Perspectives of healthcare workers on the morality of abortion: a multicenter study in seven Brazilian public hospitals.

We used the questionnaire "Mosaic of Opinions on Induced Abortion" to conduct a multi-centered study to evaluate the perspectives of physicians, nurses, social workers, psychologists and pharmacists on the morality of abortion. In all, 254 participants constituted the sample. The inadequate knowledge on Brazilian abortion laws was the only determinant negatively associated with the construct "Sexual and Reproductive Rights", corroborating the hypothesis that a better understanding of abortion legislation could mitigate the opposition of some professionals to the ethical perspective that access to safe abortion should be seen as a sexual and reproductive right.

Factors associated with low birth weight in a historical series of deliveries in Campinas, Brazil.

OBJECTIVE: To identify the risk factors associated with low birth weight (< 2500 grams). METHODS: Unmatched case-control study performed in a tertiary maternity hospital in Campinas, Brazil, involving 43,499 liveborn infants delivered in the institution between 1986 and 2004. Analysis of the database containing information on deliveries of women who gave birth to infants with low (6,477 cases) and normal (37,467) birth weight were performed. Factors associated with low birth weight were identified according to the odds ratio (OR) and 95% confidence interval (95%CI) in the bivariate analysis and according to the adjusted OR in the multivariate analysis. Sociodemographic characteristics, reproductive history, previous morbidity and factors related to current prenatal care were studied. RESULTS: Extremes of reproductive age, poor education, low maternal weight, smoking beyond the fourth month of pregnancy, previous cesarean section, interdelivery interval < or = 24 months and > or 37 months, maternal history of hypertension, cardiopathy and premature delivery, few (< or = 5) prenatal visits and beginning prenatal care late in pregnancy (after the 3rd month), premature rupture of membranes, increased blood pressure, infectious diseases and hemorrhages during current pregnancy were all associated with low birth weight. Maternal obesity and being a primipara were found to be protective factors. CONCLUSION: These results confirm the findings of previous studies. The detection and prenatal management of modifiable factors, counseling, pre-conception intervention, adequate prenatal care and the implementation of primary and secondary prevention of maternal morbidity should be a target for all obstetrician as a potential source for reducing the incidence of low birth weight.

Measurement properties of the questionnaire "Mosaic of opinions on induced abortion": a multicenter study in seven Brazilian hospitals.

OBJECTIVE: In Brasil, abortion is legal in cases of rape, when there is a risk of maternal death, and in cases of fetal anencephaly. However, the literature reports that some doctors refuse to care for women with such demands or come to perform it in a discriminatory manner. Pretest, test and evaluate the measurement properties of the "Mosaic of Opinions on Induced Abortion," a questionnaire developed to investigate the perspectives of Brazilian healthcare professionals about the morality of abortion. METHODS: Firstly, the questionnaire was pretested in an intentional sample of specialists. Secondly, it was tested in a randomized sample of 32 healthcare professionals. Finally, we conducted a multi-center study in seven university hospitals to evaluate the measurement properties of the questionnaire. RESULTS: Combined samples of the three phases totalized 430 individuals. In pretest and test, all the evaluated aspects obtained satisfactory results. In the multicenter phase, confirmatory factorial analysis led to an important reduction of the questionnaire, which also obtained good indicators of reliability, beyond the validation of construct and criteria. CONCLUSION: Questionnaire has been validated and is suitable for use in other surveys in Brasil.

Measurement properties of the questionnaire "Mosaic of opinions on induced abortion": a multicenter study in seven Brazilian hospitals

SUMMARY In Brasil, abortion is legal in cases of rape, when there is a risk of maternal death, and in cases of fetal anencephaly. However, the literature reports that some doctors refuse to care for women with such demands or come to perform it in a discriminatory manner. OBJECTIVE: Pretest, test and evaluate the measurement properties of the "Mosaic of Opinions on Induced Abortion," a questionnaire developed to investigate the perspectives of Brazilian healthcare professionals about the morality of abortion. METHODS: Firstly, the questionnaire was pretested in an intentional sample of specialists. Secondly, it was tested in a randomized sample of 32 healthcare professionals. Finally, we conducted a multi-center study in seven university hospitals to evaluate the measurement properties of the questionnaire. RESULTS: Combined samples of the three phases totalized 430 individuals. In pretest and test, all the evaluated aspects obtained satisfactory results. In the multicenter phase, confirmatory factorial analysis led to an important reduction of the questionnaire, which also obtained good indicators of reliability, beyond the validation of construct and criteria. CONCLUSION: Questionnaire has been validated and is suitable for use in other surveys in Brasil.

RESUMO RESUMO: No Brasil, o aborto induzido é permitido por lei em casos de estupro, risco de morte para a gestante e anencefalia fetal. Entretanto, a literatura relata que alguns médicos recusam atender mulheres com tais demandas, ou o fazem de maneira discriminatória. OBJETIVO: Pré-testar, testar e avaliar as propriedades da medida do "Mosaico de opiniões sobre o aborto induzido", um questionário para investigar as perspectivas de profissionais da saúde brasileiros sobre a moralidade do aborto. MÉTODOS: Primeiro, o questionário foi pré-testado em uma amostra intencional de especialistas. Em segundo lugar, foi testado em uma amostra aleatória de 32 profissionais da saúde. Finalmente, conduziu-se um estudo multicêntrico em sete hospitais universitários para avaliar as propriedades da medida do questionário. RESULTADOS: Combinadas, as amostras das três fases totalizaram 430 sujeitos. No pré-teste e no teste, todos os aspectos avaliados obtiveram resultados satisfatórios. Na fase multicêntrica, a análise fatorial confirmatória levou a uma importante redução do questionário, que também obteve bons indicadores de confiabilidade, além da validade de construto e de critério. CONCLUSÕES: O questionário foi validado e encontra-se apto para ser utilizado em outras pesquisas no Brasil.

Factors associated with low birth weight in a historical series of deliveries in Campinas, Brazil / Fatores associados a baixo peso ao nascer em uma série histórica de partos em Campinas, Brazil

OBJECTIVE: To identify the risk factors associated with low birth weight (<2500 grams). METHODS: Unmatched case-control study performed in a tertiary maternity hospital in Campinas, Brazil, involving 43,499 liveborn infants delivered in the institution between 1986 and 2004. Analysis of the database containing information on deliveries of women who gave birth to infants with low (6,477 cases) and normal (37,467) birth weight were performed. Factors associated with low birth weight were identified according to the odds ratio (OR) and 95 percent confidence interval (95 percentCI) in the bivariate analysis and according to the adjusted OR in the multivariate analysis. Sociodemographic characteristics, reproductive history, previous morbidity and factors related to current prenatal care were studied. RESULTS: Extremes of reproductive age, poor education, low maternal weight, smoking beyond the fourth month of pregnancy, previous cesarean section, interdelivery interval <24 months and >37 months, maternal history of hypertension, cardiopathy and premature delivery, few (<5) prenatal visits and beginning prenatal care late in pregnancy (after the 3rd month), premature rupture of membranes, increased blood pressure, infectious diseases and hemorrhages during current pregnancy were all associated with low birth weight. Maternal obesity and being a primipara were found to be protective factors. CONCLUSION: These results confirm the findings of previous studies. The detection and prenatal management of modifiable factors, counseling, pre-conception intervention, adequate prenatal care and the implementation of primary and secondary prevention of maternal morbidity should be a target for all obstetrician as a potential source for reducing the incidence of low birth weight.

OBJETIVO: Identificar os fatores de risco associados com baixo peso (<2500 g) ao nascimento. MÉTODOS: Estudo caso-controle não pareado realizado em uma maternidade terciária de Campinas, SP, envolvendo 43.499 nascidos vivos de partos realizados na instituição entre 1986 e 2004. Realizaram-se análises do banco de dados contendo informações sobre os partos de mulheres que deram à luz a crianças de baixo peso (6.477 casos) e peso normal (37.467) ao nascimento. Os fatores associados com o baixo peso ao nascimento foram identificados pelo odds ratio (OR) e IC95 por cento na análise bivariada e pelo OR ajustado na análise multivariada. Foram estudadas características sócio-demográficas, história reprodutiva, morbidade prévia e fatores relacionados ao pré-natal atual. RESULTADOS: Os fatores que estiveram associados com o baixo peso ao nascimento foram extremos de idade reprodutiva, baixa escolaridade, baixo peso materno, fumar além do quarto mês de gestação, cesariana anterior, intervalo interpartal <24 meses e >37 meses, história materna de hipertensão, cardiopatia e parto prematuro, <5 consultas de pré-natal e seu início tardiamente na gestação (após o terceiro mês), rotura prematura de membranas, aumento da pressão arterial, doenças infecciosas e hemorragias durante a atual gestação. Obesidade materna e primiparidade foram fatores de proteção. CONCLUSÃO: Estes resultados confirmam os achados de estudos prévios. A detecção e manejo ante-parto de fatores modificáveis, aconselhamento, intervenção pré-concepcional, pré-natal adequado e a implementação de prevenção primária e secundária de morbidade materna devem constituir uma preocupação para todo obstetra como potencial fonte de redução da incidência de baixo peso ao nascimento.