The impact of the type of hospital and delivery on the gestational age in São Paulo city, 2013-2014

Priscila Ribeiro Raspantini Marina Jorge de Miranda Zilda Pereira da Silva Gizelton Pereira Alencar Simone Grilo Diniz Marcia Furquim de Almeida About the authors

ABSTRACT:

Introduction:

There was a left-shift on the distribution curve of gestational age (GA) and a reduction of the proportion of live births of 40 weeks, when compared to the expected standard in many countries.

Objective:

To study the distribution of gestational age births in São Paulo city (SP) and its relationship with the type of hospital and delivery.

Methods:

Data were extracted from Live Birth Information System (SINASC) linked to the National Database of Health Establishments (CNES) in 2013 and 2014. Data are presented according to birth in public (SUS) and private (non SUS) hospitals, type of delivery and gestational age, standardized according to the mother’s age.

Results:

There was a left-shift in GA curve for total births which was more pronounced among cesarean births and private hospitals. The median GA of public hospitals was 39 weeks, while in the private hospitals, 38 weeks. The proportion of preterm births (9,5%) was similar in public and private hospitals, but among public hospital there was a higher proportion of very preterm births (<32 weeks), while (34-36) in private hospitals late preterm and early term were more frequent.

Conclusions:

The change in the distribution of gestational age in SP is related to the type of hospital and the proportion of cesarean sections in private hospitals.

Keywords:
Live births; Gestational age; Cesarean section; Infant, premature; Hospitals, private; Hospitals, public

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