THE IMPORTANCE OF CONGENITAL MALFORMATIONS AT BIRTH

Autores

  • Ruy Laurenti Department of Epidemiology of the School of Public Health/USP.
  • Arnaldo Augusto Franco de Siqueira Department of Maternal and Child Health of the School of Public Health/USP.
  • M. Helena P. de Mello Jorge Department of Epidemiology of the School of Public Health/USP.
  • Sabina Lea Davidson Gotlieb Department of Epidemiology of the School of Public Health/USP.
  • Elaine Cristina Pimentel Resident in Obstetrical Nursing - School of Nursing/USP.

DOI:

https://doi.org/10.7322/jhgd.88972

Palavras-chave:

congenital malformations, live births and still births, maternal and child health.

Resumo

Introduction: Countries that have overcome high infant mortality rates show, nowadays, concentration of deaths in the neonatal period and, within it, mainly in the first week of life (early neonatal deaths). Regarding causes of death, as some diseases have started to be controlled, a significant proportional increase in the participation of congenital malformations has been verified. Objective: To describe the prevalence of congenital malformations (CM) at birth in conceptuses (stillbirths and live births) of women hospitalized in institutions located in the city of São Paulo, Brazil. Methods: Descriptive, cross-sectional study carried out at 4 hospitals in the city of São Paulo during 3 months in the 2 and semester of 2011. Data were collected by means of interviews with the women and examinations of hospital records. The CM were studied according to variables of epidemiological and socio-demographic interest. The deaths were analyzed according to underlying and associated causes. Results: The results showed the occurrence of 9.1% of CM registered among stillbirths and 4.3% among live births. Among the latter – 238 newborns – 284 CM were registered, totaling 1.2 CM per live birth with CM registered. Among the 238 newborns that had a CM register, there were 10 deaths by CM (4.2%). This value differs from the one verified among the live births without CM register that died (19 out of 5,341 or 0.4%). Aiming to identify possible  occurrences of death after hospital discharge, a linkage was performed between the official mortality database of the city of São Paulo and the study’s database. The occurrence of 18 deaths was found in this way, 4 of which were caused by CM. Thus, the total of deaths in the 1 st year of life was 47, and 14 of them had CM as the underlying cause, which leads to a proportional infant mortality by CM equal to 29.8% and an infant mortality coefficient by CM of 2.5%o live births. The data show a high undercount of CM in the registers of the official information systems (regarding SINASC, the prevalence of CM in the study was three times the prevalence for the city of São Paulo and 5.4 times the prevalence for Brazil). Conclusion: It is necessary to implement measures to improve the register of CM in the information systems, such as: raising doctors’ awareness concerning the importance of diagnosing CM and registering it in the newborn’s hospital records, creating a specific space to register the CM in the newborn’s hospital records, and qualifying and monitoring the personnel in charge of filling in the Certificate of Live Birth and transcribing it to the information systems.

Referências

Horovitz DDG, LlerenaJR JC, Mattos RA. Atenção aos defeitos congênitos no Brasil: panorama atual. Cad. Saúde Pública, Rio de Janeiro, 21(4): 1055-1064, 2005.

Amorim MMR, Vileza PC, Santos ARVD e col. Impacto das malformações congênitas na mortalidade perinatal e neonatal em uma maternidade escola do Recife. Rev. Brasil. Saúde Marterno-Infantil, V6 – Suplemento, Recife, 2006.

Ortiz LP,Camargo ABM. Mortalidade infantil no Estado em 2003. Resenha de Estatísticas Vitais do Estado de São Paulo, Fundação SEADE do Estado de São Paulo, 2004.

Paho: Pan American Health Organization Health Situation in the Americas. Basic Indicators. Washington, 2012.

Guerra FAR,Llerena JR, JC, Gama SGN e col. Defeitos Congênitos no Município do Rio de Janeiro, Brasil: uma avaliação através do SINASC (2000-2004). Cadernos de Saúde Pública, Rio de Janeiro, 24(1):140-149, 2008.

Moratilla NA, Garcia AMG, Benavides FG. El conjunto mínimo básico de dados al alta hospitalaria como fuente da información para el estudo de las anomalias congênitas. Rev. Esp. Salud Publica, 73(1); Madrid, 1999.

Mello J, MHP, GotliebSLD, Soboll MLMS e col. Avaliação do Sistema de Informações sobre nascidos vivos – SINASC – e o uso de seus dados em epidemiologia e estatísticas de saúde. Rev. Saúde Pública, São Paulo, 27(1), 1993.

Pinto CO,Nascimento LFC. Estudo da prevalência de defeitos congênitos no Vale do Paraíba Paulista. Rev. Paulista Pediatria, 25(3), 2007.

MS/SINASC: Ministério da Saúde. Sistema de Informações sobre Nascidos Vivos (disponível em: http://www2.datasus.gov.br/DATASUS/index.php?area=0205&VObj=http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sinasc/cnv/nv).

SÃO PAULO: Secretaria Municipal de Saúde, CEINFO São Paulo, 2013.

Polita NB,Ferrari RA,Moraes PS e col. Anomalias congênitas: internações em unidades pediátricas. Rev. Paulista de Pediatria, 2013: 31(2): 205-10.

OMS: Organização Mundial da Saúde. Relatório Mundial sobre Deficiência (Trad. Secretaria dos Direitos da Pessoa com Deficiência, São Paulo, 2011.

SÃO PAULO: Secretaria Municipal de Saúde. CEINFO. Manual de aperfeiçoamento no Diagnóstico de Anomalias Congênitas. São Paulo, 2012.

ECLANC: Estudo Colaborativo Latino-Americano sobre Anomalias Congênitas, disponível em: http://www.eclamc.org.

Mello J, MHP, LaurentiR,GotliebSLD, Oliveira BZ, PimentelEC. Características das gestações de adolescentes internadas em maternidades do Estado de São Paulo, 2011. Epidemiol. Serv. Saúde. Brasília. 23(1) 45-56,jan-mar 2014.

Laurenti R, Siqueira AAF, Mello J, MHP, Gotlieb SLD, Pimentel EC. Perinatal Mortality in hospitals of the state of São Paulo: methodological aspects and some characteristics of mothers and conceptuses. Journal of Human Growth and Development. 2013, 23(3):261-269.

OMS: Organização Mundial da Saúde. Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde. 10ª Revisão. Centro Brasileiro de Classificação de Doenças, São Paulo, 1996.

Organizacion Mundial de la Salud. Estatisticas Sanitarias, 2012. Geneva, 2012.

Nazer JH, Cifuentes LO, Ramirez CR. Malformações urinárias delrecién nascido. Estudo ECLAMC 1998 – 2010. Revista Chilena de Pediatria, 2011, 82 (6): 512–519.

LuquettiDV,KoifmanRJ. Quality of reporting on birth defects in birth certificados: case study from a Brazilian reference hospital. Cad. Saúde Pública, Rio de Janeiro, 25 (8): 1721–1731, ago, 2009.

Minton SD,SeegmillerRE. An improved system for reporting congenital malformation. JAMA, Dec 5, 1986 – v. 256 nº 21.

Geremias AL, Almeida MF, Flores LPO. Avaliação das declarações de nascidos vivo com fonte de informação sobre defeitos congênitos. Rev. Bras. Epidemiol., 2009; 12(1): 60–68.

Muñoz J, Bustus I, Quintero C ,Giraldo A. Factores de riesgo para algumas anomalías congénitas em población colombiana. Rev. Salud Pública, 3(3): 268 – 282, 2001.

Luquetti DV, Koifman RJ. Surveillance of birth defects: Brazil and the US. Ciência e Saude Coletiva. 16 (supl. 1) 777–785, 2011.

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Publicado

2014-12-17

Edição

v. 24 n. 3 (2014)

Seção

Pesquisa Original

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