0.46 ± 1.00 (0–4)	0.05 ± 0.22 (0–1)
9	16	15	1	1	0.06 ± 025 (0–1)	0.00 ± 0.00 (0–0)
10	215	175	40	78	0.34 ± 0.81 (0–4)	0.02 ± 0.15 (0–1)
11	144	109	35	64	0.34 ± 0.76 (0–4)	0.10 ± 0.62 (0–7)
12	238	186	52	84	0.32 ± 0.69 (0–3)	0.04 ± 0.22 (0–2)
13	378	284	94	144	0.32 ± 071 (0–4)	0.06 ± 027 (0–3)
14	101	79	22	43	0.37 ± 0.79 (0–3)	0.06 ± 0.23 (0–1)
15	217	164	53	95	0.41 ± 0.82 (0–3)	0.03 ± 016 (0–1)
16	285	230	55	91	0.27 ± 068 (0–4)	0.05 ± 0.23 (0–2)
17	256	199	57	93	0.32 ± 070 (0–5)	0.05 ± 0.21 (0–1)
18	156	124	32	62	0.36 ± 081 (0–4)	0.04 ± 019 (0–1)
19	150	143	27	49	0.28 ± 0.68 (0–3)	0.05 ± 0.24 (0–2)
20	309	250	59	111	0.31 ± 073 (0–4)	0.05 ± 0.22 (0–2)
21	112	81	31	49	0.38 ± 0.77 (0–3)	0.05 ± 0.22 (0–1)
City	4.480	3533	947	1637	0.32 ± 0.74 (0–5)	0.05 ± 0.26 (0–7)

Health units	Biological risk rate	Social risk rate	General risk rate	Rate ratio
1	0.263	0.033	0.296	7.97
2	0.273	0.038	0.312	7.18
3	1.000	0.000	1.000	–
4	0.293	0.064	0.357	4.58
5	0.354	0.054	0.408	6.56
6	0.279	0.066	0.345	4.23
7	0.391	0.048	0.440	8.15
8	0.464	0.052	0.515	8.92
9	0.063	0.000	0.063	–
10	0.340	0.023	0.363	14.78
11	0.340	0.104	0.444	3.27
12	0.315	0.042	0.357	7.50
13	0.320	0.061	0.381	5.25
14	0.366	0.059	0.426	6.20
15	0.410	0.028	0.438	14.64
16	0.267	0.053	0.319	5.04
17	0.316	0.047	0.363	6.72
18	0.359	0.038	0.397	9.45
19	0.280	0.047	0.327	5.96
20	0.314	0.045	0.359	6.98
21	0.384	0.054	0.438	7.11
City	0.351	0.045	0.397	7.39

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Aline Adryane Morishigue Bássiga da Cruz Rua Izidoro Bertáglia, 1955 Ap. 01, Jardim Paraíso II 18610-140 – Botucatu, SP, Brazil aline.morishigue@gmail.com