Rates of instrumental vaginal birth and cesarean and quality of maternal and newborn health care in private versus public facilities: Results of the IMAgiNE EURO study in 16 countries.

Autor: Lazzerini M; WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy., Valente EP; WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy., Covi B; WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy., Rozée V; Sexual and Reproductive Health and Rights Research Unit, Institut National d'Études Démographiques (INED), Paris, France., Costa R; Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.; Lusófona University/HEI-Lab: Digital Human-environment Interaction Labs, Lisbon, Portugal., Otelea MR; University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.; SAMAS Association, Bucharest, Romania., Abderhalden-Zellweger A; School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland., Węgrzynowska M; Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland., Linden K; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden., Arendt M; Beruffsverband vun de Laktatiounsberoderinnen zu Lëtzebuerg asbl (Professional Association of Lactation Consultants in Luxembourg), Luxembourg, Luxembourg., Brigidi S; Department of Anthropology, Philosophy and Social Work, Medical Anthropology Research Center (MARC), Rovira i Virgili University (URV), Tarragona, Spain., Miani C; Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany., Pumpure E; Department of Obstetrics and Gynecology, Riga Stradins University, Rīga, Latvia.; Riga Maternity Hospital, Rīga, Latvia., Radetic J; Centar za mame, Belgrade, Serbia., Drandic D; Roda - Parents in Action, Zagreb, Croatia., Cerimagic A; NGO Baby Steps, Sarajevo, Bosnia and Herzegovina., Nedberg IH; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway., Liepinaitienė A; Kaunas University of Applied Sciences, Kaunas, Lithuania., Rodrigues C; Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal., de Labrusse C; School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland., Baranowska B; Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland., Zaigham M; Department of Obstetrics and Gynecology, Institution of Clinical Sciences Lund, Lund University, Lund and Skåne University Hospital, Malmö, Sweden., Castañeda LM; Institut Català de la Salut, Generalitat de Catalunya, Spain., Batram-Zantvoort S; Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany., Jakovicka D; Faculty of Medicine, Riga Stradins University, Rīga, Latvia., Ruzicic J; Centar za mame, Belgrade, Serbia., Juciūtė S; Kaunas University of Applied Sciences, Kaunas, Lithuania., Santos T; Universidade Europeia, Lisbon, Portugal.; Plataforma CatólicaMed/Centro de Investigação Interdisciplinar em Saúde (CIIS) da Universidade Católica Portuguesa, Lisbon, Portugal., Gemperle M; Research Institute of Midwifery, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland., Tataj-Puzyna U; Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland., Elden H; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.; Department of Obstetrics and Gynecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden., Mizgaitienė M; Kaunas Hospital of the Lithuanian University of Health Sciences, Kaunas, Lithuania., Lincetto O; Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland., Sacks E; Department of International Health, Johns Hopkins University, Baltimore, Massachusetts, USA., Mariani I; WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2022 Dec; Vol. 159 Suppl 1, pp. 22-38.
DOI: 10.1002/ijgo.14458
Abstrakt: Objective: To explore the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic by facility type among 16 European countries, comparing rates of instrumental vaginal birth and cesarean.
Methods: Women who gave birth in the WHO European Region from March 1, 2020, to February 7, 2022, answered a validated online questionnaire. Rates of instrumental birth, instrumental vaginal birth, and cesarean, and a QMNC index were calculated for births in public versus private facilities.
Results: Responses from 25 206 participants were analyzed. Women giving birth in private compared with public facilities reported significantly more frequent total cesarean (32.5% vs 19.0%; aOR 1.70; 95% CI 1.52-1.90), elective cesarean (17.3% vs 7.8%; aOR 1.90; 95% CI 1.65-2.19), and emergency cesarean before labor (7.4% vs 3.9%; aOR 1.39; 95% CI 1.14-1.70) (P < 0.001 for all comparisons), with analyses by country confirming these results. QMNC index results were heterogeneous across countries and regions in the same country and were largely affected by geographical distribution of regions rather than by type of facility alone.
Conclusion: The study confirms that births in private facilities have higher odds of cesarean. It also suggests that QMNC should be closely monitored in all facilities to achieve high-quality care, independent of facility type or geographical distribution.
Gov Identifier: NCT04847336.
(© 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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