摘要：OBJECTIVE: To examine whether the low birth weight (LBW) paradox existsin Brazil.METHODS: LBW and cesarean section rates between 1995 and 2007 wereestimated based on data from SINASC (Brazilian Live Births Database). Infantmortality rates (IMRs) were obtained using an indirect method that correct forunderreporting. Schooling information was obtained from census data. Trendsin LBW rate were assessed using joinpoint regression models. The correlationsbetween LBW rate and other indicators were graphically assessed by lowessregression and tested using Spearman’s rank correlation.RESULTS: In Brazil, LBW rate trends were non-linear and non-signifi cant: therate dropped from 7.9% in 1995 to 7.7% in 2000, then increased to 8.2% in2003 and remained nearly steady thereafter at 8.2% in 2007. However, trendsvaried among Brazilian regions: there were signifi cant increases in the Northfrom 1999 to 2003 (2.7% per year), and in the South (1.0% per year) andCentral-West regions (0.6% per year) from 1995 to 2007. For the entire periodstudied, higher LBW and lower IMRs were seen in more developed comparedto less developed regions. In Brazilian States, in 2005, the higher the IMRrate, the lower the LBW rate (p=0.009); the lower the low schooling rate, thelower the LBW rate (p=0.007); the higher the number of neonatal intensivecare beds per 1,000 live births, the higher the LBW rate (p=0.036).CONCLUSIONS: The low birth weight paradox was seen in Brazil. LBWrate is increasing in some Brazilian regions. Regional differences in LBWrate seem to be more associated to availability of perinatal care services thanunderlying social conditions.
其他摘要：OBJECTIVE: To examine whether the low birth weight (LBW) paradox existsin Brazil.METHODS: LBW and cesarean section rates between 1995 and 2007 wereestimated based on data from SINASC (Brazilian Live Births Database). Infantmortality rates (IMRs) were obtained using an indirect method that correct forunderreporting. Schooling information was obtained from census data. Trendsin LBW rate were assessed using joinpoint regression models. The correlationsbetween LBW rate and other indicators were graphically assessed by lowessregression and tested using Spearman’s rank correlation.RESULTS: In Brazil, LBW rate trends were non-linear and non-signifi cant: therate dropped from 7.9% in 1995 to 7.7% in 2000, then increased to 8.2% in2003 and remained nearly steady thereafter at 8.2% in 2007. However, trendsvaried among Brazilian regions: there were signifi cant increases in the Northfrom 1999 to 2003 (2.7% per year), and in the South (1.0% per year) andCentral-West regions (0.6% per year) from 1995 to 2007. For the entire periodstudied, higher LBW and lower IMRs were seen in more developed comparedto less developed regions. In Brazilian States, in 2005, the higher the IMRrate, the lower the LBW rate (p=0.009); the lower the low schooling rate, thelower the LBW rate (p=0.007); the higher the number of neonatal intensivecare beds per 1,000 live births, the higher the LBW rate (p=0.036).CONCLUSIONS: The low birth weight paradox was seen in Brazil. LBWrate is increasing in some Brazilian regions. Regional differences in LBWrate seem to be more associated to availability of perinatal care services thanunderlying social conditions.
