{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:23:51Z","timestamp":1788560631829,"version":"build-2803163510"},"reference-count":31,"publisher":"BMJ","issue":"12","funder":[{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006507","name":"Funda\u00e7\u00e3o Oswaldo Cruz","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006507","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,10,5]]},"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate the national rate of early-term live births in Brazil and to evaluate the effect of birth at 37 and 38 weeks\u2019 gestation, as compared with 39 and 40 weeks\u2019 gestation on infant outcomes according to precursors of birth and the existence of maternal\/fetal medical conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>National perinatal population-based cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>266 maternity services located in the five Brazilian macroregions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>18\u2009652 singleton live newborns from 37 0\/7 to 40 6\/7 weeks of gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Resuscitation in delivery room, oxygen therapy, transient tachypnoea, admission to neonatal intensive care unit (NICU), hypoglycaemia, use of antibiotics, phototherapy, phototherapy after hospital discharge, neonatal death and breastfeeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Early terms accounted for 35% (95% CI 33.4% to 36.7%) of all live births. Among provider-initiated births in women without medical conditions, infants of 37 and 38 weeks\u2019 gestation had higher odds of oxygen therapy (adjusted OR (AOR) 2.93, 95% CI 1.72 to 4.98 and AOR 1.92\u200995% CI 1.18 to 3.13), along with admission to NICU (AOR 2.01, 95% CI 1.18 to 3.41 and AOR 1.56, 95% CI 1.02 to 2.60), neonatal death (AOR 14.40, 95% CI 1.94 to 106.69 and AOR 13.76,95% CI 2.84 to 66.75), hypoglycaemia in the first 48\u2009hours of life (AOR 7.86, 95% CI 1.95 to 31.71 and AOR 5.76, 95% CI 1.63 to 20.32), transient tachypnoea (AOR 2.98, 95% CI 1.57 to 5.65 and AOR 2.12, 95% CI 1.00 to 4.48) and the need for phototherapy within the first 72\u2009hours of life (AOR 3.59, 95% CI 1.95 to 6.60 and AOR 2.29, 95% CI 1.49 to 3.53), yet lower odds of breastfeeding up to 1\u2009hour after birth (AOR 0.67, 95% CI 0.53 to 0.86 and AOR 0.87, 95% CI 0.76 to 0.99) and exclusive breastfeeding during hospital stay (AOR 0.68, 95% CI 0.51 to 0.89 and AOR 0.84, 95% CI 0.71 to 0.99).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Birth at 37 and 38 weeks\u2019 gestation increased the risk of most adverse infant outcomes analysed, especially among provider-initiated births and should be avoided before 39 weeks\u2019 gestation in healthy pregnancies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-017789","type":"journal-article","created":{"date-parts":[[2017,12,28]],"date-time":"2017-12-28T02:50:47Z","timestamp":1514429447000},"page":"e017789","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Burden of early-term birth on adverse infant outcomes: a population-based cohort study in Brazil"],"prefix":"10.1136","volume":"7","author":[{"given":"Maria do Carmo","family":"Leal","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Quantitative Methods in Health, Women\u2019s, Children\u2019s and Adolescents\u2019 Research Group, S\u00e9rgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Paula","family":"Esteves-Pereira","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Quantitative Methods in Health, Women\u2019s, Children\u2019s and Adolescents\u2019 Research Group, S\u00e9rgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos","family":"Nakamura-Pereira","sequence":"additional","affiliation":[{"name":"Figueira National Institute for Women\u2019s, Children\u2019s and Adolescents Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Maria Soares Madeira","family":"Domingues","sequence":"additional","affiliation":[{"name":"Research Laboratory on STI\/Aids, National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos Augusto Bastos","family":"Dias","sequence":"additional","affiliation":[{"name":"Figueira National Institute for Women\u2019s, Children\u2019s and Adolescents Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Elisabeth","family":"Moreira","sequence":"additional","affiliation":[{"name":"Figueira National Institute for Women\u2019s, Children\u2019s and Adolescents Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariza","family":"Theme-Filha","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Quantitative Methods in Health, Women\u2019s, Children\u2019s and Adolescents\u2019 Research Group, S\u00e9rgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana Granado Nogueira","family":"da Gama","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Quantitative Methods in Health, Women\u2019s, Children\u2019s and Adolescents\u2019 Research Group, S\u00e9rgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,12,27]]},"reference":[{"key":"2025121513463433000_7.12.e017789.1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182255999"},{"key":"2025121513463433000_7.12.e017789.2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000428647.67925.d3"},{"key":"2025121513463433000_7.12.e017789.3","unstructured":"NICE. 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