Estudio observacional, transversal, de una muestra representativa de las mujeres españolas en edad fértil, sobre los cuidados, hábitos y promoción de la salud previamente y durante el embarazo: Estudio GESTMUJER / Cross-sectional study of vitamin and folic acid supplementation in a representative sample of Spanish women of fertile age before and during pregnancy: The GESTMUJER study

Objetivo. Conocer los hábitos de las mujeres españolas en edad fértil, respecto al uso de suplementos vitamínicos y ácido fólico antes y durante el embarazo. Material y método. Encuesta telefónica realizada a una muestra representativa de 1.020 mujeres residentes en España de 15 a 49 años de edad, durante el mes de marzo del 2013. Resultados. Una de cada 4 mujeres españolas planifica su embarazo. Como consecuencia de esta falta de planificación, solo el 28,6% de las mujeres había tomado un suplemento de ácido fólico con anterioridad al momento de quedar embarazada. Conclusiones. Sigue existiendo la necesidad de informar y aconsejar a las mujeres en edad fértil sobre la conveniencia de utilizar ácido fólico previamente a un embarazo. Parecen necesarias campañas institucionales que promuevan tanto la planificación de un futuro embarazo, como el uso de suplementos vitamínicos antes y durante el mismo (AU)

Objective. To identify the use of folic acid and other vitamins in Spanish women of fertile age before and during pregnancy. Material and method. A representative survey of 1020 Spanish women aged 15 to 49 years was carried out in March 2013. Results. Only one quarter of Spanish women planned their pregnancies and,as a result, only 28.6% of women took folic acid before becoming pregnant. Conclusions. There is a lack of information about the role and importance of folic acid to prevent neural tube defects. Institutional campaigns are needed to promote both pregnancy planningand the use of vitamin supplements before and during pregnancy (AU)

Trends in contraception use in Spanish adolescents and young adults (15 to 24 years) between 2002 and 2008.

OBJECTIVE: To assess changes in the use of contraceptive methods, and induced abortion rates, in Spanish adolescents and young adults aged 15 to 24 years, between 2002 and 2008. STUDY DESIGN: Representative samples of Spanish men and women aged 15 to 24 years were surveyed in 2002 (N = 1826) and 2008 (N = 2000). RESULTS: The rate of use of contraceptive methods increased from 61% in men and 60% in women in 2002 to 80% and 75%, respectively, in 2008. The most commonly used method was the condom (51% in 2002 and 71% in 2008), followed by the contraceptive pill (18% in 2002 and 18% in 2008). None of the adolescents and young adults surveyed used natural methods or the diaphragm, or had undergone sterilisation. The induced abortion rate increased from 9.28 to 13.48 per 1000 women in the group aged between 15 and 19 years, and from 14.37 to 21.05 per 1000 women in the group aged 20 to 24 years. CONCLUSION: Despite an increase in the use of effective birth control methods, the rates of abortion rose during the study period, which may indicate that compliance with the use of condoms is inadequate. There is an urgent need to develop educational campaigns or to design specific policies addressing contraception-related issues for young people.

Contraceptive practices of women requesting induced abortion in Spain: a cross-sectional multicentre study.

OBJECTIVES: To collect information on (i) contraceptive methods used immediately before unwanted pregnancy, and (ii) planned contraception following induced abortion among Spanish residents. METHODS: Eight centres officially accredited to perform abortions participated in a cross-sectional study. The study population included 2475 women requesting induced abortion between 1 January and 31 March 2007. RESULTS: Contraceptive methods used before unwanted pregnancy were condoms in 40% of the cases, combined hormonal contraception in 14%, and other methods (mainly natural methods and withdrawal) in 10%. Thirty-six percent of women did not use any contraceptive method. Failure of the method due to incorrect use was reported by 77% of those using condoms and by 84% of those using hormonal contraception. Only 23% of women planned to use a contraceptive method after abortion. Almost half of the women were immigrants. CONCLUSION: Despite the use of effective contraceptive methods, the majority of women requesting induced abortion in Spain became pregnant during the use of these methods. These data reflect a lack of compliance. More education programmes are needed to improve compliance rates. The long-acting reversible contraceptive methods could constitute an appropriate approach.

Attitudes of Spanish women toward premenstrual symptoms, premenstrual syndrome and premenstrual dysphoric disorder: results of a nationwide survey.

OBJECTIVE: To assess the attitudes of women with premenstrual symptoms in relation to their perception of complaints and request for medical advice. STUDY DESIGN: Cross-sectional study of a representative cohort of 2018 Spanish women aged 15-49 years. Participants were personally interviewed at home and completed the premenstrual symptoms screening tool. RESULTS: A total of 1554 women (73.7%) complained of some of the premenstrual symptoms during the last 12 menstrual cycles. The prevalence of moderate or severe premenstrual syndrome (PMS) was 8.9% and the prevalence of premenstrual dysphoric disorder (PMDD) 1.1%. Only 291 (18.7%) women had sought medical advice. The main reason given by 90.6% of symptomatic women for not seeking medical consultation was to consider that symptoms were normal. A total of 175 (60.1%) women received pharmacological treatment (hormonal contraceptives in 95% followed by analgesics in 50% and anti-inflammatory agents in 44%), 20% were not treated because physicians considered that symptoms were not important and would disappear spontaneously, and 12% received only advice to change life style. CONCLUSION: Women suffering from PMS or PMDD do not usually seek medical advice and among those seeking medical care, in many cases, an adequate response to their demands is not obtained.

Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in a representative cohort of Spanish women of fertile age.

OBJECTIVE: To assess the prevalence of premenstrual symptoms, premenstrual syndrome and premenstrual dysphoric disorder in a cohort of women of fertile age representative of the general Spanish population. STUDY DESIGN: During the period between November 27th and December 22nd, 2008, a cross-sectional nationwide survey was conducted among a cohort of Spanish women aged between 15 and 49 years. Participants were personally interviewed at home and completed the premenstrual symptoms screening tool. RESULTS: Of the 2108 participants, 1554 women (73.7%) complained of some of the premenstrual symptoms during the last 12 menstrual cycles. A total of 1415 (91%) women presented isolated symptoms and 139 (8.9%) a moderate/severe premenstrual syndrome. Twenty-four (1.1%) women fulfilled criteria for a diagnosis of premenstrual dysphoric disorder. CONCLUSION: The prevalence of premenstrual symptoms (73.7%) and premenstrual dysphoric disorder (1.1%) in Spanish women aged between 15 and 49 years is similar to that reported in other Western countries. Only women with moderate or severe premenstrual syndrome or premenstrual dysphoric disorder, however, had daily life activities significantly impaired by premenstrual symptoms.

Trends in the use of contraceptive methods and voluntary interruption of pregnancy in the Spanish population during 1997-2007.

BACKGROUND: This study was designed to acquire information about the use of contraceptive methods in order to reduce the number of elective abortions. STUDY DESIGN: Since 1997, representative samples of Spanish women of childbearing potential (15-49 years) have been surveyed by the Daphne Team every 2 years to gather data of contraceptive methods used. RESULTS: During the study period, 1997 to 2007, the overall use of contraceptive methods increased from 49.1% to 79.9%. The most commonly used method was the condom (an increase from 21% to 38.8%), followed by the pill (an increase from 14.2% to 20.3%). Female sterilization and IUDs decreased slightly and were used by less than 5% of women in 2007. The elective abortion rate increased from 5.52 to 11.49 per 1000 women. CONCLUSIONS: The factors responsible for the increased rate of elective abortion need further investigation.

Un nuevo escenario asistencial / A new healthcare scenario

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Adenocarcinoma de cérvix y embarazo / Cervical adenocarcinoma and pregnancy

El 3% de los cánceres de cérvix se diagnostican en mujeres embarazadas. La decisión terapéutica está en función de la edad gestacional, el estadio de la enfermedad y los deseos de la paciente una vez informada sobre el pronóstico y el tratamiento. Presentamos un caso de adenocarcinoma de cérvix diagnosticado en la semana 28.a de embarazo (AU)

The three percent of cervical cancers are diagnosed during pregnancy. Therapeutic management is according to gestational age, extend of desease and patient desires after being well informed about prognosis and treatement. We report a case of cervical adenocarcinoma wich was diagnosed at28 weeks of pregnanacy (AU)

La juventud española y el doble método: un análisis de la situación actual. Resultados de un estudio transversal de una muestra amplia / Spanish 15-24-year-olds and the «double method»: Analysis of the current situation. Results of a cross-sectional study in a broad sample

Objetivos: Conocer el porcentaje de jóvenes españoles de ambos sexos, con edades comprendidas entre los 15 y los 24 años, que utilizan o conocen el doble método. Material y métodos: Estudio descriptivo, transversal, realizado en el mes de marzo de 2005 mediante una encuesta nacional entre una muestra de 2.015 jóvenes españoles con edades comprendidas entre los 15 y los 24 años. Los datos fueron recogidos en una base de datos diseñada para el estudio y su tratamiento estadístico se realizó mediante el paquete SPSS. Resultados: El 70% de los jóvenes es sexualmente activo. El método anticonceptivo más utilizado es el preservativo. Sólo el 3,4% de los jóvenes varones españoles y el 7,3% de las mujeres han utilizado, en alguna ocasión, un doble método, y este porcentaje desciende hasta el 0,2 y el 2,9%, respectivamente, cuando se refiere a la última relación sexual mantenida. El 31% de los varones y el 36,8% de las mujeres conocen el doble método. Conclusiones: El uso y el conocimiento del doble método entre la población joven española son bajos

Objectives: To determine the percentage ofSpanish 15-24-year-olds of both sexes that use orknow about the double method.Material and methods: We performed a crosssectionalstudy in March 2005 through a national survey of a sample of 2015 Spanish 15-24-yearolds.The data were collected in a databasespecifically designed for the study and wereanalyzed using the SPSS statistical system.Results: Seventy percent of the 15-24-year-oldswere sexually active. The most widely usedcontraceptive method was the condom. Only 3.4%of males and 7.3% of females had ever used thedouble method and this percentage decreased to0.2% and 2.9%, respectively, in the last sexualrelationship. Thirty-one percent of males and 36.8%of females were aware of the double method.Conclusions: Use and knowledge of the double method are low among young Spaniards (AU)