Nascer no Amazonas: estudo epidemiológico para caracterização de partos realizados e perfil de saúde dos recém-nascidos vivos

Abstract

BACKGROUND: The interest in increasing cesarean sections stems from the "epidemic" observed in several countries, especially Brazil. In Amazonas, geographic and population diversity make analyzing cesarean rate determinants essential. Using the Live Birth Information System (SINASC), it is possible to identify the epidemiological profile of births, through birth variables and maternal characteristics. The evidence generated by this research can contribute to the improvement and enhancement of the quality of obstetric care in Amazonas, encouraging the work of multidisciplinary teams. OBJECTIVES: To characterize the health profile of live newborns and investigate the factors associated with the risk of low birth weight in the state of Amazonas, from 2016 to 2020. METHOD: This is a retrospective cohort study using secondary data from DATASUS, made available by PCDAS-Fiocruz. Live birth records were extracted from the SINASC microdatabase for the period 2016 to 2020. Variables regarding the characteristics of live births, maternal characteristics, and information on health care were selected to analyze the survival curves of total and full-term newborns according to gestation time in weeks, using the Kaplan-Meier method. Based on the research results, an e-book on aspects of maternal and neonatal health was prepared through a narrative review of the literature, including scientific articles, government documents, and documents from health associations, gathering the most recent and recommended evidence for professional health practice. RESULTS: SINASC data from 2016 to 2020 present 386,113 records of live births in Amazonas, with a predominance of males (51.21%), brown skin color (84.07%), and adequate birth weight (85.39%). The profile of maternal characteristics shows a higher proportion of postpartum women aged 20 to 36 years and with single marital status. A total of 38.11% of deliveries were by cesarean section, with the majority of newborns being full-term, occurring in the period of 37 to 41 weeks of gestation. The main risk factors associated with low birth weight identified were being a female newborn and having attended fewer than 7 prenatal consultations. Among newborns with a fifth-minute Apgar score of less than seven points, there was a higher occurrence of low birth weight. The preparation of the e-book resulted in the writing of seven chapters on the following topics: Maternal and child health policies; Nutrition in maternal and child health; Maternal health profile in Brazil and Amazonas; Health profile of live newborns in Brazil and Amazonas; Nutritional assessment of pregnant women; Nutritional care during pregnancy and breastfeeding; Importance of the nutritionist in primary care. CONCLUSION: Epidemiological surveillance, based on DATASUS data, is essential for health monitoring. This study contributes to maternal and child health research in Amazonas by highlighting regional challenges and their impacts on health indicators. To strengthen the prevention and control of complications in the mother-child binomial in the Amazon, it is essential to disseminate information about birth and associated factors through scientific dissemination materials aimed at health professionals and managers.