Author | Paixao, Enny Santos da | |
Author | Bottomley, Christian | |
Author | Pescarini, Julia M | |
Author | Wong, Kerry L. M | |
Author | Cardim, Luciana L | |
Author | Silva, Rita de Cássia Ribeiro | |
Author | Brickley, Elizabeth B | |
Author | Rodrigues, Laura C | |
Author | Alves, Flavia Jôse Oliveira | |
Author | Leal, Maria do Carmo | |
Author | Costa, Maria da Conceição N | |
Author | Teixeira, Maria Gloria | |
Author | Ichihara, Maria Yury | |
Author | Smeeth, Liam | |
Author | Barreto, Mauricio Lima | |
Author | Campbell, Oona M. R. | |
Access date | 2022-02-18T15:43:42Z | |
Available date | 2022-02-18T15:43:42Z | |
Document date | 2021 | |
Citation | Paixão, Enny Santos da. et al. Associations between cesarean delivery and child mortality: a national record linkage longitudinal study of 17.8 million births in Brazil. PLoS Med, v.18, n. 10, p. 1-18, 2021. | pt_BR |
ISSN | 1549-1676 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/51294 | |
Description | Infectious Disease Department. Faculty of Epidemiology and Population Health. London School of Hygiene & Tropical Medicine. London, United Kingdom / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil. Infectious Disease Department. Faculty of Epidemiology and Population Health. London School of Hygiene & Tropical Medicine. London, United Kingdom. Infectious Disease Department. Faculty of Epidemiology and Population Health. London School of Hygiene & Tropical Medicine. London, United Kingdom / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil. Infectious Disease Department. Faculty of Epidemiology and Population Health. London School of Hygiene & Tropical Medicine. London, United Kingdom. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil /Universidade Federal da Bahia. Escola de Nutrição. Salvador, BA, Brasil. Infectious Disease Department. Faculty of Epidemiology and Population Health. London School of Hygiene & Tropical Medicine. London, United Kingdom. Infectious Disease Department. Faculty of Epidemiology and Population Health. London School of Hygiene & Tropical Medicine. London, United Kingdom / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil. Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva, Salvador, BA, Brasil. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva, Salvador, BA, Brasil. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil. Infectious Disease Department. Faculty of Epidemiology and Population Health. London School of Hygiene & Tropical Medicine. London, United Kingdom. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimento para a Saúde. Salvador, BA, Brasil. Infectious Disease Department. Faculty of Epidemiology and Population Health. London School of Hygiene & Tropical Medicine. London, United Kingdom. | pt_BR |
Sponsorship | Wellcome Trust. | pt_BR |
Language | eng | pt_BR |
Publisher | Public Library of Science | pt_BR |
Rights | open access | pt_BR |
Subject in Portuguese | Cesárea | pt_BR |
Subject in Portuguese | Mortalidade Infantil | pt_BR |
Subject in Portuguese | Parto Normal | pt_BR |
Subject in Portuguese | Indicadores (Estatística) | pt_BR |
Title | Associations between cesarean delivery and child mortality: a national record linkage longitudinal study of 17.8 million births in Brazil | pt_BR |
Type | Article | pt_BR |
DOI | doi.org/10.1371/journal.pmed.1003791 | |
Abstract | Background: There is an increasing use of cesarean delivery (CD) based on preference rather than on medical indication. However, the extent to which nonmedically indicated CD benefits or harms child survival remains unclear. Our hypothesis was that in groups with a low indication for CD, this procedure would be associated with higher child mortality and in groups with a clear medical indication CD would be associated with improved child survival chances. Methods and findings: We conducted a population-based cohort study in Brazil by linking routine data on live births between January 1, 2012 and December 31, 2018 and assessing mortality up to 5 years of age. Women with a live birth who contributed records during this period were classified into one of 10 Robson groups based on their pregnancy and delivery characteristics. We used propensity scores to match CD with vaginal deliveries (1:1) and prelabor CD with unscheduled CD (1:1) and estimated associations with child mortality using Cox regressions. A total of 17,838,115 live births were analyzed. After propensity score matching (PSM), we found that live births to women in groups with low expected frequencies of CD (Robson groups 1 to 4) had a higher death rate up to age 5 years if they were born via CD compared with vaginal deliveries (HR = 1.25, 95% CI: 1.22 to 1.28; p < 0.001). The relative rate was greatest in the neonatal period (HR = 1.39, 95% CI: 1.34 to 1.45; p < 0.001). There was no difference in mortality rate when comparing offspring born by a prelabor CD to those born by unscheduled CD. For the live births to women with a CD in a prior pregnancy (Robson group 5), the relative rates for child mortality were similar for those born by CD compared with vaginal deliveries (HR = 1.05, 95% CI: 1.00 to 1.10; p = 0.024). In contrast, for live births to women in groups with high expected rates of CD (Robson groups 6 to 10), the child mortality rate was lower for CD than for vaginal deliveries (HR = 0.90, 95% CI: 0.89 to 0.91; p < 0.001), particularly in the neonatal period (HR = 0.84, 95% CI: 0.83 to 0.85; p < 0.001). Our results should be interpreted with caution in clinical practice, since relevant clinical data on CD indication were not available. Conclusions:In this study, we observed that in Robson groups with low expected frequencies of CD, this procedure was associated with a 25% increase in child mortality. However, in groups with high expected frequencies of CD, the findings suggest that clinically indicated CD is associated with a reduction in child mortality. | pt_BR |
Affilliation | "Múltipla ver em Notas" | pt_BR |
Subject | Cesarean Section | pt_BR |
Subject | Infant mortality | pt_BR |
Subject | Natural Childbirth | pt_BR |
Subject | Indicators (Statistics) | pt_BR |
Subject in Spanish | Cesárea | pt_BR |
Subject in Spanish | Mortalidad infantil | pt_BR |
Subject in Spanish | Parto Normal | pt_BR |
Subject in Spanish | Indicadores (Estadística) | pt_BR |
Subject in French | Césarienne | pt_BR |
Subject in French | Mortalité infantile | pt_BR |
Subject in French | Accouchement naturel | pt_BR |
Subject in French | Indicateurs (Statistiques) | pt_BR |