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Background: The occurrence of preterm birth remains a complex public health condition. It is considered the main
cause of neonatal morbidity and mortality, resulting in a high likelihood of sequelae in surviving children. With variable
incidence in several countries, it has grown markedly in the last decades. In Brazil, however, there are still difficulties to
estimate its real occurrence. Therefore, itis essential to establish the prevalence and causes of this condition in order to
propose prevention actions. This study intend to collect information from hospitals nationwide on the prevalence of
preterm births, their associated socioeconomic and environmental factors, diagnostic and treatment methods
resulting from causes such as spontaneous preterm labor,prelabor rupture of membranes, and therapeutic preterm
birth, as well as neonatal results.
Methods/Design: This proposal is a multicenter cross-sectional study plus a nested case-control study, to be
implemented in 27 reference obstetric centers in several regions of Brazil (North: 1; Northeast: 10; Central-west: 1;
Southeast: 13; South: 2). For the cross sectional component, the participating centers should perform, during a period
of six months, a prospective surveillance of all patients hospitalized to give birth, in order to identify preterm birth cases
and their main causes. In the first three months of the study, an analysis of the factors associated with preterm birth will
also be carried out, comparing women who have preterm birth with those who deliver at term. For the prevalence
study, 37,000 births will be evaluated (at term and preterm), corresponding to approximately half the deliveries of all
participating centers in 12 months. For the case-control study component, the estimated sample size is 1,055 women
in each group (cases and controls). The total number of preterm births estimated to be followed in both components
of the study is around 3,600. Data will be collected through a questionnaire all patients will answer after delivery. The
data will then be encoded in an electronic form and sent online by internet to a central database. The data analysis will
be carried out by subgroups according to gestational age at preterm birth, its probable causes, therapeutic
management, and neonatal outcomes. Then, the respective rates, ratios and relative risks will be estimated for the
possible predictors.
Discussion: These findings will provide information on preterm births in Brazil and their main social and biological risk
factors, supporting health policies and the implementation ofclinical trials on preterm birth prevention and treatment
strategies, a condition with many physical and emotional consequences to children and their families
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