in the assessed hospitals, Sinasc presented high coverage, completeness and reliability.

Premature birth is the result of a complex interaction among genetic, epigenetic, behavioral, socioeconomic, and environmental factors. We evaluated the possible associations between air pollution and the incidence of prematurity in spatial clusters of high and low prevalence in the municipality of São Paulo. It is a spatial case-control study. The residential addresses of mothers with live births that occurred in 2012 and 2013 were geo-coded. A spatial scan statistical test performed to identify possible low-prevalence and high-prevalence clusters of premature births. After identifying, the spatial clusters were drawn samples of cases and controls in each cluster. Mothers were interviewed face-to-face using questionnaires. Air pollution exposure was assessed by passive tubes (NO2 and O3) as well as by the determination of trace elements’ concentration in tree bark. Binary logistic regression models were applied to determine the significance of the risk of premature birth. Later prenatal care, urinary infection, and hypertension were individual risk factors for prematurity. Particles produced by traffic emissions (estimated by tree bark accumulation) and photochemical pollutants involved in the photochemical cycle (estimated by O3 and NO2 passive tubes) also exhibited significant and robust risks for premature births. The results indicate that air pollution is an independent risk factor for prematurity.

The early detection of congenital anomaly epidemics occurs when comparing current with previous frequencies in the same population. The success of epidemiologic surveillance depends on numerous factors, including the accuracy of the rates available in the base period, wide population coverage, and short periodicity of analysis. This study aims to describe the Latin American network of congenital malformation surveillance: ReLAMC, created to increase epidemiologic surveillance in Latin America. We describe the main steps, tasks, strategies used, and preliminary results. From 2017 to 2019, five national registries (Argentina [RENAC], Brazil [SINASC/SIM‐BRS], Chile [RENACH], Costa Rica [CREC], Paraguay [RENADECOPY‐PNPDC]), six regional registries (Bogotá [PVSDC‐Bogota], Cali [PVSDC‐Cali], Maule [RRMC SSM], Nicaragua [SVDC], Nuevo‐León [ReDeCon HU], São Paulo [SINASC/SIM‐MSP]) and the ECLAMC hospital network sent data to ReLAMC on a total population of 9,152,674 births, with a total of 101,749 malformed newborns (1.1%; 95% CI 1.10–1.12). Of the 9,000,651 births in countries covering both live and stillbirths, 88,881 were stillborn (0.99%; 95% CI 0.98–0.99), and among stillborns, 6,755 were malformed (7.61%; 95% CI 7.44–7.79). The microcephaly rate was 2.45 per 10,000 births (95% CI 2.35–2.55), hydrocephaly 3.03 (2.92–3.14), spina bifida 2.89 (2.78–3.00), congenital heart defects 15.53 (15.27–15.79), cleft lip 2.02 (1.93–2.11), cleft palate and lip 2.77 (2.66–2.88), talipes 2.56 (2.46–2.67), conjoined twins 0.16 (0.14–0.19), and Down syndrome 5.33 (5.18–5.48). Each congenital anomaly showed heterogeneity in prevalence rates among registries. The harmonization of data in relation to operational differences between registries is the next step in developing the common ReLAMC database.

RESUMO Objetivo: Identificar fatores associados à definição do método estimador da idade gestacional (IG) registrado na declaração de nascido vivo (DNV) e comparar os resultados obtidos segundo método no município de São Paulo, entre 2012 e 2019. Métodos: Estudo transversal de base populacional utilizando o Sistema de Informações sobre Nascidos Vivos. Realizou-se análise descritiva e comparativa segundo método de estimativa da IG, seguida de modelo de regressão logística uni e multivariada para identificar as variáveis preditoras do método utilizado. Resultados: A estimativa da IG pela data da última menstruação (DUM) (39,9%) foi inferior à obtida por outros métodos (OM) (60,1%) — exame físico e ultrassonografia, entre 2012-2019. O registro da DUM na DNV aumentou com a idade da mãe, foi maior entre as brancas, mais escolarizadas e com companheiro, nas cesarianas e nos partos realizados com financiamento privado. Na regressão logística, o financiamento público apresentou chance 2,33 vezes maior que o privado para uso de OM. A proporção de prematuros (<37 semanas) com IG pela DUM foi 26,5% maior do que a obtida por OM. A mediana de peso ao nascer foi maior entre prematuros com IG estimada pela DUM. Conclusão: A prematuridade foi mais elevada com a IG estimada pela DUM no MSP, o que pode indicar superestimação por este método. A fonte de financiamento foi a variável mais explicativa para definição do método estimador da IG na DNV. Os resultados apontam a necessidade de cautela ao comparar a IG obtida por métodos diferentes.