JOURNAL ARTICLE
OBSERVATIONAL STUDY
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Frequency and risk factors for the birth of small-for-gestational-age newborns in a public maternity hospital.

Einstein 2016 July
OBJECTIVE:: To determine the frequency and risk factors of small-for-gestational-age newborns in a high-risk maternity.

METHODS:: This is an observational, cross-sectional, and case-control study, conducted in a public tertiary care maternity hospital. Data from 998 newborns and their mothers were collected through interviews and review of medical records and prenatal care cards. Some placentas underwent histopathological analysis. The variables of small-for-gestational-age and non-small-for-gestational-age newborns and of their mothers were statistically compared by means of Student's t test, Fisher's exact test, and odds ratio. The significance level used was 0.050.

RESULTS:: There was a 17.9% frequency of small-for-gestational-age newborns. The statistically significant factors associated with the birth of these babies were female sex (p=0.012); positive history of another small-for-gestational-age child (p=0.006); inadequate prenatal care (p=0.019); smoking (p=0.003); hypertensive disorders of pregnancy (p=0.007); placental bleeding (p=0.009) and infarction (p=0.001).

CONCLUSION:: In the population studied, the frequency of small-for-gestational-age newborns was high and associated with sex, inappropriate prenatal care, presence of maternal diseases and addictions, and placental abnormalities.

OBJETIVO:: Determinar a frequência e os fatores de risco de recém-nascidos pequenos para idade gestacional em uma maternidade de alto risco.

MÉTODOS:: Trata-se de um estudo observacional, transversal e caso-controle, realizado em maternidade pública de nível terciário. Foram levantados dados de 998 recém-nascidos e de suas respectivas mães por meio de entrevista e análise de prontuários e de cartões do pré-natal. Algumas placentas foram submetidas à análise anatomopatológica. As variáveis dos recém-nascidos pequenos e não pequenos para idade gestacional e de suas respectivas mães foram comparadas estatisticamente pelo teste paramétrico t de Student, pelo teste exato de Fisher e por odds ratio. O nível de significância adotado foi de 0,050.

RESULTADOS:: A frequência de recém-nascidos pequenos para idade gestacional foi de 17,9%. Os fatores com significado estatístico associados ao nascimento desses bebês foram sexo feminino (p=0,012); história positiva para filho anterior pequeno para idade gestacional (p=0,006); realização de pré-natal inadequado (p=0,019); tabagismo (p=0,003); doença hipertensiva específica da gestação (p=0,007); hemorragia (p=0,009) e infarto (p=0,001) placentários.

CONCLUSÃO:: Na população estudada, a frequência de recém-nascidos pequenos para idade gestacional foi elevada e relacionada ao sexo, à inadequação do pré-natal, à presença de doenças e vícios maternos e às alterações placentárias.

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