Social Inequalities in Child Development: Analysis of Low-Birth-Weight Trends in Brazil, 2010–2020

Audêncio Victor, Italo Wesley Oliveira Aguiar, Renzo Flores-Ortiz, Manuel Mahoche, Ana Raquel Manuel Gotine, Ila Falcão, Melsequisete Daniel Vasco, Andrêa Ferreira, Sancho Pedro Xavier, Mark Omenka, José Leopoldo Ferreira Antunes, Patrícia H. Rondo
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Abstract

Introduction

Low birth weight (LBW) is a global issue prevalent in low-income countries. Economic assessments of interventions to reduce this burden are crucial to guide health policies. However, there is a relative scarcity of research that illustrates the magnitude of LBW by country and region to support the design of public policies.

Objective

This study aimed to analyze the temporal trend of fetal growth in newborns in Brazil between 2010 and 2020.

Methods

A time series study was conducted using data from the Live Births Information System (SINASC), which is managed by the Department of Information and Informatics of the Unified Health System (DATASUS) of the Brazilian Ministry of Health. The Prais-Winsten linear model was applied to analyze the annual proportions of LBW. The annual percentage changes (APC) and their respective 95% confidence intervals (95%CI) were calculated. Prevalence rate averages of LBW were calculated and displayed on thematic maps to visualize the evolution dynamics in each Federation Unit (FU).

Results

A total of 31,887,329 women from all Federative Units of Brazil were included in the study from 2010 to 2020. The Southeast region had the largest proportion of participants, with records from 2015 accounting for 9.5% of the total. Among the women in the study, 49.6% were between the ages of 20 and 29, and the majority (75.5%) had between 8 and 12 years of schooling. The newborns of these women were predominantly male (58.8%) and non-white (59.5%). The study found that there was a trend towards stabilization of increasing proportions of LBW in the North, Northeast, and Centre-West regions between 2010 and 2020. In Brazil and other regions, these tendencies remained stable.

Conclusion

To improve living conditions and reduce social inequalities and health inequities, public policies and actions are necessary. Strengthening the Unified Health System (SUS), income transfer programs, quota policies for vulnerable groups, and gender equality measures such as improving access to education for women and the labor sector are among the suggested approaches.

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儿童发展中的社会不平等:2010-2020 年巴西低出生体重趋势分析
导言出生体重不足(LBW)是低收入国家普遍存在的一个全球性问题。对减少这一负担的干预措施进行经济评估对于指导卫生政策至关重要。本研究旨在分析 2010 年至 2020 年间巴西新生儿胎儿发育的时间趋势。研究方法:采用巴西卫生部统一卫生系统信息和信息学司(DATASUS)管理的活产信息系统(SINASC)的数据进行时间序列研究。普拉伊斯-温斯顿线性模型用于分析每年的低体重儿比例。计算了年度百分比变化(APC)及其各自的 95% 置信区间(95%CI)。研究还计算了膀胱癌发病率的平均值,并将其显示在专题地图上,以直观显示每个联邦单位(FU)的演变动态。东南部地区的参与者比例最高,2015 年的记录占总数的 9.5%。在参与研究的妇女中,49.6%的人年龄在20至29岁之间,大多数(75.5%)的受教育年限在8至12年之间。这些妇女的新生儿主要是男性(58.8%)和非白人(59.5%)。研究发现,2010 年至 2020 年间,北部、东北部和中西部地区的低体重儿比例呈稳定上升趋势。结论为了改善生活条件,减少社会不平等和健康不公平,有必要采取公共政策和行动。加强统一卫生系统(SUS)、收入转移计划、针对弱势群体的配额政策以及性别平等措施(如改善妇女和劳动部门的受教育机会)都是建议采取的方法。
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