Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(6):442-451
To determine the adequacy of compliance with antenatal care (ANC) by pregnant women in Peru and to identify the associated factors.
An analytical cross-sectional study of data from the 2019 Peruvian Demographic and Family Health Survey (Encuesta Demográfica y de Salud Familiar, ENDES, in Spanish) was conducted. The dependent variable was adequate compliance with ANC (provided by skilled health care professionals; first ANC visit during the first trimester of pregnancy; six or more ANC visits during pregnancy; ANC visits with appropriate content) by women aged 15 to 49 years in their last delivery within the five years prior to the survey. Crude and adjusted prevalence ratios and their 95% confidence intervals were calculated using a log-binomial regression model.
A total of 18,386 women were analyzed, 35.0% of whom adequately complied with ANC. The lowest proportion of compliance was found with the content of ANC (42.6%). Sociodemographic factors and those related to pregnancy, such as being in the age groups of 20 to 34 years and 35 to 49 years, havingsecondaryor higher education, belonging to a wealth quintile of the population other than the poorest, being from the Amazon region, not being of native ethnicity, having a second or third pregnancy, and having a desired pregnancy, increased the probability of presenting adequate compliance with ANC.
Only 3 out of 10women in Peru showed adequate compliancewith ANC. Compliance with the content of ANC must be improved, and strategies must be developed to increase the proportion of adequate compliance with ANC.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(11):587-595
To identify the prevalence of maternal morbidity and its socioeconomic, demographic and health care associated factors in a city in Northeastern Brazil.
A cross-sectional and population-based study was conducted, with a design based on multi-stage complex sampling. A validated questionnaire was applied to 848 women aged between 15 and 49 years identified in 8,227 households from 60 census tracts of Natal, the capital of the state of Rio Grande do Norte (RN), Brazil. The main outcome measure was maternal morbidity. The Poisson regression analysis, with 5% significance, was used for the analysis of the associated factors.
The prevalence of maternal morbidity was of 21.2%. A bivariate analysis showed the following variables associated with an increased number of obstetric complications: non-white race (prevalence ratio [PR] =1.23; 95% confidence interval [95%CI]: 1.04-1.46); lower socioeconomic status (PR = 1.33; 95%CI: 1.12-1.58); prenatal care performed in public services (PR = 1.42; 95%CI: 1.16-1.72): women that were not advised during prenatal care about where they should deliver (PR = 1.24; 95%CI: 1.05-1.46); delivery in public services (PR = 1.63; 95%CI: 1.30-2.03); need to search for more than one hospital for delivery (PR = 1.22; 95%CI: 1.03-1.45); and no companion at all times of delivery care (PR = 1.25, 95%CI: 1.05-1.48). The place where the delivery occurred (public or private) and the socioeconomic status remained significant in the final model.
Women in a worse socioeconomic situation and whose delivery was performed in public services had a higher prevalence of maternal morbidity. Such an association reinforces the need to strengthen public policies to tackle health inequalities through actions focusing on these determinants.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):229-232
DOI 10.1590/SO100-720320150005295
To compare the frequency of an ASCUS Pap Smear result in pregnant and
non-pregnant women, stratified by age group.
We analyzed the results of 1,336,180 cytopathologyc exams of Pap smears performed
between 2000 and 2009 (ten years) with the purpose of screening for cervical
carcinoma. Comparisons were made between pregnant and non-pregnant women, and the
sample was stratified into three age groups (20-24, 25-29 and 30-34 years). The
χ2 test was used and the magnitude of association was determined by
the by Odds Ratio (OR) with the 95% confidence interval (95%CI).
A Total of 447,489 samples were excluded on the basis of the criteria adopted,
for a total final sample of 37,137 pregnant women and 851,554 non-pregnant women.
An ASCUS result was detected in 1.2% of cases, with a significant difference
between pregnant and non-pregnant women in the age groups of 20-24 years (OR=0.85;
95%CI 0.75-0.97) and 25-29 years (OR=0.78; 95%CI 0.63-0.96). There was no
difference in the group between 30-34 years (OR=0.76; 95%CI 0.57-1.03).
This study suggested that non-pregnant women have a higher frequency of ASCUS,
most evident in the age group of 20 to 29 years. The collection of cervical cancer
screening should not be a compulsory part of the prenatal routine.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):163-169
DOI 10.1590/S0100-7203201400040002
To assess the prevalence of Climacteric Syndrome (CS) in women from a municipality of Northeastern Brazil which is less developed socioeconomically.
A prospective household survey was performed in São Luís, Maranhão, Brazil with 1,210 climacteric women aged 45 to 60 years. Interviews were applied using previously tested standard questionnaires from April to July 2008. The severity of climacteric symptoms was analyzed by circulatory and psychological indexes and the latter were associated with menopausal status. Multiple correspondence analysis was used to assess the relation among climacteric symptoms.
Most patients were 55 to 60 years old (35.3%), mulatto (37.9%), with 9-11 years of schooling (39.8%), with a partner (56%), Catholic (73.9%) and belonged to the socioeconomic class C (51.1%). The prevalence of CS was 85.9%, and hot flashes (56.4%) and sweating (50.4%) were the most prevalent symptoms. The most frequent psychological symptoms were nervousness (45%) and emotional liability (44.8%). The severity of vasomotor and psychological symptoms was significantly higher during the peri and postmenopausal period (p<0.05). Vaginal dryness (62.7%) was the most prevalent urogenital complaint.
The prevalence of CS was high among women from São Luís, Maranhão, Brazil.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(7):323-330
DOI 10.1590/S0100-72032013000700007
PURPOSE: To estimate the prevalence and identify the factors associated with delayed pap smear test of the cervix (carried out more than three years ago) among mothers with sons under two years of age, who attended the prenatal care. METHODS: Cross-sectional, population-based household survey. Women with sons under two years old, living in the northern area of the city of Juiz de Fora (MG), Brazil, were interviewed. Stratification and clustering were used in a complex sampling procedure. We applied a survey questionnaire to capture women's demographic and socioeconomic characteristics of women and information about prenatal and practices for preventing cancer of the cervix. For statistical analysis of the possible bivariate association of factors, we used χ² test and a logistic regression model with the explanatory variables that had a significance less than or equal to 0.05 in the bivariate analysis. RESULTS: We found a delayed test prevalence of 26.6% (95%CI 21.3 - 32.6), including women who were never submitted to the exam. The variables associated with the non-adherence to the examination within the stipulated time were: to be married (OR 0.5; 95%CI 0.2 - 0.9), and divorced/widowed (OR 0.1; 95%CI 0.02 - 0,8), having performed gynecological examination in prenatal care (OR 0.3; 95%CI 0.1 - 0.6) and number of prenatal visits (OR 0.09; 95%CI 0.03 - 0.25 for more than 11 visits), being all protection factors. CONCLUSIONS: The prevalence of adherence to Pap smear guidelines is slightly lower than the percentage recommended by the World Health Organization. Apart from that, the fact that the woman was submitted to the prenatal care did not guarantee the adherence to Pap smear frequency guidelines.