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ObjectiveTo estimate the effect of short interdelivery interval between the first and second pregnancies in adolescence on low birth weight. ApproachA non-concurrent cohort study was carried out employing a probabilistic duplicate detection technique of the Brazilian Live Birth Information System (N=2,774,373 records). We evaluated 3,146 linked records of singleton live-born infants delivered between 1999 and 2009 in Rio de Janeiro City (Brazil), who were the second child of teenage mothers born in 1989. We estimated the association between short interdelivery interval (less than 24 months) and low birth weight (

Desfechos perinatais/infantis constituem as principais causas de morbi-mortalidade infantil em países em desenvolvimento como o Brasil. Dentre os fatores de risco, está a presença de transtornos mentais maternos. Foi realizado um estudo longitudinal retrospectivo baseado no seguimento passivo por meio do método de linkage probabilístico para verificar a prevalência de desfechos perinatais/infantis em pacientes internadas em um hospital psiquiátrico público do Rio de Janeiro, Brasil, que tiveram partos durante o período de 1999 a 2009. As prevalências encontradas foram: baixo peso ao nascer (27,6%), prematuridade (17,4%), malformações (2,5%), óbitos fetais (4,8%) e neonatais (3,7%), sendo fatores associados o cuidado pré-natal insatisfatório, a presença de esquizofrenia e a baixa renda familiar. Os resultados reforçam que a prevalência de desfechos perinatais/infantis é elevada em mães com transtornos mentais maiores, sendo fundamental o rastreamento de sintomas psiquiátricos e o acompanhamento especializado por profissionais da saúde mental durante a assistência pré e pós-parto.

Objectives The objectives were to investigate the prevalence of adverse birth outcomes according to maternal age range in the city of Rio de Janeiro, Brazil, in 2002, and to evaluate the association between maternal age range and adverse birth outcomes using additive interaction to determine whether adequate prenatal care can attenuate the harmful effect of young age on pregnancy outcomes. Methods A cross-sectional analysis was performed in women up to 24 years of age who gave birth to live children in 2002 in the city of Rio de Janeiro. To evaluate adverse outcomes, the exposure variable was maternal age range, and the outcome variables were very preterm birth, low birth weight, prematurity, and low 5-minute Apgar score. The presence of interaction was investigated with the composite variable maternal age plus prenatal care. The proportions and respective 95% confidence intervals were calculated for adequate schooling, delivery in a public maternity hospital, and adequate prenatal care, and the outcomes according to maternal age range. The chi-square test was used. The association between age range and birth outcomes was evaluated with logistic models adjusted for schooling and type of hospital for each prenatal stratum and outcome. Attributable proportion was calculated in order to measure additive interaction. Results Of the 40,111 live births in the sample, 1.9% corresponded to children of mothers from 10-14 years of age, 38% from 15-19 years, and 59.9% from 20-24 years. An association between maternal age and adverse outcomes was observed only in adolescent mothers with inadequate prenatal care, and significant additive interaction was observed between prenatal care and maternal age for all the outcomes. Conclusion Adolescent mothers and their newborns are exposed to greater risk of adverse outcomes when prenatal care fails to comply with current guidelines.

OBJECTIVES: to evaluate infant mortality in very low birth weight newborns from a public hospital in Rio de Janeiro, Brazil (2002-2006). METHODS: a retrospective cohort study was performed using the probabilistic linkage method to identify infant mortality. Mortality proportions were calculated according to birth weight intervals and period of death. The Kaplan-Meier method was used to estimate overall cumulative survival probability. The association between maternal schooling and survival of very low birth weight infants was evaluated by means of Cox proportional hazard models adjusted for: prenatal care, birth weight, and gestational age. RESULTS: the study included 782 very low birth weight newborns. Of these, (28.6%) died before one year of age. Neonatal mortality was 19.5%, and earlyneonatal mortality was 14.9%. Mortality was highest in the lowest weight group (71.6%). Newborns whose mothers had less than four years of schooling had 2.5 times higher risk of death than those whose mothers had eight years of schooling or more, even after adjusting for intermediate factors. CONCLUSIONS: the results showed higher mortality among very low birth weight infants. Low schooling was an independent predictor of infant death in this low-income population sample. OBJETIVOS: avaliar a mortalidade infantil em recém-nascidos de muito baixo peso ao nascer em um hospital público no município do Rio de Janeiro, Brasil (2002-2006). MÉTODOS: foi realizado um estudo de coorte retrospectivo utilizando o método probabilístico de linkage para identificar a mortalidade infantil. As proporções de mortalidade infantil foram calculadas de acordo com os intervalos de peso ao nascer e período de óbito. Kaplan-Meier foi utilizado para estimar a sobrevida. A associação entre escolaridade materna e sobrevida dos recém-nascidos de muito baixo peso foi avaliada por modelos de Cox ajustados para: cuidado pré-natal, peso ao nascer e idade gestacional. RESULTADOS: no estudo havia 782 recém-nascidos de muito baixo peso. Destes, 28,6% morreram antes de completar um ano. A mortalidade neonatal foi de 19,5% e a mortalidade neonatal precoce 14,9%. A mortalidade foi maior no grupo de menor peso (71,6%). Recém-nascidos de mães com menos de quatro anos de estudo tiveram risco 2,5 maior de morte em comparação com aqueles com mães com mais de oito anos de estudo, mesmo após ajuste parafatores mediadores. CONCLUSÕES: os resultados encontrados mostraram maior mortalidade entre crianças de muito baixo peso ao nascer. Baixa escolaridade foi um fator preditor independente de mortalidade infantil nesta população de baixa renda.

Adverse perinatal and infant outcomes are the leading causes of infant morbidity and mortality in developing countries like Brazil. Among the risk factors are maternal mental disorders. A retrospective longitudinal study was conducted based on passive follow-up using probabilistic record linkage to estimate the prevalence of adverse perinatal and infant outcomes in children of women admitted to a public psychiatric hospital in Rio de Janeiro, Brazil, and who gave birth from 1999 to 2009. Prevalence rates were: low birth weight (27.6%), prematurity (17.4%), malformations (2.5%), stillbirths (4.8%), and neonatal deaths (3.7%). Associated factors were deficient prenatal care, schizophrenia, and low income. The results corroborate the high prevalence of adverse perinatal and infant outcomes in mothers with major mental disorders, and that screening of psychiatric symptoms and specialized care by mental health professionals are essential throughout prenatal and postpartum care.