Childbirth complications in Brazil: An analysis of socioeconomic, epidemiological, and health care factors.

OBJECTIVE

To analyze the factors associated with the occurrence of childbirth complications in Brazil.

METHODS

A cross-sectional study was conducted using data from the 2019 National Health Survey (Pesquisa Nacional de Saúde - PNS). Data from 2,875 women were analyzed. Chi-square tests and logistic regression were used to investigate the association between sociodemographic characteristics, childbirth care indicators, and the occurrence of childbirth complications (outcome).

RESULTS

The prevalence of childbirth complications was 12.3% (95%CI 10.6-14.2). Childbirth complications were more prevalent among women with lower educational attainment (14.4%) and lower income (13.9%), chronic hypertension (37.1%) or hypertension occurring only during pregnancy (29.8%), cesarean delivery (13.9%), and delivery through the Brazilian Unified Health System (Sistema Único de Saúde - SUS) (14.5%), compared with their respective reference groups (p<0.05). The multivariate logistic regression model showed significant associations between the outcome and chronic hypertension (OR=5.49; 95%CI 2.90-10.41), gestational hypertension (OR=4.18; 95%CI 2.47-7.08), absence of blood pressure measurement during prenatal visits (OR=2.16; 95%CI 1.01-4.67), delivery through SUS (OR=1.99; 95%CI 1.06-3.71), cesarean delivery without labor (OR=1.75; 95%CI 1.10-2.80), and medically indicated cesarean delivery (OR=1.90; 95%CI 1.06-3.41). Among women who experienced childbirth complications, the odds of neonatal problems were higher (OR=4.12; 95%CI 2.48-6.85), as were the odds of low birth weight (OR=2.59; 95%CI 1.58-4.23) and preterm birth (OR=2.43; 95%CI 1.60-3.68).

CONCLUSION

Clinical factors and characteristics of childbirth care were associated with the occurrence of childbirth complications in Brazil. Furthermore, women who experienced childbirth complications had higher odds of adverse neonatal outcomes.