Temporal trends and factors associated with live preterm births in Espírito Santo, 2012-2021.

OBJECTIVE

To analyze the temporal trend of live premature births in the State of Espírito Santo (Brazil) between 2012 and 2022 and to identify associated factors.

METHODS

Ecological study using secondary data from the Live Birth Information System (SINASC), covering premature births in Espírito Santo between 2012 and 2022. Prais-Winsten regression was used to assess the temporal trend of the prematurity rate, and the Prevalence Ratio (PR) was used to identify factors associated with premature birth.

RESULTS

A higher prevalence of premature birth was observed among boys (PR=1.06) with weight <2,500 g, Apgar score at one and five minutes <7 (PR=3.10 and PR=4.05), and with the presence of congenital anomalies (PR=2.74). Among maternal factors, higher prevalences were found among mothers with no schooling (PR=1.51), without a partner (PR=1.11), aged <19 years or >35 years (PR 1.14; PR 1.32), who did not have prenatal care (PR=2.32), twin pregnancy (PR=6.21) and cesarean delivery (PR=1.05). In all analyses, statistical significance was p<0.001. Regarding the temporal trend analysis, Barra de São Francisco, Santa Teresa, and Vitória showed an increasing prematurity rate (2012-2022). Alegre, Cachoeiro de Itapemirim, and Itapemirim showed decreasing rates. Espírito Santo showed a stationary rate.

CONCLUSION

Espírito Santo has a stationary prematurity rate, with some microregions showing increasing or decreasing rates, indicating territorial heterogeneity and regional inequalities in access to health. Maternal and gestational socioeconomic risk factors stand out as indicators of a higher prevalence of prematurity.