Adverse neonatal outcomes among high-risk pregnant women in the State of Rondônia, Amazon, Brazil

Amazon urbanization drives profound changes in the environment, and rising exploitation of natural resources, resulting in greater exposure to environmental contaminants and pregnancy complications. Aim: To describe the adverse outcomes of high-risk pregnant women attending a reference hospital in Rondônia State (RO). Methods: Cross-sectional study with high-risk pregnant women residing in RO for at least two years, with a singleton pregnancy, and no alcohol, cigarettes, and drugs consumption during pregnancy. Information on pregnancy, adverse pregnancy outcomes (malformation, low birth weight, preterm infants), sociodemographic characteristics, gestational history, and birth data were collected throughout the questionnaire. Data were described as absolute and relative frequencies. Results: Among 330 mother/child binomials assessed, 57% of newborns were premature, 53% had low birth weight, and 37% had congenital malformations, being the most frequent those related to the cardiovascular, digestive, musculoskeletal, and neurological systems. About 68% of newborns required neonatal intensive care. Most mothers were younger than 35y (70%), were married or had a stable partner (70%), had completed high school or more (58%), had family income of up to two minimum wages (74%), and used water from a well (51%). The majority had six or more prenatal consultations (61%) and were multiparous. The most frequent clinical complications were urinary tract infection, hypertension, preeclampsia, and anemia. Most women (56%) reported using some "household pesticides” (mainly insecticides and herbicides). Some women have worked in agriculture (16%), livestock (9%), and gold mining (2%). And about 80% reported having a partner currently or previously working in these activities. Conclusions: Adverse pregnancy outcomes can be related to individual, socio-environmental and clinical factors. Therefore, understanding these risk factors makes it possible to glimpse paths towards an assistance capable of protecting maternal and child health, with particular attention to vulnerable populations.