Temporal and Spatial Trends of Adverse Pregnancy and Birth Outcomes in a Sample of Births from a Public Hospital in Chile.

Autor: Blanco E; Centro de Investigación en Sociedad y Salud y Núcleo Milenio de Sociomedicina, Universidad Mayor, Santiago, Chile.; Center for Climate and Resilience Research, (CR)2, Santiago, Chile., Ruiz-Rudolph P; Programa de Epidemiología, Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Avenida Independencia 939, Independencia, Santiago, Chile., Yohannessen K; Programa de Epidemiología, Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Avenida Independencia 939, Independencia, Santiago, Chile., Ayala S; PhD Program in Public Health, Facultad de Medicina, Universidad de Chile, Avenida Independencia 939, Independencia, Santiago, Chile., Quinteros ME; Departamento de Salud Pública, Facultad de Ciencias de La Salud, Universidad de Talca, Avenida Lircay S/N, Talca, Chile.; PhD Program in Public Health, Facultad de Medicina, Universidad de Chile, Avenida Independencia 939, Independencia, Santiago, Chile., Delgado-Saborit JM; Perinatal Epidemiology, Environmental Health and Clinical Research, School of Medicine, Universitat Jaume I, Avinguda de Vicent Sos Baynat, S/N, 12071, Castellón de La Plana, Castellón, Spain.; Environmental Research Group, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, Michael Uren Biomedical Engineering Hub, White City Campus, Wood Lane, London, W12 0BZ, UK.; School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK., Blazquez CA; Department of Engineering Sciences, Universidad Andres Bello, Quillota 980, Viña del Mar, Chile., Iglesias V; Programa de Epidemiología, Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Avenida Independencia 939, Independencia, Santiago, Chile., Zapata DA; PhD Program in Public Health, Facultad de Medicina, Universidad de Chile, Avenida Independencia 939, Independencia, Santiago, Chile., Bartington SE; Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK., Harrison RM; School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.; Department of Environment, Faculty of Environmental Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia., Ossa X; Departamento de Salud Pública y Centro de Excelencia CIGES, Universidad de La Frontera, Claro Solar 115, Temuco, Chile. ximena.ossa@ufrontera.cl.
Jazyk: angličtina
Zdroj: Journal of urban health : bulletin of the New York Academy of Medicine [J Urban Health] 2023 Jun; Vol. 100 (3), pp. 513-524. Date of Electronic Publication: 2023 May 22.
DOI: 10.1007/s11524-023-00733-y
Abstrakt: Understanding temporal and spatial trends in pregnancy and birth outcomes within an urban area is important for the monitoring of health indicators of a population. We conducted a retrospective cohort study of all births in the public hospital of Temuco, a medium-sized city in Southern Chile between 2009 and 2016 (n = 17,237). Information on adverse pregnancy and birth outcomes, as well as spatial and maternal characteristics (insurance type, employment, smoking, age, and overweight/obesity), was collected from medical charts. Home addresses were geocoded and assigned to neighborhood. We tested whether births and prevalence of adverse pregnancy outcomes changed over time, whether birth events were spatially clustered (Moran's I statistic), and whether neighborhood deprivation was correlated to outcomes (Spearman's rho). We observed decreases in eclampsia, hypertensive disorders of pregnancy, and small for gestational age, while gestational diabetes, preterm birth, and low birth weight increased over the study period (all p < 0.01 for trend), with little changes after adjusting for maternal characteristics. We observed neighborhood clusters for birth rate, preterm birth, and low birth weight. Neighborhood deprivation was negatively correlated with low birth weight and preterm birth, but not correlated with eclampsia, preeclampsia, hypertensive disorders of pregnancy, small for gestational age, gestational diabetes, nor stillbirth. Several encouraging downward trends and some increases in adverse pregnancy and birth outcomes, which, overall, were not explained by changes in maternal characteristics were observed. Identified clusters of higher adverse birth outcomes may be used to evaluate preventive health coverage in this setting.
(© 2023. The New York Academy of Medicine.)
Databáze: MEDLINE
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