Aspectos do perfil social da gestação e do parto da adolescente e da mulher adulta e suas repercursões sobre o recém-nascido

Abstract

Introduction: The controversial results, pointed in literature, had propitiated this study to investigate if there were differences between the age groups of adolescents and adult mothers and which were the outcomes in the newborns.. Objectives: To compare aspects of the social profile of the gestation and the childbirth of the adolescent and of the adult women and to search if the mothers age, classified by age groups, had consequences on the newborn, as far as to the presence of anomaly, hypoxia (to apgar) in first and the fifth minute of life, gestation length and weight. Methodology: 6,302 medical records of pregnant women were analyzed, of all ages, admitted during the five year period, from 2000 to 2004, in the maternity of the Hospital of the Clinics of the Federal University of the Espírito Santo. It was used the Computer Perinatal System from the Latin American Center of Perinatology and Human Development (SIP-CLAP), created and developed byWorld Health Organization (WHO). The statistics analyses were carried through with assistance of a professional in the area and in two stages to control the confusion factors. Initially the univariate analysis was carried through and after that the multivaried one. The model of logistic regression was used in both the analyses for anomalies. The politomic regression model was used for duration of the gestation, for one and five minutes apgar and birth weight. Groups I, II and IV had been compared with group III, which served as reference Results: Of all the births, 89 (1,4%) had been of adolescents 10-14 years (Group I) and 1,462 (23,2%) had been of 15-19 years (Group II), 4,138 (65,7%) of mothers 20-34 years (Group III) and 613 (9,7%) of mothers 35 years and older (Group IV). Among 89 adolescents, age range 10 to 14 years, 74.8% declared to be mulattos; none were illiterate; 96,6% had 4 to 7 years schooling;46,1% lived with the boyfriend. Regarding prenatal care, 43.8% had 7 or more office visits; they didnt report previous live birth and 98.9% reported not having stillbirth. Regarding labor and delivery, it was observed that 57.3% of them had normal delivery and 89,9% of them were in good conditions at birth, or with Apgar of 7 the 10 in the first minute of life and 98.9% in the fifth minute; 73% were full term, 95.5% single fetus, 51.7% born with adequate weight and 100% not carrying any anomalies. Among 1,462 adolescents, age range 15 to 19 years, 76.4% declared to be mulattos, 18 (1,2%) to be illiterate; 41,7% had from 4 to 7 years of study; 61,9% lived with a boyfriend. As far as prenatal care 45,1% had 7 or more office visits; 79% reported having had a previous live birth and 99.3% reported that they didnt have previous stillbirth. Regarding labor anddelivery, it was observed that 65.6% of them had normal delivery, 88,2% were in good conditions with Apgar of 7 the 10 in the first and 97.7% in the fifth minute; 76,4% were full term, 95.8% single fetus, 47.3% born with adequate weight and 98,8% not carrying any anomalies. Conclusions: It was concluded that the main factor for the occurrence of hipoxia grave and moderated with one and five minutes of life, low birth weight,insufficient weight and prematurity was the number of consultations in the prenatal. With the increase of one medical consultation, the chance of a newborn to have low birth weight was of 54% (p<0.0001) The maternal age, being adolescent mother did not contribute for the increase of these conditions related with the newborn.