ABSTRACT
CONTEXT AND OBJECTIVE: There are no studies on birth weights among full-term infants born by means of elective cesarean section. We aimed to study this in private and public hospitals. DESIGN AND SETTING: Retrospective study at Universidade Federal do Triângulo Mineiro, Uberaba, Brazil. METHODS: Data were collected from the municipal medical birth register of Uberaba from January to December 2000. The data obtained (maternal age, type of delivery, number of prenatal care visits and birth weight, from full-term pregnancy) from the university hospital (UH), which is a tertiary hospital that only attends patients within the National Health System (SUS), were compared with data from four private hospitals (PHs) that attend health insurance plans and private patients. Student's t test, chi2 test and multiple logistic regression were used for statistical analysis, with the significance level set at p < 0.05. RESULTS: In the PHs, 1,100 out of 1,354 births (81.2 percent) were by cesarean section and in the UH, 373 out of 1,332 (28 percent). Birth weight increased significantly in association with increasing numbers of prenatal care visits, except for cesarean section cases in PHs. Birth weights among vaginal delivery cases in PHs were greater than in the UH (p < 0.05), but this was not observed among cesarean section cases. Multiple logistic regression showed that there was greater risk of low birth weight in PHs (odds ratio: 2.33; 95 percent confidence interval: 1.19 to 4.55). CONCLUSION: Elective cesarean section performed in PHs may be associated with low birth weight among full-term infants.
CONTEXTO E OBJETIVO: Uma das principais causas do aumento das taxas de cesariana no Brasil é o predominante caráter eletivo das indicações, principalmente em hospitais privados. O risco de desconforto respiratório neonatal pode ser uma complicação da cesariana eletiva, mas pelos nossos conhecimentos, não há estudo sobre peso ao nascimento de fetos a termo. Portanto, o objetivo deste trabalho é estudar o peso de fetos a termo nascidos em hospitais privados e públicos. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo realizado de Janeiro a Dezembro de 2000 na Universidade Federal do Triângulo Mineiro, em que os dados foram coletados do registro médico de nascimento de Uberaba (Brasil). MÉTODOS: Nós comparamos os dados obtidos (idade materna, tipo de parto, número de consultas pré-natais e o peso ao nascer de fetos a termo) no Hospital Universitário (HU), hospital terciário que atendo pelo Sistema Unico de Saúde (SUS) com quatro hospitais da rede privada (HPs - Hospitais Particulares) que atendem planos de saúde e privados. Os testes de "T de Student's", "chi2" e regressão logística múltipla foram usados para análise estatística com nível de significância estabelecido em p < 0,05. RESULTADOS: 1.100 em 1.354 (81,2 por cento) e 373 em 1.332 (28 por cento) cesarianas ocorreram, respectivamente, no HPs e HU. Nós observamos que o peso ao nascimento aumenta significantemente em associação com o número de consulta pré-natais, com exceção das cesarianas no HPs. Além disso, o peso ao nascimento nos partos vaginais no HPs é maior que no HU (p < 0,05) mas isto não é observado nas cesarianas. A análise de regressão múltipla demonstrou que o risco de baixo peso ao nascer no HPs é 2,33 (1,19 to 4,55). CONCLUSÃO: As cesarianas eletivas realizadas nos hospitais privados podem estar associadas a um menor peso ao nascimento de fetos a termo.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Birth Weight , Cesarean Section/statistics & numerical data , Delivery, Obstetric/statistics & numerical data , Infant, Low Birth Weight , Elective Surgical Procedures/statistics & numerical data , Brazil/epidemiology , Hospitals, Private/statistics & numerical data , Hospitals, Public/statistics & numerical data , Logistic Models , Maternal Age , Prenatal Care/statistics & numerical data , Retrospective StudiesABSTRACT
CONTEXT AND OBJECTIVE: There are no studies on birth weights among full-term infants born by means of elective cesarean section. We aimed to study this in private and public hospitals. DESIGN AND SETTING: Retrospective study at Universidade Federal do Triângulo Mineiro, Uberaba, Brazil. METHODS: Data were collected from the municipal medical birth register of Uberaba from January to December 2000. The data obtained (maternal age, type of delivery, number of prenatal care visits and birth weight, from full-term pregnancy) from the university hospital (UH), which is a tertiary hospital that only attends patients within the National Health System (SUS), were compared with data from four private hospitals (PHs) that attend health insurance plans and private patients. Student's t test, chi2 test and multiple logistic regression were used for statistical analysis, with the significance level set at p < 0.05. RESULTS: In the PHs, 1,100 out of 1,354 births (81.2%) were by cesarean section and in the UH, 373 out of 1,332 (28%). Birth weight increased significantly in association with increasing numbers of prenatal care visits, except for cesarean section cases in PHs. Birth weights among vaginal delivery cases in PHs were greater than in the UH (p < 0.05), but this was not observed among cesarean section cases. Multiple logistic regression showed that there was greater risk of low birth weight in PHs (odds ratio: 2.33; 95% confidence interval: 1.19 to 4.55). CONCLUSION: Elective cesarean section performed in PHs may be associated with low birth weight among full-term infants.
Subject(s)
Birth Weight , Cesarean Section/statistics & numerical data , Delivery, Obstetric/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Infant, Low Birth Weight , Adult , Brazil/epidemiology , Female , Humans , Infant, Newborn , Logistic Models , Maternal Age , Pregnancy , Retrospective StudiesABSTRACT
Objetivos: investigar a presença de cargas de trabalho em famílias de trabalhadores rurais. Método: um roteiro de pesquisa de cargas de trabalho foi aplicado em zona rural agrícola, por acadêmicos de medicina e profissionais de saúde da família. Resultados: foram identificados problemas de origem ambiental, sanitária e decorrentes da organização de processos de trabalho. O roteiro e os resultados obtidos foram referendados pela equipe rural de saúde da família. Conclusão: propõe-se um instrumento de coleta de dados complementar para identificação de demandas de saúde decorrentes do trabalho rural.
Purpose: To investigate the presence of occupational rural risks and their consequences to family health. Methods: The workers answered a questionary about the work burden. Resulte: Several occupational risks were identified in agricultural work, originated from the environment and sanitary and work process organization. The results were analyzed by a Family Health Program team. Conclusion: This questionary can be a supplementary instrument to other parameters aiming the identification of health problems related to the work in rural area.