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[PMID]:28742443
[Au] Autor:Smith E; Charantimath US; Wilson SF; Hoffman MK
[Ad] Endereço:a Department of Obstetrics and Gynecology , Christiana Care Health System , Newark , DE, USA.
[Ti] Título:Family planning in Southern India: A survey of women's attitudes.
[So] Source:Health Care Women Int;38(10):1022-1033, 2017 Oct.
[Is] ISSN:1096-4665
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Women were recruited from villages in the Belgaum district of India. Members of the research team obtained consent and led 58 interviews in the local languages. Participants were asked questions covering topics related to postpartum contraceptive counseling, knowledge, and experience; postpartum sexual practice; birth spacing desire and counseling; and interest in long-acting reversible contraceptives (LARCs). Women generally desired 3 years of birth spacing. A majority did not receive counseling regarding postpartum contraception during the prenatal period, although most would have liked to have received such counseling. Those who had made a contraceptive plan during the prenatal period had an odds ratio of 25.2 (95% CI 4.9-128.6, p = 0.00001) for using postpartum contraception. Influences on contraceptive decisions primarily came from friends and family, while information from medical providers was not a major influence. Most women did not believe they could make their own decisions regarding contraception use, but those who did had an adjusted odds ratio of 56 (95% CI 3.4-9161, p = 0.0047) of utilizing postpartum contraception. Women generally liked the idea of LARCs. A large majority of the women surveyed (89.66%) liked the idea of a subdermal contraceptive implant, a method currently unavailable in this region. Ultimately, the women surveyed do have healthy attitudes and goals regarding birth spacing but few utilize effective contraception in order to meet their goals. Further efforts in counseling as well as availability of a wider variety of contraceptive methods, including the subdermal contraceptive implant, may decrease the disparity between desires and practices.
[Mh] Termos MeSH primário: Comportamento Contraceptivo
Anticoncepção/métodos
Serviços de Planejamento Familiar/métodos
Conhecimentos, Atitudes e Prática em Saúde
[Mh] Termos MeSH secundário: Adolescente
Adulto
Intervalo entre Nascimentos
Anticoncepção/utilização
Aconselhamento
Serviços de Planejamento Familiar/recursos humanos
Feminino
Seres Humanos
Índia
Período Pós-Parto
Saúde da População Rural
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1080/07399332.2017.1356306


  2 / 1509 MEDLINE  
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[PMID]:27776483
[Au] Autor:Holmlund S; Kauko T; Matomäki J; Tuominen M; Mäkinen J; Rautava P
[Ad] Endereço:Department of Public Health, University of Turku, 20014, Turun yliopisto, Finland. susanna.holmlund@utu.fi.
[Ti] Título:Induced abortion - impact on a subsequent pregnancy in first-time mothers: a registry-based study.
[So] Source:BMC Pregnancy Childbirth;16(1):325, 2016 10 24.
[Is] ISSN:1471-2393
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To date, several studies concerning the effects of induced abortion (IA) on women's later psychosocial well-being and future delivery complications have been published. However, the lack of reports on woman's physical well-being during their first full-term pregnancy occurring after IA is what inspired the current study. Here, we evaluate the physical well-being and use of maternity services of first-time mothers with a history of IA. METHODS: Finnish National Birth Registry data from 2008 to 2010 were linked with the Induced Abortion Registry data from 1983 to 2007. After excluding first-time mothers with a history of miscarriage, ectopic pregnancy or delivery, 57,406 mothers were eligible for the study, with 5,167 (9.0 %) having experienced prior IA. Data from the pregnancy follow-up visits were evaluated and compared between IA mothers and primiparous mothers. RESULTS: Women with IA had higher rates of smoking after the first trimester and were more likely to be overweight (body mass index >25 kg/m ) than the control group mothers. A higher use of maternity health clinic (MHC) services, thrombosis prophylaxis and participation in a second trimester ultrasound and amniotic fluid sample testing were evident in IA mothers, whereas the likelihood of assisted fertilisation procedure(s) was elevated in the control group. A shorter interpregnancy interval (IPI) seemed to contribute to a late first MHC visit and first trimester serum screening test participation, a higher incidence of placenta samples and an increased presence of preeclampsia and maternal care for poor foetal growth. CONCLUSIONS: IA is associated with being overweight before the subsequent pregnancy and with smoking after the first trimester. More frequent pregnancy follow-up visits in the IA group may be due to greater participation in the placenta sample testing and use of thrombosis prophylaxis. No association between IA and preeclampsia, hypertension, gestational diabetes or preterm premature rupture of membranes was evident in the pregnancy parameters. According to our findings, experiencing IA decreased the need for fertilisation procedures before the next pregnancy when compared to primiparous mothers. Among the IA mothers, the short IPI seemed to contribute to the higher risk for preeclampsia and maternal care for poor foetal growth. However, more research is needed around the IPI before establishing its effect on later pregnancy.
[Mh] Termos MeSH primário: Aborto Induzido/psicologia
Mães/psicologia
Complicações na Gravidez/epidemiologia
Cuidado Pré-Natal/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Intervalo entre Nascimentos/psicologia
Feminino
Finlândia/epidemiologia
Seres Humanos
Incidência
Paridade
Gravidez
Complicações na Gravidez/etiologia
Complicações na Gravidez/psicologia
Primeiro Trimestre da Gravidez
Cuidado Pré-Natal/psicologia
Sistema de Registros
Fatores de Risco
Fumar/epidemiologia
Fumar/psicologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171203
[Lr] Data última revisão:
171203
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


  3 / 1509 MEDLINE  
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[PMID]:28619692
[Au] Autor:Stevens J; Lutz R; Osuagwu N; Rotz D; Goesling B
[Ad] Endereço:Nationwide Children's Hospital and the Ohio State University Department of Pediatrics, Columbus, OH. Electronic address: Jack.Stevens@nationwidechildrens.org.
[Ti] Título:A randomized trial of motivational interviewing and facilitated contraceptive access to prevent rapid repeat pregnancy among adolescent mothers.
[So] Source:Am J Obstet Gynecol;217(4):423.e1-423.e9, 2017 Oct.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Most interventions designed to reduce teen pregnancy rates have not focused on pregnant and/or parenting adolescents. Therefore, a large randomized controlled trial was conducted regarding a motivational interviewing program entitled Teen Options to Prevent Pregnancy in a low-income sample of adolescent mothers. This program recommended monthly sessions between a participant and a registered nurse over 18 months. This program also featured facilitated birth control access through transportation assistance and a part-time contraceptive clinic. OBJECTIVE: The impact of this program on rapid repeat pregnancies at 18 months after enrollment was evaluated. STUDY DESIGN: Five hundred ninety-eight adolescent females were enrolled from 7 obstetrics-gynecology clinics and 5 postpartum units of a large hospital system in a Midwestern city. Each participant was enrolled at least 28 weeks pregnant or less than 9 weeks postpartum. Each participant was randomized to either the Teen Options to Prevent Pregnancy intervention or a usual-care control condition. Intervention participants averaged 4.5 hours of assistance. Participants were contacted by blinded research staff at 6 and 18 months to complete self-report surveys. Differences in outcomes between the intervention and control groups were assessed using ordinary least-squares regression. RESULTS: There was an 18.1% absolute reduction in self-reported repeat pregnancy in the intervention group relative to the control group (20.5% vs 38.6%%; P < .001). There was a 13.7% absolute increase in self-reported long-acting reversible contraception use in the intervention group relative to the control group (40.2% vs 26.5%, P = .002). There was no evidence of harmful effects of the intervention on sexual risk behaviors, such as having sexual intercourse without a condom or greater number of partners. CONCLUSION: The Teen Options to Prevent Pregnancy program represents one of the few evidence-based interventions to reduce rapid repeat teen pregnancy. This relatively brief intervention may be a viable alternative to more time-intensive programs that adolescent mothers may be unable or unwilling to receive.
[Mh] Termos MeSH primário: Anticoncepção
Acesso aos Serviços de Saúde
Entrevista Motivacional
Gravidez na Adolescência/prevenção & controle
[Mh] Termos MeSH secundário: Adolescente
Intervalo entre Nascimentos
Comportamento Contraceptivo
Feminino
Seres Humanos
Meio-Oeste dos Estados Unidos
Período Pós-Parto
Gravidez
Assistentes Sociais
Transportes
Sexo sem Proteção/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170617
[St] Status:MEDLINE


  4 / 1509 MEDLINE  
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[PMID]:28505223
[Au] Autor:Norman M; Piedvache A; Børch K; Huusom LD; Bonamy AE; Howell EA; Jarreau PH; Maier RF; Pryds O; Toome L; Varendi H; Weber T; Wilson E; Van Heijst A; Cuttini M; Mazela J; Barros H; Van Reempts P; Draper ES; Zeitlin J; Effective Perinatal Intensive Care in Europe (EPICE) Research Group
[Ad] Endereço:Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden2Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden.
[Ti] Título:Association of Short Antenatal Corticosteroid Administration-to-Birth Intervals With Survival and Morbidity Among Very Preterm Infants: Results From the EPICE Cohort.
[So] Source:JAMA Pediatr;171(7):678-686, 2017 Jul 01.
[Is] ISSN:2168-6211
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Administration-to-birth intervals of antenatal corticosteroids (ANS) vary. The significance of this variation is unclear. Specifically, to our knowledge, the shortest effective administration-to-birth interval is unknown. Objective: To explore the associations between ANS administration-to-birth interval and survival and morbidity among very preterm infants. Design, Setting, and Participants: The Effective Perinatal Intensive Care in Europe (EPICE) study, a population-based prospective cohort study, gathered data from 19 regions in 11 European countries in 2011 and 2012 on 4594 singleton infants with gestational ages between 24 and 31 weeks, without severe anomalies and unexposed to repeated courses of ANS. Data were analyzed November 2016. Exposure: Time from first injection of ANS to delivery in hours and days. Main Outcomes and Measures: Three outcomes were studied: in-hospital mortality; a composite of mortality or severe neonatal morbidity, defined as an intraventricular hemorrhage grade of 3 or greater, cystic periventricular leukomalacia, surgical necrotizing enterocolitis, or stage 3 or greater retinopathy of prematurity; and severe neonatal brain injury, defined as an intraventricular hemorrhage grade of 3 or greater or cystic periventricular leukomalacia. Results: Of the 4594 infants included in the cohort, 2496 infants (54.3%) were boys, and the mean (SD) gestational age was 28.5 (2.2) weeks and mean (SD) birth weight was 1213 (400) g. Mortality for the 662 infants (14.4%) unexposed to ANS was 20.6% (136 of 661). Administration of ANS was associated with an immediate and rapid decline in mortality, reaching a plateau with more than 50% risk reduction after an administration-to-birth interval of 18 to 36 hours. A similar pattern for timing was seen for the composite mortality or morbidity outcome, whereas a significant risk reduction of severe neonatal brain injury was associated with longer administration-to-birth intervals (greater than 48 hours). For all outcomes, the risk reduction associated with ANS was transient, with increasing mortality and risk for severe neonatal brain injury associated with administration-to-birth intervals exceeding 1 week. Under the assumption of a causal relationship between timing of ANS and mortality, a simulation of ANS administered 3 hours before delivery to infants who did not receive ANS showed that their estimated decline in mortality would be 26%. Conclusions and Relevance: Antenatal corticosteroids may be effective even if given only hours before delivery. Therefore, the infants of pregnant women at risk of imminent preterm delivery may benefit from its use.
[Mh] Termos MeSH primário: Intervalo entre Nascimentos/estatística & dados numéricos
Glucocorticoides/administração & dosagem
Mortalidade Hospitalar
Mortalidade Infantil
Cuidado Pré-Natal/métodos
[Mh] Termos MeSH secundário: Estudos de Coortes
Europa (Continente)
Feminino
Idade Gestacional
Glucocorticoides/efeitos adversos
Seres Humanos
Lactente
Lactente Extremamente Prematuro
Recém-Nascido
Recém-Nascido Prematuro
Doenças do Prematuro/mortalidade
Masculino
Gravidez
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Glucocorticoids)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170516
[St] Status:MEDLINE
[do] DOI:10.1001/jamapediatrics.2017.0602


  5 / 1509 MEDLINE  
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[PMID]:28281274
[Au] Autor:Cinnirella F; Klemp M; Weisdorf J
[Ad] Endereço:Ifo Institute-Leibniz Institute for Economic Research at the University of Munich, Poschingerstr. 5, 81679, Munich, Germany. cinnirella@ifo.de.
[Ti] Título:Malthus in the Bedroom: Birth Spacing as Birth Control in Pre-Transition England.
[So] Source:Demography;54(2):413-436, 2017 Apr.
[Is] ISSN:1533-7790
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We use duration models on a well-known historical data set of more than 15,000 families and 60,000 births in England for the period 1540-1850 to show that the sampled families adjusted the timing of their births in accordance with the economic conditions as well as their stock of dependent children. The effects were larger among the lower socioeconomic ranks. Our findings on the existence of parity-dependent as well as parity-independent birth spacing in England are consistent with the growing evidence that marital birth control was present in pre-transitional populations.
[Mh] Termos MeSH primário: Intervalo entre Nascimentos/estatística & dados numéricos
Coeficiente de Natalidade/tendências
Anticoncepção/história
Renda/história
[Mh] Termos MeSH secundário: Inglaterra
Características da Família
História do Século XVI
História do Século XVII
História do Século XVIII
História do Século XIX
Seres Humanos
Renda/estatística & dados numéricos
Idade Materna
Fatores Socioeconômicos
Tempo (Meteorologia)
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171101
[Lr] Data última revisão:
171101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170311
[St] Status:MEDLINE
[do] DOI:10.1007/s13524-017-0556-4


  6 / 1509 MEDLINE  
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[PMID]:28225798
[Au] Autor:Scott S; Kendall L; Gomez P; Howie SR; Zaman SM; Ceesay S; D'Alessandro U; Jasseh M
[Ad] Endereço:Medical Research Council, The Gambia Unit, Fajara, The Gambia.
[Ti] Título:Effect of maternal death on child survival in rural West Africa: 25 years of prospective surveillance data in The Gambia.
[So] Source:PLoS One;12(2):e0172286, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The death of a mother is a tragedy in itself but it can also have devastating effects for the survival of her children. We aim to explore the impact of a mother's death on child survival in rural Gambia, West Africa. METHODS: We used 25 years of prospective surveillance data from the Farafenni Health and Demographic surveillance system (FHDSS). Mortality rates per 1,000 child-years up to ten years of age were estimated and Kaplan-Meier survival curves plotted by maternal vital status. Cox proportional hazard models were used to examine factors associated with child survival. FINDINGS: Between 1st April 1989 and 31st December 2014, a total of 2, 221 (7.8%) deaths occurred during 152,906 child-years of follow up. Overall mortality rate was 14.53 per 1,000 child-years (95% CI: 13.93-15.14). Amongst those whose mother died, the rate was 25.89 (95% CI: 17.99-37.25) compared to 14.44 (95% CI: 13.84-15.06) per 1,000 child-years for those whose mother did not die. Children were 4.66 (95% CI: 3.15-6.89) times more likely to die if their mother died compared to those with a surviving mother. Infants whose mothers died during delivery or shortly after were up to 7 times more likely to die within the first month of life compared to those whose mothers survived. Maternal vital status was significantly associated with the risk of dying within the first 2 years of life (p-value <0.05), while this was no longer observed for children over 2 years of age (P = 0.872). Other factors associated with an increased risk of dying were living in more rural areas, and birth spacing and year of birth. CONCLUSIONS: Mother's survival is strongly associated with child survival. Our findings highlight the importance of the continuum of care for both the mother and child not only throughout pregnancy, and childbirth but beyond 6 weeks post-partum.
[Mh] Termos MeSH primário: Mortalidade da Criança
Mortalidade Infantil
Mortalidade Materna
[Mh] Termos MeSH secundário: Adulto
Intervalo entre Nascimentos
Criança
Pré-Escolar
Feminino
Gâmbia/epidemiologia
Seres Humanos
Lactente
Recém-Nascido
Masculino
Meia-Idade
Vigilância da População
Estudos Prospectivos
População Rural
Fatores Socioeconômicos
Taxa de Sobrevida
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0172286


  7 / 1509 MEDLINE  
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[PMID]:28194605
[Au] Autor:Barclay KJ; Kolk M
[Ad] Endereço:Department of Social Policy, London School of Economics and Political Science, London, UK. k.j.barclay@lse.ac.uk.
[Ti] Título:The Long-Term Cognitive and Socioeconomic Consequences of Birth Intervals: A Within-Family Sibling Comparison Using Swedish Register Data.
[So] Source:Demography;54(2):459-484, 2017 Apr.
[Is] ISSN:1533-7790
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We examine the relationship between birth-to-birth intervals and a variety of mid- and long-term cognitive and socioeconomic outcomes, including high school GPA, cognitive ability, educational attainment, earnings, unemployment status, and receiving government welfare support. Using contemporary Swedish population register data and a within-family sibling comparison design, we find that neither the birth interval preceding the index person nor the birth interval following the index person are associated with any substantively meaningful changes in mid- or long-term outcomes. This is true even for individuals born before or after birth-to-birth intervals of less than 12 months. We conclude that in a contemporary high-income welfare state, there appears to be no relationship between unusually short or long birth intervals and adverse long-term outcomes.
[Mh] Termos MeSH primário: Intervalo entre Nascimentos/estatística & dados numéricos
Escolaridade
Fatores Socioeconômicos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Cognição
Feminino
Seres Humanos
Masculino
Assistência Pública/estatística & dados numéricos
Suécia/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171101
[Lr] Data última revisão:
171101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170215
[St] Status:MEDLINE
[do] DOI:10.1007/s13524-017-0550-x


  8 / 1509 MEDLINE  
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[PMID]:28178044
[Au] Autor:Hanley GE; Hutcheon JA; Kinniburgh BA; Lee L
[Ad] Endereço:Perinatal Services BC, and the Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada.
[Ti] Título:Interpregnancy Interval and Adverse Pregnancy Outcomes: An Analysis of Successive Pregnancies.
[So] Source:Obstet Gynecol;129(3):408-415, 2017 Mar.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To examine the association between interpregnancy interval and maternal-neonate health when matching women to their successive pregnancies to control for differences in maternal risk factors and compare these results with traditional unmatched designs. METHODS: We conducted a retrospective cohort study of 38,178 women with three or more deliveries (two or greater interpregnancy intervals) between 2000 and 2015 in British Columbia, Canada. We examined interpregnancy interval (0-5, 6-11, 12-17, 18-23 [reference], 24-59, and 60 months or greater) in relation to neonatal outcomes (preterm birth [less than 37 weeks of gestation], small-for-gestational-age birth [less than the 10th centile], use of neonatal intensive care, low birth weight [less than 2,500 g]) and maternal outcomes (gestational diabetes, beginning the subsequent pregnancy obese [body mass index 30 or greater], and preeclampsia-eclampsia). We used conditional logistic regression to compare interpregnancy intervals within the same mother and unconditional (unmatched) logistic regression to enable comparison with prior research. RESULTS: Analyses using the traditional unmatched design showed significantly increased risks associated with short interpregnancy intervals (eg, there were 232 preterm births [12.8%] in 0-5 months compared with 501 [8.2%] in the 18-23 months reference group; adjusted odds ratio [OR] for preterm birth 1.53, 95% confidence interval [CI] 1.35-1.73). However, these risks were eliminated in within-woman matched analyses (adjusted OR for preterm birth 0.85, 95% CI 0.71-1.02). Matched results indicated that short interpregnancy intervals were significantly associated with increased risk of gestational diabetes (adjusted OR 1.35, 95% CI 1.02-1.80 for 0-5 months) and beginning the subsequent pregnancy obese (adjusted OR 1.61, 95% CI 1.05-2.45 for 0-5 months and adjusted OR 1.43, 95% CI 1.10-1.87 for 6-11 months). CONCLUSION: Previously reported associations between short interpregnancy intervals and adverse neonatal outcomes may not be causal. However, short interpregnancy interval is associated with increased risk of gestational diabetes and beginning a subsequent pregnancy obese.
[Mh] Termos MeSH primário: Intervalo entre Nascimentos
Recém-Nascido Pequeno para a Idade Gestacional
Unidades de Terapia Intensiva Neonatal/utilização
Obesidade/epidemiologia
Complicações na Gravidez/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Colúmbia Britânica/epidemiologia
Diabetes Gestacional/epidemiologia
Feminino
Seres Humanos
Recém-Nascido
Pré-Eclâmpsia/epidemiologia
Gravidez
Nascimento Prematuro/epidemiologia
Estudos Retrospectivos
Medição de Risco
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170616
[Lr] Data última revisão:
170616
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170209
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000001891


  9 / 1509 MEDLINE  
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[PMID]:28137261
[Au] Autor:Sedekia Y; Nathan R; Church K; Temu S; Hanson C; Schellenberg J; Marchant T
[Ad] Endereço:Ifakara Health Institute, P.O BOX 78373, Dar-es-Salaam, Tanzania. Yovitha.sedekia@lshtm.ac.uk.
[Ti] Título:Delaying first birth: an analysis of household survey data from rural Southern Tanzania.
[So] Source:BMC Public Health;17(1):134, 2017 Jan 31.
[Is] ISSN:1471-2458
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Currently, family planning metrics derived from nationally-representative household surveys such as the Demographic and Health Surveys (DHS) categorise women into those desiring to space or limit (permanently stop) births, or according to their age in the case of young women. This conceptualisation potentially ignores a large and growing group of young women who desire to delay a first birth. This study uses household survey data to investigate the characteristics and needs for family planning of women who want to delay their first birth. METHODS: The research was conducted in two rural districts in southern Tanzania (Tandahimba and Newala), and nested within the Expanded Quality Management Using Information Power (EQUIP) study. Data were collected as part of a repeated cross sectional household survey conducted between September 2013 and April 2014. The socio-demographic characteristics, including parity, contraceptive practices and fertility intentions of 2128 women aged 13-49 were analysed. The association between women's life stages of reproduction (delayers of first birth, spacers of subsequent pregnancies and limiters of future birth) and selected contraceptive outcomes (current use, unmet need and demand for modern contraceptives) was assessed using the point estimates and 95% confidence intervals for each indicator, adjusted for the survey design. RESULTS: Overall, four percent of women surveyed were categorised as 'delayers of first birth', i.e. sexually active but not started childbearing. Among this group, the majority were younger than 20 years old (82%) and unmarried (88%). Fifty-nine percent were currently using a modern method of contraception and injectables dominated their contraceptive use. Unmet need for contraception was higher among delayers (41%; 95% CI 32-51) and limiters (41%; 95% CI 35-47) compared to spacers (19%; 95% CI 17-22). CONCLUSIONS: Delayers of first birth have very high unmet needs for modern contraceptives and they should be routinely and separately categorised and measured within nationally-representative surveys such as Demographic and Health Survey and Multiple Indicator Cluster surveys. Acknowledging their unique needs could help catalyse a programmatic response.
[Mh] Termos MeSH primário: Comportamento Contraceptivo/estatística & dados numéricos
Anticoncepção/estatística & dados numéricos
Serviços de Planejamento Familiar
População Rural/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Intervalo entre Nascimentos
Ordem de Nascimento
Estudos Transversais
Demografia
Feminino
Inquéritos Epidemiológicos
Seres Humanos
Gravidez
Tanzânia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE
[do] DOI:10.1186/s12889-017-4069-2


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[PMID]:28079768
[Au] Autor:Männistö J; Bloigu A; Mentula M; Gissler M; Heikinheimo O; Niinimäki M
[Ad] Endereço:Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University Hospital of Oulu and University of Oulu, the National Institute for Health and Welfare, Oulu, the Department of Obstetrics and Gynecology, University of Helsinki, Kätilöopisto Hospital, Helsinki University Hospital, and the National Institute for Health and Welfare, Helsinki, Finland; and the Karolinska Institutet, Stockholm, Sweden.
[Ti] Título:Interpregnancy Interval After Termination of Pregnancy and the Risks of Adverse Outcomes in Subsequent Birth.
[So] Source:Obstet Gynecol;129(2):347-354, 2017 Feb.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess whether the length of the interpregnancy interval after termination of pregnancy influences the risk of preterm birth, low birth weight, and small-for-gestational-age neonates in a subsequent pregnancy. METHODS: In this register-based study, we included all women (N=19,894) who underwent termination of pregnancy between 2000 and 2009 and whose subsequent pregnancy ended in live singleton delivery. The women were divided into five groups depending on the interpregnancy interval between termination of pregnancy and subsequent conception: interpregnancy interval less than 6 months (n=2,956), 6 to less than 12 months (n=3,203), 12 to less than 18 months (n=2,623), 18 to less than 24 months (n=2,076), and 24 months or greater (n=9,036). The incidences and unadjusted and adjusted risks of preterm birth, low birth weight, and small-for-gestational-age neonates were calculated in relation to the different interpregnancy interval lengths, the reference group being that with an interpregnancy interval of 18 to less than 24 months. RESULTS: There was a significant difference in the rate of preterm birth between the group with the interpregnancy interval less than 6 months and the reference group (5.6% compared with 4.0%, respectively, P=.008). After adjusting for nine background factors, an interpregnancy interval of less than 6 months was associated with an increased risk of preterm birth (adjusted odds ratio 1.35, 95% confidence interval 1.02-1.77). No such association emerged in longer interpregnancy interval groups or regarding other adverse events. The possibility of unmeasured confounding cannot be ruled out. CONCLUSION: Slightly but significantly increased estimated risk of preterm delivery in subsequent pregnancy was seen when the interpregnancy interval after termination of pregnancy was less than 6 months. These data emphasize the need for prompt initiation of effective contraception after termination and enable counseling the patient for optimal conception interval.
[Mh] Termos MeSH primário: Aborto Induzido/efeitos adversos
Intervalo entre Nascimentos
Resultado da Gravidez
Nascimento Prematuro/etiologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Idade Gestacional
Seres Humanos
Incidência
Recém-Nascido de Baixo Peso
Recém-Nascido
Recém-Nascido Pequeno para a Idade Gestacional
Idade Materna
Gravidez
Nascimento Prematuro/epidemiologia
Sistema de Registros
Fatores de Risco
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170113
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000001836



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