Brazilian researchers have uncovered a concerning trend among expectant mothers, particularly around the Carnival holiday. According to a recent study, the manipulation of delivery dates to avoid this festive period is leading to early births, potentially compromising the health of newborns.
The research, conducted by economists Carolina Melo and Naercio Menezes Filho from INSPER, a renowned institution in São Paulo, reveals that many cesarean sections are either rescheduled to occur before or postponed until after Carnival. This deliberate timing adjustment, while convenient for mothers and obstetricians, can have significant implications for infant health. The findings, published in the journal *Health Economics*, highlight the complex effects of this practice.
The study found that postponing deliveries to avoid Carnival generally results in healthier outcomes, with an increase in gestational age and a reduction in neonatal mortality. Conversely, advancing the delivery date can decrease gestational age and birth weight, especially in high-risk pregnancies. On average, the manipulation of delivery dates around Carnival led to a slight increase in gestational age by 0.06 days and a notable decrease in neonatal and early neonatal mortality by 0.30 and 0.26 per 1,000 live births, respectively.
Melo explained that women with higher educational attainment often choose to have their babies delivered earlier to avoid the holiday. This decision, while understandable from a convenience standpoint, can unintentionally shorten pregnancies, putting the newborns at risk of complications. On the other hand, if a cesarean section cannot be rescheduled, many mothers end up going into natural labor, leading to vaginal deliveries that are often associated with better neonatal outcomes, including improved gestational maturity and survival rates.
Interestingly, the research suggests that when delivery is postponed, there can be a significant gain in birth weight, with an average increase of 60 grams associated with a net extension of 3.5 days in gestation.
The study also sheds light on the broader context of cesarean sections in Brazil. In private hospitals, where the majority of these elective C-sections occur, 86% of deliveries are by cesarean, far exceeding the World Health Organization’s (WHO) recommended maximum of 15%. Brazil’s overall cesarean rate stands at 55%, the second highest in the world after the Dominican Republic.
While this study focused on the Carnival period, Melo believes the tendency to opt for early deliveries is widespread and not limited to holidays. The average gestational age in Brazil is 38.5 weeks, slightly below the WHO’s recommendation of 39 weeks for a healthy pregnancy. This trend raises concerns about the prevalence of preterm births, which can have long-term consequences for child health.
The researchers emphasize the urgent need for public policies that discourage unnecessary early deliveries and promote the health benefits of full-term pregnancies. By addressing this issue, Brazil can work towards reducing the risks associated with premature births and improving outcomes for mothers and babies alike.
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