Socioeconomic factors Archives - Revista Brasileira de Ginecologia e Obstetrícia
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Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(3):134-141
, , , , , , This study assessed maternal mortality (MM) and related factors in a large-sized municipality in the Southeastern region of Brazil (Campinas, São Paulo) during the period 2000-2015.
This study consisted of two phases: 1. An analytical nested case-control phase that assessed the impact of individual and contextual variables on MM; and 2. an ecological phase designed to contextualize maternal deaths by means of spatial analysis. The case group consisted of all maternal deaths (n = 87) and the control group consisted of 348 women who gave birth during the same period. Data analysis included descriptive statistics, association, and multiple logistic regression (MLR) tests at p < 0.05 as well as spatial analysis.
Maternal Mortality Ratio was 37 deaths per 100.000 live births. Deaths were dispersed throughout the urban territory and no formation of cluster was observed. MLR showed that pregnant women aged > 35 years old (OR = 2.63) or those with cesarean delivery (OR = 2.51) were more prone to maternal death.
Maternal deaths were distributed dispersedly among the different socioeconomic levels and more prone to occur among older women or those undergoing cesarean deliveries.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(3):134-141
, , , , , , This study assessed maternal mortality (MM) and related factors in a large-sized municipality in the Southeastern region of Brazil (Campinas, São Paulo) during the period 2000-2015.
This study consisted of two phases: 1. An analytical nested case-control phase that assessed the impact of individual and contextual variables on MM; and 2. an ecological phase designed to contextualize maternal deaths by means of spatial analysis. The case group consisted of all maternal deaths (n = 87) and the control group consisted of 348 women who gave birth during the same period. Data analysis included descriptive statistics, association, and multiple logistic regression (MLR) tests at p < 0.05 as well as spatial analysis.
Maternal Mortality Ratio was 37 deaths per 100.000 live births. Deaths were dispersed throughout the urban territory and no formation of cluster was observed. MLR showed that pregnant women aged > 35 years old (OR = 2.63) or those with cesarean delivery (OR = 2.51) were more prone to maternal death.
Maternal deaths were distributed dispersedly among the different socioeconomic levels and more prone to occur among older women or those undergoing cesarean deliveries.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(1):27-32
DOI 10.1590/S0100-72032013000100006
PURPOSE: To compare and analyze socioeconomic aspects and the emotional experience of women with spontaneous or induced abortion and in women living in the outskirts of São Paulo. METHODS: A prospective case-control study carried out from July 2008 to March 2010, involving semi-structured interviews with women who presented a previous diagnosis of abortion and who had been admitted to two public hospitals in the outskirts of São Paulo. The study included 100 women with diagnosis of abortion and were hospitalized for curettage. Eleven women who reported induced abortion (11%) represented the case group. The control group (n=22) was selected at a 2:1 ratio according to the following procedure: for every case of induced abortion, the next two cases of spontaneous abortion at the same hospital. A semistructured interview was conducted with questions regarding emotional aspects and family, social and economic context. RESULTS: The women with induced abortion compared to the group with spontaneous abortion had lower educational level, with more frequent elementary level (82 versus 36%, p=0.04), lower income (median, R$ 1,000.00 versus R$ 1,400.00, p=0.04), lower personal income (median, R$ 200.00 versus R$ 333.00, p=0.04), higher frequency of negative feelings upon suspicion (82 versus 22%, p=0.004) and confirmation (72 versus 22%, p=0.03) of pregnancy. CONCLUSION: Among women looking for health care in hospitals in the outskirts of São Paulo, induced abortion is related to unfavorable socioeconomic conditions, which affects the emotional experiences of suspicion and confirmation of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(1):27-32
DOI 10.1590/S0100-72032013000100006
PURPOSE: To compare and analyze socioeconomic aspects and the emotional experience of women with spontaneous or induced abortion and in women living in the outskirts of São Paulo. METHODS: A prospective case-control study carried out from July 2008 to March 2010, involving semi-structured interviews with women who presented a previous diagnosis of abortion and who had been admitted to two public hospitals in the outskirts of São Paulo. The study included 100 women with diagnosis of abortion and were hospitalized for curettage. Eleven women who reported induced abortion (11%) represented the case group. The control group (n=22) was selected at a 2:1 ratio according to the following procedure: for every case of induced abortion, the next two cases of spontaneous abortion at the same hospital. A semistructured interview was conducted with questions regarding emotional aspects and family, social and economic context. RESULTS: The women with induced abortion compared to the group with spontaneous abortion had lower educational level, with more frequent elementary level (82 versus 36%, p=0.04), lower income (median, R$ 1,000.00 versus R$ 1,400.00, p=0.04), lower personal income (median, R$ 200.00 versus R$ 333.00, p=0.04), higher frequency of negative feelings upon suspicion (82 versus 22%, p=0.004) and confirmation (72 versus 22%, p=0.03) of pregnancy. CONCLUSION: Among women looking for health care in hospitals in the outskirts of São Paulo, induced abortion is related to unfavorable socioeconomic conditions, which affects the emotional experiences of suspicion and confirmation of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(7):143-149
DOI 10.1590/S0100-72032011000700005
PURPOSE: To determine the main contraceptive methods adopted by users of the public and private health sectors in the city of Aracaju (SE), Brazil, with a secondary focus on orientations for their use and reasons for interruption. METHODS: A cross-sectional study was conducted on 210 women, 110 from the public service and 100 from the private sector. The data were collected by applying a questionnaire to sexually active patients who agreed to sign a consent form. The software Statistical Package for Social Sciences (SPSS) version 15.0 was used for statistical analysis, with the 
test for categorical variables and the Student's t-test for independent samples. RESULTS: The overall prevalence of contraceptive use in this study was 83.3%. The main methods used in the public and private sectors, were the hormonal (41 and 24%, p=0.008) and permanent (20 and 26%, p=0.1) ones, respectively. The rate of condom use was 17.3% in the public sector and 12% in the private sector, with no significant difference (p=0.12). Medical orientation about the correct use of the method chosen and/or indicated was provided to 37.3% of users from the public sector and to 48% of users from the private sector. Discontinuation of the use of contraceptive methods was 14.5% in the public sector and 12.0% in the private sector, mainly because of side effects and the desire to become pregnant. CONCLUSIONS: The main contraceptive methods adopted by users of the public and private sectors were hormonal contraception and permanent contraception. It is important to highlights the low frequency of use of male condoms in the two groups studied.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(7):143-149
DOI 10.1590/S0100-72032011000700005
PURPOSE: To determine the main contraceptive methods adopted by users of the public and private health sectors in the city of Aracaju (SE), Brazil, with a secondary focus on orientations for their use and reasons for interruption. METHODS: A cross-sectional study was conducted on 210 women, 110 from the public service and 100 from the private sector. The data were collected by applying a questionnaire to sexually active patients who agreed to sign a consent form. The software Statistical Package for Social Sciences (SPSS) version 15.0 was used for statistical analysis, with the test for categorical variables and the Student's t-test for independent samples. RESULTS: The overall prevalence of contraceptive use in this study was 83.3%. The main methods used in the public and private sectors, were the hormonal (41 and 24%, p=0.008) and permanent (20 and 26%, p=0.1) ones, respectively. The rate of condom use was 17.3% in the public sector and 12% in the private sector, with no significant difference (p=0.12). Medical orientation about the correct use of the method chosen and/or indicated was provided to 37.3% of users from the public sector and to 48% of users from the private sector. Discontinuation of the use of contraceptive methods was 14.5% in the public sector and 12.0% in the private sector, mainly because of side effects and the desire to become pregnant. CONCLUSIONS: The main contraceptive methods adopted by users of the public and private sectors were hormonal contraception and permanent contraception. It is important to highlights the low frequency of use of male condoms in the two groups studied.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(3):139-143
DOI 10.1590/S0100-72032010000300007
PURPOSE: to identify if there is a difference in the prevalence of sexual dysfunction and in the sexual domain scores between a group of women attended at a public service and a group attended at a private service, and to investigate if there is an association between sexual dysfunction, family income and educational status. METHODS: transversal study including 201 sexually active women aged from 18 to 45 years, 90 of them from a public service and 111 from private services. We evaluated age, marital status, use of hormonal contraception, income and educational status, and all women were submitted to the Female Sexual Function Index (FSFI), an instrument for the evaluation of their sexuality. The Statistical Package for Social Sciences, version 15.0, was used for statistical analysis. The χ2 test was applied for categorical variables and the Student's t-test to independent samples. RESULTS: there was no significant difference regarding the prevalence of sexual dysfunction between groups (public versus private) (20 and 23.4%, p=0.5), or concerning the domain scores, desire (3.9±1.3 and 3.8±1.0, p=0.6), sexual arousal (4.5±0.8 and 4.4±0.9, p=0.5), lubrication (5.2±1.2 and 5.0±0.9, p=0.1), orgasm (5.0±1.2 and 4.9±1.1, p=0.5), satisfaction (5.2±1.2 and 5.1±1.0, p=0.9), and pain (5.3±1.1 and 5.2±1.0, p=0.8). Sexual dysfunction was detected in 28% of the women with income between two and four minimum wages, in 17.5% of those with an income of five wages or more, and in 14.3% among those with an income of one wage or less (p=0,1). The dysfunction occurred in 30.2% of women with elementary education, in 24.2% of those with high school education and in 13.4% of those with higher education (p=0.09). CONCLUSIONS: There was no significant difference in the prevalence of sexual dysfunction or in the sexual domain scores between groups, nor was there an association with income or education status.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(3):139-143
DOI 10.1590/S0100-72032010000300007
PURPOSE: to identify if there is a difference in the prevalence of sexual dysfunction and in the sexual domain scores between a group of women attended at a public service and a group attended at a private service, and to investigate if there is an association between sexual dysfunction, family income and educational status. METHODS: transversal study including 201 sexually active women aged from 18 to 45 years, 90 of them from a public service and 111 from private services. We evaluated age, marital status, use of hormonal contraception, income and educational status, and all women were submitted to the Female Sexual Function Index (FSFI), an instrument for the evaluation of their sexuality. The Statistical Package for Social Sciences, version 15.0, was used for statistical analysis. The χ2 test was applied for categorical variables and the Student's t-test to independent samples. RESULTS: there was no significant difference regarding the prevalence of sexual dysfunction between groups (public versus private) (20 and 23.4%, p=0.5), or concerning the domain scores, desire (3.9±1.3 and 3.8±1.0, p=0.6), sexual arousal (4.5±0.8 and 4.4±0.9, p=0.5), lubrication (5.2±1.2 and 5.0±0.9, p=0.1), orgasm (5.0±1.2 and 4.9±1.1, p=0.5), satisfaction (5.2±1.2 and 5.1±1.0, p=0.9), and pain (5.3±1.1 and 5.2±1.0, p=0.8). Sexual dysfunction was detected in 28% of the women with income between two and four minimum wages, in 17.5% of those with an income of five wages or more, and in 14.3% among those with an income of one wage or less (p=0,1). The dysfunction occurred in 30.2% of women with elementary education, in 24.2% of those with high school education and in 13.4% of those with higher education (p=0.09). CONCLUSIONS: There was no significant difference in the prevalence of sexual dysfunction or in the sexual domain scores between groups, nor was there an association with income or education status.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(5):248-255
DOI 10.1590/S0100-72032008000500007
PURPOSE: to describe the socio-demographic characteristics of deaths caused by uterine cervix cancer in women living in Recife, Pernambuco, Brazil, from 2000 to 2004. METHODS: a transversal populational study, including 323 deaths by uterine cervix cancer, among which 261 were recorded in the Information System about Mortality and 62 were identified after investigation on deaths by cancer at non-specified sites of the uterus. Mortality rate for all the variables was obtained and statistics for central tendency and variance were calculated. The χ2 test was performed to obtain the mortality coefficient concerning the living place and age range of the patients. RESULTS: death among women under 60 (54.7%), black (60.5%), single (67.6%), housewives (71.2%) and the ones living in poor neighborhood (53.3%) preponderated. Most of deaths occurred in hospitals (85.1%) and 90.2% of them occurred inside national health system hospitals. The mortality coefficient varied from 0.3 (among women under 30) to 54.9/100.00 (among women over 80). Significant statistical differences (p<0.05) were evidenced when death linked to age range and sanitary district was compared to characteristics of the female population living in the city. CONCLUSIONS: in Recife, death by cervix cancer are more frequent among adult, black, single, housewives, women living in poor neighborhoods and attended to at national health system hospitals, with differences in death risk among age ranges and living place.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(5):248-255
DOI 10.1590/S0100-72032008000500007
PURPOSE: to describe the socio-demographic characteristics of deaths caused by uterine cervix cancer in women living in Recife, Pernambuco, Brazil, from 2000 to 2004. METHODS: a transversal populational study, including 323 deaths by uterine cervix cancer, among which 261 were recorded in the Information System about Mortality and 62 were identified after investigation on deaths by cancer at non-specified sites of the uterus. Mortality rate for all the variables was obtained and statistics for central tendency and variance were calculated. The χ2 test was performed to obtain the mortality coefficient concerning the living place and age range of the patients. RESULTS: death among women under 60 (54.7%), black (60.5%), single (67.6%), housewives (71.2%) and the ones living in poor neighborhood (53.3%) preponderated. Most of deaths occurred in hospitals (85.1%) and 90.2% of them occurred inside national health system hospitals. The mortality coefficient varied from 0.3 (among women under 30) to 54.9/100.00 (among women over 80). Significant statistical differences (p<0.05) were evidenced when death linked to age range and sanitary district was compared to characteristics of the female population living in the city. CONCLUSIONS: in Recife, death by cervix cancer are more frequent among adult, black, single, housewives, women living in poor neighborhoods and attended to at national health system hospitals, with differences in death risk among age ranges and living place.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):34-40
DOI 10.1590/S0100-72032007000100006
PURPOSE: to determine the cesarean section (CS) rate in Campinas (SP) and to identify its risk factors. METHODS: a cross-sectional study that analyzed data obtained from Live Birth Certificates in 2001. The dependent variable was the type of delivery and the independent variables were: mothers’ characteristics and those related to their pregnancies, deliveries and to newborns. The assessment of the association among variables was performed through the chi2 test, and crude and adjusted odds ratio (OR) values were calculated. RESULTS: the CS rate was 54.9%. The chances of having CS increased 1.9 times for women from 20-34 years old (adjOR-1.9; 95% CI:1.7-2.1); 3.7 times for those over 35 years old (adjOR-3.8; 95% CI:3.2-4.5); 1.5 times for those who studied from 8-11 years (adjOR-1.5; 95% CI:1.4-1.6); 2.5 times for those who studied more than 11 years (adjOR-2.6; 95% CI:2.2-2.9); 1.3 times for those who were married (adjOR-1.3; 95 % CI:1.2-1.4); 1.6 times for those who had jobs (adjOR-1.6; 95% CI:1.5-1.8); 1.2 times for who had good living conditions (adjOR-1.2; 95% CI:1.0-1.3); 2.2 times for primiparous (adjOR-2.2; 95% CI:1.9-2.5), 1.6 times for multiparous (adjOR-1.6; 95% CI:1.4-1.9) and 2.7 times in twin gestations (adjOR-2.7; 95% CI:1.9-3.9). The women who had inadequate prenatal care were protected for CS (adjOR-0.6; 95% CI:0.5-0.7). CONCLUSION: the chance of having CS was greater among women with better socio-economic conditions, with adequate prenatal care, for primiparous, for multiparous and in twin gestations, suggesting that the basis for indication of cesarean sections were not restricted to clinical factors but influenced by non-medical reasons.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):34-40
DOI 10.1590/S0100-72032007000100006
PURPOSE: to determine the cesarean section (CS) rate in Campinas (SP) and to identify its risk factors. METHODS: a cross-sectional study that analyzed data obtained from Live Birth Certificates in 2001. The dependent variable was the type of delivery and the independent variables were: mothers’ characteristics and those related to their pregnancies, deliveries and to newborns. The assessment of the association among variables was performed through the chi2 test, and crude and adjusted odds ratio (OR) values were calculated. RESULTS: the CS rate was 54.9%. The chances of having CS increased 1.9 times for women from 20-34 years old (adjOR-1.9; 95% CI:1.7-2.1); 3.7 times for those over 35 years old (adjOR-3.8; 95% CI:3.2-4.5); 1.5 times for those who studied from 8-11 years (adjOR-1.5; 95% CI:1.4-1.6); 2.5 times for those who studied more than 11 years (adjOR-2.6; 95% CI:2.2-2.9); 1.3 times for those who were married (adjOR-1.3; 95 % CI:1.2-1.4); 1.6 times for those who had jobs (adjOR-1.6; 95% CI:1.5-1.8); 1.2 times for who had good living conditions (adjOR-1.2; 95% CI:1.0-1.3); 2.2 times for primiparous (adjOR-2.2; 95% CI:1.9-2.5), 1.6 times for multiparous (adjOR-1.6; 95% CI:1.4-1.9) and 2.7 times in twin gestations (adjOR-2.7; 95% CI:1.9-3.9). The women who had inadequate prenatal care were protected for CS (adjOR-0.6; 95% CI:0.5-0.7). CONCLUSION: the chance of having CS was greater among women with better socio-economic conditions, with adequate prenatal care, for primiparous, for multiparous and in twin gestations, suggesting that the basis for indication of cesarean sections were not restricted to clinical factors but influenced by non-medical reasons.