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Rollins College

Publication Date

Fall 12-1-2014

Program Name

Chile: Public Health, Traditional Medicine, and Community Empowerment

Abstract

Research Question: What are the major socio-demographic risk factors influencing the rate of preterm birth in Valparaiso, Chile? Objectives: The objective of this study is to identify risk factors that influence the rate of preterm birth in an urban population of women living in Valparaiso, Chile. This study aims to understand whether a relationship exists between socio-demographic characteristics, such as economic level, education, lifestyle, access to medical attention and resources and the risk of prematurity. The outcomes of this study seek to determine the major biological, cultural, and social relationships and identify at-risk social groups. Additionally, this study considers the access and efficacy of governmental health programs available for pregnant women. Background: Preterm birth is defined as a birth that takes place at less than 37 weeks of gestational age. The rate of prematurity is considered to be a principal indicator of health due to its relationship to prenatal care, infant mortality, and maternal mortality. Throughout the world, approximately 15 million babies are born prematurely each year and face not only the highest risk of infant mortality, but also chronic diseases and physical and mental disabilities. Although this problem is prevalent worldwide, direct causes of preterm birth remain relatively unknown. In comparison to other countries, Chile has achieved a fairly low rate of preterm births (7%), but has experienced a slightly increased rate within some regions. Methods: Questionnaires were distributed to ten women who had a preterm birth and were patients of a Family Health Center in the region of Playa Ancha in Valparaiso, Chile. The questionnaires consisted of open and closed questions regarding the mother’s overall health, lifestyle choices, prenatal care, and potential risk factors influencing her pregnancy and preterm birth. Additionally, if the mother elected, a formal interview was arranged which included questions about the mother’s perceptions and thoughts surrounding premature births. Six healthcare professionals were also formally interviewed about their roles in the attention of pregnant women, their experiences with preterm births, and knowledge of risk factors. The results of all interviews and questionnaires were analyzed in order to better understand the socio-demographic characteristics and other factors influencing the rate of preterm birth. Results: The prevalence of women who were pregnant at or before the age of 18 was very high. Unplanned pregnancies, despite anti-conceptive use, contributed to a large portion of the population. Additionally, the majority of participants suffered from diabetes and hypertension, along with high rates of obesity and sedentary lifestyles. However, all participants avoided smoking and drinking during their pregnancy. All participants were enrolled in a low level of health insurance, signifying a low socioeconomic income level. This was also supported by the low levels of education obtained by the majority of the mothers. However, all participants received medical care and gave birth in a hospital. The use of governmental programs and the free supplemental milk program were frequently used and encouraged by health care professionals. A general profile of mothers most at-risk of preterm birth was identified by the health care professionals and included the aforementioned characteristics along with the geographical risk that Valparaiso poses, due to the steep hills that complicate access and increase the level of physical stress for the mother. Conclusions: Along with somewhat unpredictable biological factors like preeclampsia, the principal risk factors identified for premature births relate to the social determinants of health, including low socioeconomic status, age, and lifestyle factors including eating habits, physical activity, and obesity rates. Although prenatal care and education is widely available within the public sector, a disconnect in the implementation of this knowledge in the daily lives of pregnant women was prevalent. Therefore, it is evident that prematurity risks are multifactorial and interrelated to the overall health of the mother and the level of vulnerability within the region. Understanding these risk factors in context of daily life in Valparaiso is crucial for future studies and an enhanced understanding of the causes of preterm birth throughout the world.

Disciplines

Demography, Population, and Ecology | Health Economics | International and Area Studies | Latin American Studies | Maternal and Child Health | Maternal, Child Health and Neonatal Nursing | Medical Education | Nursing Midwifery | Political Economy | Public Health Education and Promotion | Regional Sociology | Sociology of Culture

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