Disparidades étnico/racial e parto prematuro numa cidade do interior da Bahia/Brasil

Abstract

Prematurity is the leading cause of neonatal morbidity and mortality and the second leading cause of death in children under five years in all countries of the world. Its etiology is not well known and many risk factors have been blamed for their occurrence, among them are those related to social inequality, low education, poor access to health services and the black race. There are several evidences that ethnic and racial disparities can lead to premature birth, however, in Brazil, there are few studies that seek to evaluate the association of race/skin color and the occurrence of prematurity. To analyze the incidence of prematurity and maternal racial differences is necessary so that ethnic and racial disparities can be considered when planning programs to improve health outcomes. The aim of this study is to analyze the association between race/color maternal and prematurity among pregnant women assisted in the prenatal public network, residents in Santo Antônio de Jesus - Bahia. The design of this study was through conducting a meta-analysis and cross-sectional study nested in a prospective cohort study of a random sample of pregnant women assisted in the prenatal public health network services. For the meta-analysis were analyzed 17 articles of observational epidemiological studies. The meta-analysis indicates a positive association to the risk of prematurity according to race / skin color, where the black women had a risk of 51% more premature birth, compared with non-black women (RR: 1.51; 95% CI: 1.39 to 1.65). In the cross-sectional study in a sample of 938 pregnant women, 18 to 45 years old the prevalence of preterm birth was 11.8% and the probability of prematurity was higher in black women (PR = 2.16, CI: 1.12 to 4.17) when compared with non-black women. The results highlight the variation in the prevalence of prematurity according to race / color, even after adjustment of covariates.