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BACKGROUND: Falls are among the most common and serious adverse events for hospitalised patients. In-hospital falls pose a major medical and economic challenge for public health worldwide. Nevertheless, the issue is often addressed without regard to certain relevant variables such as the time of the fall. The aim of this study was to determine the effect of the implementation of a nurse-led intervention based on the temporal patterns of falls and their aetiology on the occurrence of falls. METHODS: A mixed-method research design was carried out in three phases: a) a longitudinal prospective study (audits, chronobiological analyses and implementation of a multicentre nurse-led intervention based on temporal patterns of falls); b) a retrospective study of fall records; and c) a qualitative study based on focus groups. The protocol was published in 2021. RESULTS: A difference was observed in the number of fall records before and after the chronopreventive intervention (retrospective: 64.4% vs. 35.6%; p < 0,001). According to the interrupted series analysis, considering the influence of the COVID-19 pandemic, a reduction in falls of 2.96% (95% CI 1.70%-4.17%) was observed. The concepts of falls, the COVID-19 pandemic and the causes of non-registration have emerged as categories for qualitative analysis. CONCLUSIONS: A multicentric nurse-led program based on tailored organisational, educational and behavioural chronopreventive measures seems to lead to a reduction in the number of in-hospital falls. The findings of the present study, highlighting the implementation of chronopreventive measures, can serve as a basis for future health policies. TRIAL REGISTRATION: The project was registered on the Clinical Trials Registry NCT04367298 (29/04/2020).
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BACKGROUND: Accidental falls in hospitals are serious events concerning the safety of the patients. Recent studies demonstrated that the time of falls is a key factor to be considered in prevention. It has been shown that the time of day, the day of the week and the month of the year impact on the occurrence of falls. The aim of the study is to determine the effect of the application of a programme of preventive measures based on the temporal patterns of the risk factors on the hospital fall occurrence. METHODS: A mixed-method research design. The following three phases will be carried out: 1) Longitudinal prospective study in two parts: (a) audits and seminars of healthcare professionals focused on an effective and efficient hospital falls register. Multi-Component and Single Cosinor analyses will be performed to obtain the temporal patterns of hospital falls and their related variables and (b) implementation of a based-temporal patterns, multidimensional prevention programme. 2) Retrospective study of falls registered in institutional databases. 3) Qualitative study based on focus groups (physicians, nurses and nursing assistants). The study protocol was approved in 2018. DISCUSSION: With regard to the safety of patients, hospital falls are serious events. Recent studies have demonstrated that the time of falls is a key factor to be considered in prevention. It has been shown that the time of day, the day of the week and the month of the year impact on the occurrence of falls. It is imperative to study temporal patterns of hospital falls to effectively and comprehensively define the aetiology of falls and, therefore, design preventive strategies. A reduction of the number of in-hospital falls and related injuries is expected, as well as an improvement in the quality of life of patients. Considering temporal patterns and levels of mood and sleep of healthcare professionals will achieve an improvement in patient safety. TRIAL REGISTRATION: Retrospectively registered in ClinicalTrials.gov ID: NCT04367298.
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Young adults have a significant prevalence of mental disorders, which could lead to dysfunctional quality of life. Records of 1,645 Spanish adolescents were examined and multiple logistic regressions were performed. Being a woman, being older and having a sedentary life were all associated with a higher psychological vulnerability, whereas a low frequency of fresh fruit and bread/cereals consumption, as well as regular intense physical activity, were considered protective against such susceptibility. Regular physical activity and a diet with a high consumption of fruit and cereals may help reduce depressive symptoms, but sociodemographic features are as much as important as lifestyle habits.
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Dieta/psicología , Ejercicio Físico/psicología , Conducta Alimentaria/psicología , Adolescente , Depresión , Femenino , Frutas , Humanos , Estilo de Vida , Masculino , Calidad de Vida , Factores Socioeconómicos , España , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The objective of the study was to evaluate alcohol and tobacco consumption in young people in Spain, after Law 42/2010, during the interval of 2011-2014. The sample consisted of 3270 young people aged between 15 and 24 years who completed the National Survey of Health in Spain (ENSE) of 2011 and the European Survey of Health in Spain (EESE) of 2014. Variables: consumption, type of tobacco, attempts to quit smoking, consumption and type of alcoholic beverage, binge drinking, and sociodemographic variables. Logistic regression analysis was performed with the sociodemographic variables. The results indicated a decrease in tobacco and alcohol consumption from 2011 to 2014, and increased attempts to quit smoking. Beer is the most popular drink, most consumption is carried out between 1 and 2 days per week, and half of the young people who drink alcohol have taken part in binge drinking in the last 12 months. There are significant differences in tobacco and alcohol consumption. Between 2011 and 2014, the number of occasional and daily smokers, and alcohol consumption decreased, coinciding with the entry into force of Law 42/2010. Binge drinking is the most common pattern among young people. The factors that relate to greater consumption of tobacco are: being male, being married, and not having university studies. On another hand, the variables related to alcohol consumption are: being male, having Spanish nationality and university studies.
El objetivo del estudio fue evaluar el consumo de alcohol y tabaco en jóvenes en España, posterior a la ley 42/2010, periodo 2011-2014. La muestra estaba formada por 3270 jóvenes entre 15 y 24 años de la Encuesta Nacional de Salud en España (ENSE) de 2011 y la Encuesta Europea de Salud en España (EESE) de 2014. Variables: consumo, tipo de tabaco, intentos de dejar de fumar, consumo y tipo de bebida alcohólica, consumo intensivo de alcohol en una misma ocasión y variables sociodemográficas. Se realizó análisis de regresión logística con las variables sociodemográficas. Los resultados indicaron una disminución del consumo de tabaco y alcohol desde 2011 a 2014, aumentado los intentos de dejar de fumar. El tipo de bebida que más esta aumentado es la cerveza, el consumo mayoritario es entre 1 y 2 días/semana y la mitad de jóvenes que consumen alcohol han tenido un consumo intensivo en una misma ocasión en los últimos 12 meses. Existen diferencias significativas en el consumo de tabaco y alcohol. Entre 2011 y 2014 ha descendido el número de fumadores ocasionales, a diario y consumo de alcohol, coincidiendo con la entrada en vigor de la ley 42/2010. El consumo intensivo de alcohol, binge drinking, es el patrón que más se está dando entre jóvenes. Los factores que se relacionan con mayor consumo de tabaco son: ser hombre, estar casado y no tener estudios universitarios. Por otro lado, las variables relacionadas con consumo de alcohol son: sexo masculino, nacionalidad española y estudios universitarios.
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Consumo de Bebidas Alcohólicas/epidemiología , Fumar/legislación & jurisprudencia , Uso de Tabaco/epidemiología , Adolescente , Estudios Transversales , Femenino , Encuestas Epidemiológicas/métodos , Humanos , Masculino , Factores de Riesgo , Distribución por Sexo , Cese del Hábito de Fumar/estadística & datos numéricos , Factores Socioeconómicos , España/epidemiología , Adulto JovenRESUMEN
Background: Cervical cancer has decreased in developed countries thanks to cytology screening programmes. The aims of this study were To analyse the frequency and evolution of performing cytology tests and to determine the variables that influence their use. Methods: Cross-sectional study of non-institutionalized women who participated in the national health survey (2006, 2011/12) and the European Health Survey in Spain (2009, 2014). Study variables: cytology-testing, time since last cytology-test, reason for performing the test, age, nationality, marital status, social status, education level and place of residence. Results: The study evaluated 53 628 women in Spain over 15 years old, with a mean age of 52.68 (SD ± 19.12). About 94.1% were Spanish, 49.2% were married and 77.2% lived with a partner. In 2014, 72% had a cytology test, a number that increased significantly. Women aged 25-65 were 5.13 times more likely to undergo a cytology test than those aged 15-24 years old (odds ratio (OR): 5.13; P < 0.001); women with university educations were 9.23 times more likely to undergo a cytology test than those without university educations (P > 0.001); those of social classes I and II (high) were 1.2 more likely to undergo a cytology test than those of low social class (P = 0.026); and Spanish women were 1.74 times more likely to undergo a cytology test than foreigners living in Spain (P < 0.001). Conclusion: Frequency of cytology testing has increased in the last few years. Screening for cervical cancer is associated with higher social status, education level, age, and not being foreign.
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Citodiagnóstico/estadística & datos numéricos , Detección Precoz del Cáncer/estadística & datos numéricos , Neoplasias del Cuello Uterino/diagnóstico , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Encuestas de Atención de la Salud , Humanos , Persona de Mediana Edad , Prevalencia , Factores Socioeconómicos , España , Adulto JovenRESUMEN
PURPOSE: Perinatal mortality has been decreasing in Europe thanks to a reduction in neonatal mortality. The causes of fetal mortality remain poorly studied. The objective was to determine the late fetal mortality rate in Spain in 2015 and the associated factors. METHODS: A cross-sectional study was performed using data regarding births in 2015 in Spain extracted from the National Institute of Statistics. Single births at 28 or more weeks of pregnancy were included. The sample comprised 340,371 births. Sociodemographic, obstetrical and neonatal variables were analyzed using univariate and multivariate logistic regression (MLR), with the fetal mortality from 28 weeks of pregnancy as the dependent variable. RESULTS: The total number of late fetal deaths was 884 (2.6 × 1000). The MLR model showed that the following factors were associated with late fetal mortality: birth before 37 weeks of pregnancy (OR 13.1); weight of the newborn < 2500 g (OR 3.22) and ≥ 4000 g (OR 3.36); low training level (OR 2.28); and others, such as African origin, maternal age ≥ 35 years, primiparity and mothers who were single. CONCLUSIONS: The rate of late fetal mortality in Spain has not decreased and has remained at the same level as in 2010. This result is related to prematurity, low birth weight, macrosomia and sociodemographic factors, such as low maternal preparation, mothers of African origin, age ≥ 35 years and mothers who are single. It is necessary to improve the quality and accessibility of prenatal care and the early detection of risk factors.
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Muerte Fetal/etiología , Mortalidad Fetal , Muerte Perinatal/etiología , Mortinato/epidemiología , Adulto , Estudios Transversales , Femenino , Humanos , Lactante , Mortalidad Infantil , Recién Nacido de Bajo Peso , Recién Nacido , Masculino , Edad Materna , Madres , Paridad , Mortalidad Perinatal , Embarazo , Complicaciones del Embarazo , Atención Prenatal , Factores de Riesgo , España/epidemiologíaRESUMEN
OBJECTIVE: To describe and analyze the relationship between pregnancy-related anxiety, prenatal distress, and individual resilience in pregnant women during the first trimester of pregnancy and compare it with the obstetric variable of parity. METHOD: Quantitative, descriptive, cross-sectional study using non-probabilistic circumstantial sampling. A total of 144 women participated. The Prenatal Distress Questionnaire, the Resilience Scale, and the Pregnancy-Related Anxiety Questionnaire were used. A descriptive analysis with measures of central tendency was performed, and the reliability of the instruments was assessed. RESULTS: The average age was 33.57 years. 58.3% were multiparous and 41.7% primiparous. Anxiety was found in 21.5% and very high levels of resilience in 54.9%. Primiparous women showed higher levels of worry about the future and fear of childbirth than multiparous women. Pregnant women with high resilience showed lower levels of anxiety and stress. CONCLUSION: Pregnant women with higher levels of resilience show less anxiety and stress during the first trimester of pregnancy. Primiparous women show more anxiety and stress than multiparous women.
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Ansiedad , Complicaciones del Embarazo , Primer Trimestre del Embarazo , Resiliencia Psicológica , Estrés Psicológico , Humanos , Femenino , Embarazo , Estudios Transversales , Adulto , Primer Trimestre del Embarazo/psicología , Ansiedad/epidemiología , Estrés Psicológico/epidemiología , Complicaciones del Embarazo/psicología , Adulto Joven , Paridad , Encuestas y CuestionariosRESUMEN
Introduction: The COVID-19 pandemic has had numerous maternal and neonatal consequences, especially at the mental level. Pregnant women experience a rise in anxiety symptoms and prenatal stress. Aims: The aim was to describe self-perceived health status, general stress and prenatal stress and to analyze relations and associations with sociodemographic factors. Methods: A quantitative, descriptive and cross-sectional study was conducted using non-probabilistic circumstantial sampling. The sample was recruited during the first trimester of pregnancy during the control obstetrical visit. The Google Forms platform was used. A total of 297 women participated in the study. The Prenatal Distress Questionnaire (PDQ), the Perceived Stress Score (PSS) and the General Health Questionnaire (GHQ-28) were used. Results: Primiparas presented higher levels of worry about childbirth and the baby (10.93 ± 4.73) than multiparous women (9.88 ± 3.96). Somatic symptoms were present in 6% of the women. Anxiety-insomnia was scored positively by 18% of the women. In the Spearman correlation analysis, statistically significant values were found between almost all study variables. A positive correlation was observed between self-perceived health and prenatal and general stress levels. Discussion: During the first trimester of gestation, prenatal concerns increase when levels of anxiety, insomnia and depression also increase. There is a clear relationship between prenatal worries, anxiety, insomnia and depression with stress. Health education that focuses on mental health of pregnant women would help reduce worries during pregnancy and would improve the pregnant women perception of her health and well-being.
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(1) Background: The rate of cesarean sections in late fetal mortality remains high. We aimed to determine the prevalence of late fetal mortality in Spain and risk factors for cesarean birth in women with stillbirth ≥ 28 weeks gestation between 2016-2019. (2) Methods: A retrospective observational study with national data between 2016-2019. A total of 3504 births with fetal dead were included. Sociodemographic, obstetrical and neonatal variables were analyzed using univariate and multivariate logistic regression (MLR), with cesarean birth with a stillborn ≥ 28 weeks gestation as the dependent variable. (3) Results: The late fetal mortality rate was 2.8 × 1000; 22.7% of births were by cesarean section. Factors associated with cesarean were having a multiple birth (aOR 6.78); stillbirth weight (aOR 2.41); birth taking place in towns with over 50,000 inhabitants (aOR 1.34); and mother's age ≥ 35 (aOR 1.23). (4) Conclusions: The late fetal mortality rate increased during the period. The performance of cesarean sections was associated with the mother's age, obstetric factors and place of birth. Our findings encourage reflection on how to best put into practice national clinical and socio-educational prevention strategies, as well as the approved protocols on how childbirth should be correctly conducted.
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Cesárea , Mortinato , Recién Nacido , Embarazo , Femenino , Humanos , Mortinato/epidemiología , Mortalidad Fetal , España/epidemiología , PrevalenciaRESUMEN
BACKGROUND: Healthcare systems advocate for quality care and humanized relations in routine birth care, and have therefore created the Birth Plan, a document available to pregnant women to state their preferences in relation to the birth process. METHODS: This qualitative research with a phenomenological design was carried out to record the experiences of women who presented a Birth Plan. Sample selection was carried out using non-probabilistic, intentional and convenience sampling, selecting seven participants who were willing to participate and share their experiences. RESULTS: After analyzing the content of the interviews, four categories emerged: "respecting the woman's wishes: humanizing the birth process", "information and primary Care", "expectations regarding the care received" and "results of using the birth plan", with their corresponding subcategories. CONCLUSION: Women consider it beneficial to present a Birth Plan, because it informs them about the process and gives them the opportunity to have a better experience, which takes into account their preferences for making the delivery less instrumental. In addition, they state the importance of having trained professionals involved, and call for more attention to be paid to the birth process in general.
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The COVID-19 pandemic has posed a high risk to the mental health of the entire population. Pregnant women are strongly affected by the consequences of COVID-19, resulting in increased anxiety and stress. Social support can be a protective factor when it comes to mental health disturbances such as anxiety, fear, or stress in pregnant women. This research aims to describe the anxiety and stress of women in the first trimester of pregnancy in times of pandemic and its relationship with social support. A quantitative, descriptive, cross-sectional study was conducted. A total of 115 women in the first trimester of pregnancy participated. Anxiety was found in 78.3% of the women. Self-perceived stress correlated significantly with the dimensions "concern for changes in oneself", "feelings about oneself", "concern about the future", and very weakly with social support. In addition, a negative correlation was observed between "feelings about oneself" and social support. During the COVID-19 pandemic, anxiety levels of women in our population are elevated. Pregnant women during the first trimester of pregnancy showed higher levels of fear of childbirth and concern about the future than multiparous women. Increased social support and decreased stress seem to influence "feeling about oneself".
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(1) Background: Female sexual dysfunction (FSD) has a high prevalence globally, and perinatal factors favor FSD, especially in the postpartum period. The aim was to determine the prevalence and factors influencing FSD in the postpartum period; (2) Methods: An observational study carried out in three primary care centers in southern Spain, with women in the postpartum period who had a single low-risk birth. One hundred and seventeen women answered the Female Sexual Function questionnaire during the 4th month postpartum, between January 2020 and December 2021. Sociodemographic, obstetric, neonatal variables and level of self-esteem were analyzed. A multiple logistic regression model was carried out; (3) Results: 78.4% had high level of self-esteem. FSD prevalence was 89.7%. Factors related to FSD were having an instrumental vaginal delivery, women with university studies, and prenatal preparation. Maternal age ≥ 35, multiparity, pathological processes in the child, a medium-low level of self-esteem and newborn weight were associated with disorders in some of domains of sexual function; (4) Conclusions: FSD is highly prevalent in the postpartum period and is associated with preventable factors. A preventive approach by health professionals to these factors is essential. Health services should implement postpartum follow-up programs, which may coincide in time and place with newborn follow-up programs.
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BACKGROUND: Birth plans are used for pregnant women to express their wishes and expectations about childbirth. The aim of this study was to compare obstetric and neonatal outcomes between women with and without birth plans. METHODS: A multicentre, retrospective case-control study at tertiary hospitals in southern Spain between 2009 and 2013 was conducted. A total of 457 pregnant women were included, 178 with and 279 without birth plans. Women with low-risk gestation, at full-term and having been in labour were included. Sociodemographic, obstetric and neonatal variables were analysed and comparisons were established. RESULTS: Women with birth plans were older, more educated and more commonly primiparous. Caesarean sections were less common in primiparous women with birth plans (18% vs. 29%, p = 0.027); however, no significant differences were found in instrumented births, 3rd-4th-degree tears or episiotomy rates. Newborns of primiparous women with birth plans obtained better results on 1 min Apgar scores, umbilical cord pH and advanced neonatal resuscitation. No significant differences were found on 5 min Apgar scores or other variables for multiparous women. CONCLUSIONS: Birth plans were related to less intervention, a more natural process of birth and better outcomes for mothers and newborns. Birth plans can improve the welfare of the mother and newborn, leading to birth in a more natural way.
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Parto Obstétrico , Resucitación , Estudios de Casos y Controles , Femenino , Humanos , Recién Nacido , Embarazo , Estudios Retrospectivos , España/epidemiologíaRESUMEN
ABSTRACT Objective: To describe and analyze the relationship between pregnancy-related anxiety, prenatal distress, and individual resilience in pregnant women during the first trimester of pregnancy and compare it with the obstetric variable of parity. Method: Quantitative, descriptive, cross-sectional study using non-probabilistic circumstantial sampling. A total of 144 women participated. The Prenatal Distress Questionnaire, the Resilience Scale, and the Pregnancy-Related Anxiety Questionnaire were used. A descriptive analysis with measures of central tendency was performed, and the reliability of the instruments was assessed. Results: The average age was 33.57 years. 58.3% were multiparous and 41.7% primiparous. Anxiety was found in 21.5% and very high levels of resilience in 54.9%. Primiparous women showed higher levels of worry about the future and fear of childbirth than multiparous women. Pregnant women with high resilience showed lower levels of anxiety and stress. Conclusion: Pregnant women with higher levels of resilience show less anxiety and stress during the first trimester of pregnancy. Primiparous women show more anxiety and stress than multiparous women.
RESUMO Objetivo: Descrever e analisar a relação entre a ansiedade relacionada à gravidez, o estresse pré-natal e a resiliência individual em mulheres grávidas durante o primeiro trimestre da gravidez e compará-la com a variável obstétrica da paridade. Método: Estudo quantitativo, descritivo, transversal usando amostragem circunstancial não probabilística. Um total de 144 mulheres participaram. Foram utilizados o Questionário de Estresse Pré-natal, a Escala de Resiliência e o Questionário de Ansiedade Relacionada à Gravidez. Foi realizada uma análise descritiva com medidas de tendência central, e a confiabilidade dos instrumentos foi avaliada. Resultados: A idade média foi de 33,57 anos. 58,3% eram multiparas e 41,7% primíparas. Ansiedade foi encontrada em 21,5% e níveis muito altos de resiliência em 54,9%. Mulheres primíparas apresentaram níveis mais altos de preocupação com o futuro e medo do parto do que mulheres multiparas. Mulheres grávidas com alta resiliência mostraram níveis mais baixos de ansiedade e estresse. Conclusões: Mulheres grávidas com níveis mais altos de resiliência apresentam menos ansiedade e estresse durante o primeiro trimestre da gravidez. Mulheres primíparas mostram mais ansiedade e estresse do que mulheres multiparas.
RESUMEN Objetivo: Describir y analizar la relación entre la ansiedad relacionada con el embarazo, el distrés prenatal y la resiliencia individual, en mujeres gestantes durante el primer trimestre de embarazo y compararlo con la variable obstétrica de paridad. Método: Estudio cuantitativo, descriptivo y transversal utilizando muestreo no probabilístico circunstancial. Participaron 144 mujeres. Se emplearon el Cuestionario de Distrés Prenatal, la Escala de Resiliencia y el Cuestionario de Ansiedad Relacionada con el Embarazo. Se realizó un análisis descriptivo con medidas de tendencia central y se evaluó la confiabilidad de los instrumentos. Resultados: La edad promedio fue de 33,57 años. El 58,3% eran multíparas y el 41,7% primíparas. El 21,5% presenta ansiedad y el 54,9% niveles muy altos de resiliencia. Las primíparas mostraron mayores niveles preocupación sobre el futuro y miedo al parto que las multíparas. Las gestantes con alta resiliencia muestran valores más bajos en ansiedad y estrés. Conclusiones: Las gestantes con niveles más elevados de resiliencia manifiestan menos ansiedad y estrés durante el primer trimestre de embarazo. Las primíparas presentan más ansiedad y estrés que las multíparas.
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OBJECTIVE: The purpose of this study was to know who are the people who assist women, who work as a health professional in the Spanish Public Health System, when they suffer intimate partner violence (IPV). METHODS: A descriptive, cross-sectional, multicenter study was conducted. The participants were female health professionals (N = 794) working within the Spanish Public Health System. The instrument used was Delgado, Aguar, Castellano, and Luna del Castillo's (2006) scale to measure ill-treatment of women. RESULTS: Two hundred seventy women suffered IPV (34%). Of the female health professionals who suffered IPV, 25.9% had spoken with someone about the violence, most commonly talking to trusted people (24.3%), a psychologist (24.3%), health professionals (20%), and others (20%). Married female health professionals living with their current or last partner/husband, residing in an urban area, and with their own salary were least likely to speak about their problem. CONCLUSION: Female health professionals who suffer IPV usually speak about this problem with trusted people instead of consulting a health professional, which may leave the problem in the private sphere. This can be because of victims not wanting to report the violence for fear of their intimate partner or wanting it to remain private. This may deprive the victims of the help they need. For this reason, the health services should establish screening for IPV not only for their patients but also for their workers.
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Personal de Salud/estadística & datos numéricos , Violencia de Pareja/estadística & datos numéricos , Comunicación , Estudios Transversales , Femenino , Humanos , Relaciones Interpersonales , Estado Civil , España/epidemiología , Población UrbanaRESUMEN
OBJECTIVE: To assess the risk of uterine rupture (UR) in attempted vaginal birth after cesarean and to identify risk factors. METHODS: Systematic review by consulting the following databases: PubMed (MEDLINE), Cochrane Library Plus, Embase, Nursing@Ovid, Cuidatge and Dialnet. The search was conducted between January and March 2015. MeSH descriptors used were: vaginal birth after cesarean; uterine rupture; labor induced and labor obstetric or trial of labor. There were no restrictions on date or language. The selection of articles was performed by 2 independent reviewers, standardized and unblinded. A critical review of the summary was conducted, and if was necessary, the full text was consulted. Prospective and retrospective documents were included. RESULTS: A total of 39 documents were included for their relevance and interest. Few clinical trials were found. The UR incidence on the results of the studies analyzed ranged from 0.15-0.98% in spontaneous labor; 0.3-1.5% in stimulation and induction with oxytocin, and 0.68-2.3% in prostaglandin inductions. CONCLUSIONS: The success of vaginal birth after cesarean is important and improves when conditions are optimal. However it is not without risks, the main one being UR. Induction of labor with oxytocin and/or prostaglandins appears as the main risk factor, while the spontaneous onset of labor and a prior vaginal birth are protective factors.
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Complicaciones Posoperatorias/etiología , Rotura Uterina/epidemiología , Parto Vaginal Después de Cesárea , Femenino , Humanos , Embarazo , Medición de Riesgo , Factores de Riesgo , Rotura Uterina/etiología , Parto Vaginal Después de Cesárea/efectos adversosRESUMEN
OBJECTIVE: to know the degree of fulfillment of the requests that women reflect in their birth plans and to determine their influence on the main obstetric and neonatal outcomes. METHOD: retrospective, descriptive and analytical study with 178 women with birth plans in third-level hospital. Inclusion criteria: low risk gestation, cephalic presentation, single childbirth, delivered at term. Scheduled and urgent cesareans without labor were excluded. A descriptive and inferential analysis of the variables was performed. RESULTS: the birth plan was mostly fulfilled in only 37% of the women. The group of women whose compliance was low (less than or equal to 50%) had a cesarean section rate of 18.8% and their children had worse outcomes in the Apgar test and umbilical cord pH; while in women with high compliance (75% or more), the percentage of cesareans fell to 6.1% and their children had better outcomes. CONCLUSION: birth plans have a low degree of compliance. The higher the compliance, the better is the maternal and neonatal outcomes. The birth plan can be an effective tool to achieve better outcomes for the mother and her child. Measures are needed to improve its compliance.
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Parto Obstétrico , Prioridad del Paciente , Adulto , Estudios Transversales , Femenino , Humanos , Recién Nacido , Embarazo , Resultado del Embarazo , Estudios Retrospectivos , Adulto JovenRESUMEN
OBJECTIVE: to evaluate the effects of labor stimulation with oxytocin on maternal and neonatal outcomes. METHOD: descriptive and analytical study with 338 women who gave birth at a tertiary hospital. Obstetric and neonatal variables were measured and compared in women submitted and non-submitted to stimulation with oxytocin. Statistics were performed using Chi-square test, Fisher exact test, Student t-test; and crude Odds Ratio with 95% confidence interval were calculated. A p < 0.05 was considered statistically significant. RESULTS: stimulation with oxytocin increases the rates of cesarean sections, epidural anesthesia and intrapartum maternal fever in primiparous and multiparous women. It has also been associated with low pH values of umbilical cord blood and with a shorter duration of the first stage of labor in primiparous women. However, it did not affect the rates of 3rd and 4th degree perineal lacerations, episiotomies, advanced neonatal resuscitation, 5-minute Apgar scores and meconium. CONCLUSION: stimulation with oxytocin should not be used systematically, but only in specific cases. These findings provide further evidence to health professionals and midwives on the use of oxytocin during labor. Under normal conditions, women should be informed of the possible effects of labor stimulation with oxytocin.
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Trabajo de Parto/efectos de los fármacos , Oxitócicos/farmacología , Oxitocina/farmacología , Adolescente , Adulto , Puntaje de Apgar , Cesárea/estadística & datos numéricos , Femenino , Sangre Fetal/efectos de los fármacos , Humanos , Recién Nacido , Persona de Mediana Edad , Embarazo , Resultado del Embarazo , Resucitación/estadística & datos numéricos , Adulto JovenRESUMEN
El objetivo del estudio fue evaluar el consumo de alcohol y tabaco en jóvenes en España, posterior a la ley 42/2010, periodo 2011-2014. La muestra estaba formada por 3270 jóvenes entre 15 y 24 años de la Encuesta Nacional de Salud en España (ENSE) de 2011 y la Encuesta Europea de Salud en España (EESE) de 2014. Variables: consumo, tipo de tabaco, intentos de dejar de fumar, consumo y tipo de bebida alcohólica, consumo intensivo de alcohol en una misma ocasión y variables sociodemográficas. Se realizó análisis de regresión logística con las variables sociodemográficas. Los resultados indicaron una disminución del consumo de tabaco y alcohol desde 2011 a 2014, aumentado los intentos de dejar de fumar. El tipo de bebida que más está aumentado es la cerveza, el consumo mayoritario es entre 1 y 2 días/semana y la mitad de jóvenes que consumen alcohol han tenido un consumo intensivo en una misma ocasión en los últimos 12 meses. Existen diferencias significativas en el consumo de tabaco y alcohol. Entre 2011 y 2014 ha descendido el número de fumadores ocasionales, a diario y consumo de alcohol, coincidiendo con la entrada en vigor de la ley 42/2010. El consumo intensivo de alcohol, bingedrinking, es el patrón que más se está dando entre jóvenes. Los factores que se relacionan con mayor consumo de tabaco son: ser hombre, estar casado y no tener estudios universitarios. Por otro lado, las variables relacionadas con consumo de alcohol son: sexo masculino, nacionalidad española y estudios universitarios
The objective of the study was to evaluate alcohol and tobacco consumption in young people in Spain, after Law 42/2010, during the interval of 2011-2014. The sample consisted of 3270 young people aged between 15 and 24 years who completed the National Survey of Health in Spain (ENSE) of 2011 and the European Survey of Health in Spain (EESE) of 2014. Variables: consumption, type of tobacco, attempts to quit smoking, consumption and type of alcoholic beverage, binge drinking, and sociodemographic variables. Logistic regression analysis was performed with the sociodemographic variables. The results indicated a decrease in tobacco and alcohol consumption from 2011 to 2014, and increased attempts to quit smoking. Beer is the most popular drink, most consumption is carried out between 1 and 2 days per week, and half of the young people who drink alcohol have taken part in binge drinking in the last 12 months. There are significant differences in tobacco and alcohol consumption. Between 2011 and 2014, the number of occasional and daily smokers, and alcohol consumption decreased, coinciding with the entry into force of Law 42/2010. Binge drinking is the most common pattern among young people. The factors that relate to greater consumption of tobacco are: being male, being married, and not having university studies. On another hand, the variables related to alcohol consumption are: being male, having Spanish nationality and university studies
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Consumo de Bebidas Alcohólicas/epidemiología , Fumar/legislación & jurisprudencia , Uso de Tabaco/epidemiología , Estudios Transversales , Encuestas Epidemiológicas/métodos , Factores de Riesgo , Distribución por Sexo , Cese del Hábito de Fumar/estadística & datos numéricos , Factores Socioeconómicos , España/epidemiologíaRESUMEN
PURPOSE: The purpose of this study was to determine whether birth plans are associated with improved obstetric and neonatal outcomes. STUDY AND DESIGN: This retrospective case-control study (N = 182) was conducted at a hospital in Córdoba, Spain, between August 2008 and September 2011. Obstetric and neonatal outcomes were compared between groups (women with and without birth plans). Chi-square statistics and Student's t-tests were used for statistical analysis. RESULTS: Women with birth plans were older and had a higher academic background than the control group. There were no significant differences between groups for any of the obstetric outcomes or 5-minute Apgar scores; however, there was a significant difference in umbilical artery cord blood pH values (p = .019). The percent of babies with umbilical cord blood pH < 7.24 among nulliparous women with birth plans (14.7%, n = 5) was lower than among babies of nulliparous women without birth plans (37.5%, n = 26). CLINICAL IMPLICATIONS: Findings of this study provide evidence that birth plans may be helpful and are not associated with any negative obstetric or neonatal outcomes. Mothers with birth plans and their babies have at least as good outcomes as those without a birth plan. Babies of nulliparous women with birth plans had better umbilical cord blood pH values than babies of nulliparous women without birth plans. Healthcare professionals can promote the use of birth plans as a resource to enhance communication of women's desires for labor and birth.