Repercussão da pandemia de Covid-19 no peso ao nascer de crianças nascidas em uma metrópole brasileira

Abstract

Objectives: To assess the birth weight of newborns born to women who gave birth during the pandemic in a Brazilian metropolis.Methods: A cross-sectional study was conducted using data collected during the first two phases of a cohort entitled "Childbirth and Breastfeeding in Children of Mothers Infected with SARS-CoV-2." Semi-structured questionnaires were used to collect data from medical records and telephone interviews. Information was gathered on clinical, gestational, sociodemographic, and lifestyle factors, including maternal age, parity, number of prenatal visits, diabetes diagnosis, gestational age at birth, birth weight, mode of delivery, COVID-19 symptoms, education level, income, marital status, self-reported skin color, nutritional counseling, dietary intake, physical activity, smoking, and alcohol consumption. The sample included 470 women, and data collection was carried out in three public maternity hospitals in a Brazilian metropolis (Belo Horizonte, MG) between May and July 2020. Descriptive analyses were performed, along with Kolmogorov-Smirnov tests, Spearman correlation, Kruskal-Wallis, Mann-Whitney, and Chi-square tests, with Bonferroni correction when necessary, as well as multinomial regression analysis. In the regression analysis, using the backward elimination method, adjustments were made for maternal age, education level, smoking, alcohol consumption, and gestational diabetes mellitus. Results: The majority of participants had completed high school (85.3%), had a partner (62.6%), and selfidentified as brown-skinned (57.2%). Cesarean delivery was performed in 29.6% of cases, and the median gestational age at birth was 39 weeks (IQR: 2). The prevalence of low birth weight and insufficient birth weight was 9.8% and 25.7%, respectively. COVID-19 symptoms during pregnancy were reported by 8% of the sample, with no association with birth weight. After adjustments, a higher likelihood of low birth weight was observed in babies born via cesarean section (OR: 7.70; 95% CI: 2.33–25.4) and in preterm newborns (OR: 70.9; 95% CI: 16.4– 305.8). Insufficient birth weight was more frequently observed in preterm newborns (OR: 5.59; 95% CI: 1.53–20.4) and babies whose mothers did not engage in physical activity during pregnancy (OR: 2.85; 95% CI: 1.38–5.89). Additionally, a lower likelihood of low birth weight was found in newborns of women with more significant gestational weight gain (OR: 0.94; 95% CI: 0.90–0.99). No association was found between birth weight categories and other variables. Conclusion: In the pandemic context, there was a high prevalence of inadequate birth weight, which was associated with prematurity, mode of delivery, lower gestational weight gain, and maternal physical inactivity. These findings highlight the need for high-quality prenatal care and the promotion of a healthy lifestyle during pregnancy, especially during public health crises, when healthcare services must be reorganized to ensure adequate support for pregnant women.