Status of human assisted reproduction in Spain: results from the new registry of Catalonia.

The FIVCAT. NET database in Catalonia is the only official obligatory registry of human assisted reproduction practitioners in Spain. The present study assessed the effectiveness and outcomes of assisted reproduction over the period 2001-2005 relative to other established worldwide registries. The data analysed were derived from all centres conducting assisted reproduction in Catalonia, and included users of the services (resident and non-resident); all cycles performed; descriptive characteristics of the assisted reproduction procedures; and sociodemographic characteristics of the women. Effectiveness of assisted reproduction was measured by standard indicators such as rates of pregnancy and rates of live births per pregnancy. The results indicated that the preferred number of embryos for transfer changed from three to two over this period. Pregnancies per transfer improved from 33.2% to 37.1% (from 36.9% to 40.2% using fresh embryos and from to 18.4% to 27.0% with frozen embryos). Multiple births decreased from 50.1% to 38.6%, premature births from 37.5% to 28.3% and low-birth-weight infants from 38.0% to 25.6%. It is concluded that the conduct of assisted reproduction in Catalonia has improved considerably and compares favourably with other countries, not only with respect to the level of activity, but also the effectiveness and outcomes achieved, although the quality of the sociodemographic information requires improvement.

Recourse to induced abortion in Spain: profiling of users and the influence of migrant populations

Background: Social vulnerability implies a higher risk of induced abortion (IA). Immigrant status could be an additional factor. The objective was to identify the patterns surrounding which women resort to IAs, and to study the relationship between socio-economic and health system factors. Another aim was to determine the relationship between the patterns identified and the immigrant's country. Methods: A cross-sectional study was performed including all IAs notified during 2006 on women residing in three Spanish autonomous communities (the Balearic Islands, Catalonia and Comunitat Valenciana). We used sociodemographic, nationality and related variables, reproductive history and use of health services. A Categorical Principal Component Analysis was used to summarize the information and to identify profiles. Results: More than a third of IAs were performed on non-Spanish women. Four dimensions have been determined that define the profile of women resorting to IAs: age, reproductive history and marital status; type of health services used; social level; and earlier or late IA and its repetitive use. Age and related factors were important determinants. Economic status and knowledge of the health system were related to access to contraception and IA information. Spanish, Western European and South American women had a higher social level than Romanian and African women. Late IA use and a lower recurrence characterised Asian, North African and Spanish women. Conclusion: Differences on IA use between groups of different women seem to be related to vulnerability (economic, social, knowledge and use of healthcare services). There is a different situation among immigrants of differing nationalities (AU)

Objetivos: La vulnerabilidad social representa un riesgo de interrupción voluntaria del embarazo (IVE). La inmigración puede ser un factor adicional. Se pretendía identificar patrones que caracterizaran a las mujeres que abortan y estudiar la relación con factores socioeconómicos y de atención sanitaria. Otro objetivo fue determinar la relación entre los patrones identificados y el origen de las inmigrantes. Métodos: Se realizó un estudio transversal incluyendo todas las IVE notificadas durante 2006 a tres registros de IVE de comunidades autónomas: Illes Balears, Catalunya y Comunitat Valenciana. Se utilizaron variables sociodemográficas, de nacionalidad y relacionadas, historia reproductiva y de utilización de servicios sanitarios. Se realizó un análisis de componentes principales categórico para resumir la información e identificar perfiles. Resultados: Las inmigrantes representaron más de un tercio de las IVE. Cuatro dimensiones definieron el perfil de las mujeres que abortan: edad, historia reproductiva y estado civil; utilización de servicios públicos o privados; nivel social; IVE tardía o precoz y su recurrencia. Edad y factores relacionados fueron determinantes importantes. El nivel económico y el conocimiento del sistema sanitario estaban relacionados con el acceso a la anticoncepción y a la información sobre IVE. Españolas, europeas occidentales y latinoamericanas tenían mayor nivel social que rumanas y africanas. El uso tardío de la IVE y una menor recurrencia fue característico de españolas, norteafricanas y asiáticas. Conclusión: Las diferencias en el recurso a la IVE entre grupos de mujeres parecen relacionarse con la vulnerabilidad (económica, social, de conocimiento y uso del sistema sanitario). La situación varía entre inmigrantes de diferentes nacionalidades (AU)

Recourse to induced abortion in Spain: profiling of users and the influence of migrant populations.

BACKGROUND: Social vulnerability implies a higher risk of induced abortion (IA). Immigrant status could be an additional factor. The objective was to identify the patterns surrounding which women resort to IAs, and to study the relationship between socio-economic and health system factors. Another aim was to determine the relationship between the patterns identified and the immigrant's country. METHODS: A cross-sectional study was performed including all IAs notified during 2006 on women residing in three Spanish autonomous communities (the Balearic Islands, Catalonia and Comunitat Valenciana). We used sociodemographic, nationality and related variables, reproductive history and use of health services. A Categorical Principal Component Analysis was used to summarize the information and to identify profiles. RESULTS: More than a third of IAs were performed on non-Spanish women. Four dimensions have been determined that define the profile of women resorting to IAs: age, reproductive history and marital status; type of health services used; social level; and earlier or late IA and its repetitive use. Age and related factors were important determinants. Economic status and knowledge of the health system were related to access to contraception and IA information. Spanish, Western European and South American women had a higher social level than Romanian and African women. Late IA use and a lower recurrence characterised Asian, North African and Spanish women. CONCLUSION: Differences on IA use between groups of different women seem to be related to vulnerability (economic, social, knowledge and use of healthcare services). There is a different situation among immigrants of differing nationalities.