Participation in Conditional Cash Transfer Program During Pregnancy and Birth Weight-Related Outcomes.
JAMA Netw Open
; 6(11): e2344691, 2023 Nov 01.
Article
en En
| MEDLINE
| ID: mdl-38015506
ABSTRACT
Importance There is limited evidence of the association of conditional cash transfers, an important strategy to reduce poverty, with prevention of adverse birth-related outcomes. Objective:
To investigate the association between receiving benefits from the Bolsa Família Program (BFP) and birth weight indicators. Design, Setting, andParticipants:
This cohort study used a linked data resource, the Centro de Integracao de Dados e Conhecimentos Para Saude (CIDACS) birth cohort. All live-born singleton infants born to mothers registered in the cohort between January 2012 and December 2015 were included. Each analysis was conducted for the overall population and separately by level of education, self-reported maternal race, and number of prenatal appointments. Data were analyzed from January 3 to April 24, 2023. Exposure Live births of mothers who had received BFP until delivery (for a minimum of 9 months) were classified as exposed and compared with live births from mothers who did not receive the benefit prior to delivery. Main Outcomes andMeasures:
Low birth weight (LBW), birth weight in grams, and small for gestational age (SGA) were evaluated. Analytical methods used included propensity score estimation, kernel matching, and weighted logistic and linear regressions. Race categories included Parda, which translates from Portuguese as "brown" and is used to denote individuals whose racial background is predominantly Black and those with multiracial or multiethnic ancestry, including European, African, and Indigenous origins.Results:
A total of 4â¯277â¯523 live births (2â¯085â¯737 females [48.8%]; 15â¯207 among Asian [0.4%], 334â¯225 among Black [7.8%], 29â¯115 among Indigenous [0.7%], 2â¯588â¯363 among Parda [60.5%], and 1â¯310â¯613 among White [30.6%] mothers) were assessed. BFP was associated with an increase of 17.76 g (95% CI, 16.52-19.01 g) in birth weight. Beneficiaries had an 11% lower chance of LBW (odds ratio [OR], 0.89; 95% CI, 0.88-0.90). BFP was associated with a greater decrease in odds of LBW among subgroups of mothers who attended fewer than 7 appointments (OR, 0.85; 95% CI, 0.84-0.87), were Indigenous (OR, 0.73; 95% CI, 0.61-0.88), and had 3 or less years of education (OR, 0.76; 95% CI, 0.72-0.81). There was no association between BFP and SGA, except among less educated mothers, who had a reduced risk of SGA (OR, 0.83; 95% CI, 0.79-0.88). Conclusions and Relevance This study found that BFP was associated with increased birth weight and reduced odds of LBW, with a greater decrease in odds of LBW among higher-risk groups. These findings suggest the importance of maintaining financial support for mothers at increased risk of birth weight-related outcomes.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Recién Nacido Pequeño para la Edad Gestacional
/
Madres
Límite:
Female
/
Humans
/
Infant
/
Newborn
/
Pregnancy
Idioma:
En
Año:
2023
Tipo del documento:
Article