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Gestational age at birth and morbidity, mortality, and growth in the first 4 years of life: findings from three birth cohorts in Southern Brazil

Fernando C Barros13*, José Luis Diaz Rossello2, Alicia Matijasevich3, Samuel C Dumith4, Aluisio J D Barros3, Iná Silva dos Santos3, Denise Mota13 and Cesar G Victora3

Author Affiliations

1 Postgraduate Course in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil

2 Faculty of Medicine, Universidad de la Republica, Montevideo, Uruguay

3 Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil

4 Postgraduate Program in Health Science, Federal University of Rio Grande, Rio Grande, Brazil

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BMC Pediatrics 2012, 12:169  doi:10.1186/1471-2431-12-169

Published: 31 October 2012



We assessed anthropometric status, breastfeeding duration, morbidity, and mortality outcomes during the first four years of life according to gestational age, in three population-based birth cohorts in the city of Pelotas, Southern Brazil.


Total breastfeeding duration, neonatal mortality, infant morbidity and mortality, and anthropometric measures taken at 12 and 48 months were evaluated in children of different gestational ages born in 1982, 1993 and 2004 in Southern Brazil.


Babies born <34 weeks of gestation and those born between 34–36 weeks presented increased morbidity and mortality, were breastfed for shorter periods, and were more likely to be undernourished at 12 months of life, in comparison with the 39–41 weeks group. Children born with 37 weeks were more than twice as likely to die in the first year of life, and were also at increased risk of hospitalization and underweight at 12 months of life. Post-term infants presented an increased risk of neonatal mortality.


The increased risks of morbidity and mortality among preterm (<37 weeks of gestation) and post-term (>41 weeks) are well known. In our population babies born at 37 also present increased risk. As the proportion of preterm and early term babies has increased markedly in recent years, this is a cause for great concern.

Gestational age; Preterm births; Early term births; Post-term births; Infant mortality; Neonatal mortality