Determinants of seasonal influenza vaccination in pregnant women in Valencia, Spain.

BACKGROUND: In most countries the coverage of seasonal influenza vaccination in pregnant women is low. We investigated the acceptance, reasons for rejection and professional involvement related to vaccine information in pregnant women in Valencia, Spain. METHODS: Observational retrospective study in 200 pregnant women, 100 vaccinated and 100 unvaccinated, were interviewed during the 2014/2015 vaccination campaign. Electronic medical records, immunization registry and telephone interviews were used to determine reasons for vaccination and immunization rejection. RESULTS: 40.5% of pregnant women in the health department were vaccinated. The midwife was identified as source of information for 89% of women. The vaccine was rejected due to low perceptions of risk of influenza infection (23%), lack of information (19%), considering the vaccine as superfluous (16%), close proximity of delivery date (13%) and fear of side effects (12%). CONCLUSION: Pregnant women in Spain declined to be vaccinated due to under-estimation of the risk of contracting or being harmed by influenza, and lack of information. Interventions aiming to optimize vaccination coverage should include information addressing the safety and effectiveness of the current vaccine together with improved professional training and motivation.

Aceptabilidad de la vacuna contra el virus del papiloma humano en madres de la provincia de Valencia (España) / Acceptability of human papillomavirus vaccine in mothers from Valencia (Spain)

Introducción: La Comunidad Valenciana inició en octubre del 2008 el programa de vacunación contra el virus del papiloma humano (VPH) en niñas de 14 años. El objetivo de este estudio es evaluar los conocimientos sobre la infección por VPH y su vacuna en madres de adolescentes e identificar los factores asociados a la predisposición de vacunar a sus hijas. Material y métodos: Estudio observacional transversal mediante cuestionario dirigido a madres de alumnas nacidas en 1995 matriculadas en centros de secundaria de la provincia de Valencia durante 2010-2011. Muestra aleatoria estratificada por conglomerados (n=1.279). Análisis estadístico: porcentajes, intervalos de confianza, OR, contrastes chi al cuadrado y regresión logística multivariante. Resultados: Ochocientos treinta y tres cuestionarios completados (65,1%). El 76,6% de las madres habían vacunado a sus hijas contra el VPH. El 93,8% conocía la vacuna, sobre todo a través de la televisión (71,5%). El 78,5% recibió consejo favorable de un profesional sanitario, lo que mejoró la vacunación de sus hijas (OR: 2,4). Los conocimientos globales sobre la infección por VPH y la vacuna fueron bajos. La confianza de las madres en las vacunas como método preventivo mejora la vacunación contra VPH (OR: 3,8). El miedo a los efectos adversos (45,6%) fue el primer motivo de rechazo. Conclusiones: No parece que los medios de comunicación influyan en la decisión de vacunar. Sería conveniente minimizar la percepción de riesgo ante esta vacuna. El consejo del profesional sanitario actúa a favor de la vacunación si este interviene activamente en sentido positivo. Existe una brecha entre nivel de conocimientos y toma de decisión para vacunar (AU)

Introduction: In October 2008, Valencian Community started its human papillomavirus (HPV) vaccination schedules for 14 year-old girls. The aim of this study is to assess knowledge about HPV infection and its vaccine among the mothers of these girls, and to identify factors associated with the willingness to vaccinate their daughters. Material and methods: Cross-sectional study by means of a questionnaire to mothers of girls born in 1995, and attending secondary schools in the province of Valencia during 2010-2011. Cluster stratified random sample (n=1279). Statistical analysis: percentages, confidence intervals, OR, Chi-squared and multivariate logistic regression contrasts. Results: A total of 833 (65.1%) questionnaires were completed. The results obtained showed that, 76.6% of mothers had vaccinated their daughters against HPV; 93.8% knew about the vaccine, particularly through television (71.5%); and 78.5% received positive advice from a health professional which increased the vaccination of their daughters (OR: 2.4). There was low overall knowledge about HPV infection and vaccination. Confidence of the mothers in vaccines as a preventative method increases the HPV vaccination (OR: 3.8). The first reason for refusal was the fear of adverse events (45.6%). Conclusions: Apparently, the media does not influence the willingness to vaccinate. It would be desirable to minimize the perception of risk of the vaccine. Positive health advice from a health professional can have a positive effect on vaccination. There is a gap between the level of knowledge and decision-making to vaccinate (AU)

Asociación entre el índice de masa corporal materno, la ganancia de peso gestacional y el peso al nacer; estudio prospectivo en un departamento de salud / Relationship between maternal body mass index, gestational weight gain and birth weight; prospective study in a health department

Objetivo: Contrastar la relación que existe entre la ganancia de peso gestacional y el peso del recién nacido, entre cada categoría de IMC pregestacional. Material y Métodos: Estudio observacional y descriptivo con muestreo bietápico en el Departamento de Salud de la Ribera (Valencia, España). Se clasificaron en cuatro grupos dependiendo del índice de masa corporal (IMC) pregestacional. Resultados: Se estudiaron 140 gestantes. La evolución de la ganancia de peso gestacional (GPG) y de sus gradientes trimestrales fue ascendente. Se produjo un mayor incremento del primer al segundo trimestre que del segundo al tercero para todas las categorías de IMC pregestacional. Según las recomendaciones internacionales de GPG el 16,4% de la muestra tuvo una ganancia de peso inferior a la recomendada, el 38,6% una ganancia de peso igual y el 45% una ganancia de peso superior. El IMC pregestacional categorizado por la OMS, está relacionado con el peso al nacer, mostrando significación estadística (F=6,636 y p <0,001). Las obesas con una ganancia de peso mayor de la recomendada tienen recién nacidos con mayor peso (4.353±821,924 g) y las de bajo-peso con ganancia menor de la recomendada, tienen recién nacidos con pesos menores (2.900±381,83 g) que el resto de grupos. Conclusiones: La GPG de forma absoluta no mostró significación estadística con el peso al nacer con ninguna categoría materna de IMC pregestacional y, como indicador aislado, no es un valor añadido a la calidad del control prenatal (AU)

Objectives: To ascertain the relationship between maternal weight gain and birth weight, in every pre-gestational body mass index (BMI) category. Material and Methods: A two-stage sampling observational and descriptive study was carried out in the health department of La Ribera (Valencia, Spain). The sample was divided into four groups according to pre-gestational BMI. Findings: 140 pregnant women were studied. We observed rising pre-gestational weight gain (PWG) and trimestral gradients. There was a higher increase from the first to the second trimester than from the second to the third trimester in every pre-gestational BMI category. According to the international recommendations of Institute of Medicine, 16.4% of women had an inferior gestational weight gain (GWG), 38.6% were within the recommendations and 45% were above them. The pre-gestational BMI, categorized by the WHO, is related to the birth weight, showing a statistical significance (F=6.636 and p<0,001). . Obese mothers with a higher weight gain than the recommended have newborns with higher birth weight (4,353±821.924 g) and, underweight mothers with a lower weight gain than the recommended, have newborns with lower birth weights (2,900±381.83 g) than the rest of the groups. Conclusions: The absolute gestational weight gain did not show a statistical significance compared to the birth weight in any of the pre-gestational BMI categories and, as an isolated indicator, is not an added value to the prenatal quality control (AU)

[Acceptability of human papillomavirus vaccine in mothers from Valencia (Spain)]. / Aceptabilidad de la vacuna contra el virus del papiloma humano en madres de la provincia de Valencia (España).

INTRODUCTION: In October 2008, Valencian Community started its human papillomavirus (HPV) vaccination schedules for 14 year-old girls. The aim of this study is to assess knowledge about HPV infection and its vaccine among the mothers of these girls, and to identify factors associated with the willingness to vaccinate their daughters. MATERIAL AND METHODS: Cross-sectional study by means of a questionnaire to mothers of girls born in 1995, and attending secondary schools in the province of Valencia during 2010-2011. Cluster stratified random sample (n=1279). STATISTICAL ANALYSIS: percentages, confidence intervals, OR, Chi-squared and multivariate logistic regression contrasts. RESULTS: A total of 833 (65.1%) questionnaires were completed. The results obtained showed that, 76.6% of mothers had vaccinated their daughters against HPV; 93.8% knew about the vaccine, particularly through television (71.5%); and 78.5% received positive advice from a health professional which increased the vaccination of their daughters (OR: 2.4). There was low overall knowledge about HPV infection and vaccination. Confidence of the mothers in vaccines as a preventative method increases the HPV vaccination (OR: 3.8). The first reason for refusal was the fear of adverse events (45.6%). CONCLUSIONS: Apparently, the media does not influence the willingness to vaccinate. It would be desirable to minimize the perception of risk of the vaccine. Positive health advice from a health professional can have a positive effect on vaccination. There is a gap between the level of knowledge and decision-making to vaccinate.