Prenatal and Birth Care of Roma Women.

BACKGROUND: The reproductive health of Roma women has been poorly studied. It is important to determine the follow-up care received by Roma women from pregnancy to the first postpartum visit, together with neonatal outcomes, to improve prenatal care and maternal-child outcomes. OBJECTIVE: The aim of this study was to examine differences in prenatal care and maternal-infant outcomes between Roma and non-Roma women. METHODS: A retrospective longitudinal study was conducted in 122 pregnant women (28 Roma and 94 non-Roma women) recruited from seven primary care centers in three districts of Asturias (Spain). Sociodemographic variables, prenatal control, birth characteristics, feeding, and neonatal outcomes (gestational age, weight, and APGAR [appearance, pulse, grimace, activity, and respiration]) were collected from the electronic medical records. Prenatal care was assessed using three indices: the Kessner index, the Modified Adequacy of Prenatal Care Utilization Spanish Index, and an ad hoc index that considered adherence to the recommendations for pregnant women in Spain. RESULTS: Compared with non-Roma women, advanced maternal age (≥35 years) and primigravida were less common among Roma women. Roma women visited the dentist less often, smoked more, and underwent group B streptococcus screening less frequently. No differences were found in the number of prenatal visits between Roma and non-Roma women. Consequently, there were no differences between the Kessner index and the Modified Adequacy of Prenatal Care Utilization Spanish Index. Using the ad hoc index, the non-Roma women more frequently had adequate prenatal visits. There were no differences in birth characteristics, type of feeding, and neonatal outcomes. DISCUSSION: Overall, prenatal care was slightly worse in Roma women; however, this did not imply worse neonatal health outcomes. Both study groups had similar birth characteristics and immediate puerperium, including feeding.

[Hearing loss and social frailty in older men and women]. / Limitación auditiva y fragilidad social en hombres y mujeres mayores.

OBJECTIVE: To explore the association between hearing loss and social frailty in a sample of Spanish older adults recruited from primary health care network. METHOD: Cross-sectional study on a sample of 445 non-institutionalized adults aged 65 or more years (190 men and 255 women), recruited from primary care centers in Spain. Three self-reported hearing impairment questions were used to assess hearing loss. Social frailty was deemed to exist when the person presented two or more of the following conditions: living alone, absence of a person to provide help, infrequent contact with family, infrequent contact with friends, lack of confident and lack of help for daily activities in the last 3 months. To study the association between hearing loss and social frailty we used logistic regression models adjusted for potential confounders, including physical frailty. RESULTS: The mean age of participants was 76.2 years (77.5 years for women). More than half of the participants (54.4%) reported hearing loss and the frequency of social frailty was 23.2%. Hearing loss was associated with social frailty (adjusted odds ratio [aOR]=1.78; 95% confidence interval [95%CI]: 1.04-3.06). However, the association was sex-dependent (p for interaction=0.041). In stratified analysis, the association was only found in women (aOR=3.21; 95%CI: 1.44-7.17). CONCLUSIONS: Hearing loss was associated with social frailty in women, but not in men. Longitudinal studies are needed to confirm this association and to understand the differential effect of gender.