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  • 1
    Online Resource
    Online Resource
    Variações das taxas de cesariana e cesariana recorrente no Brasil segundo idade gestacional ao nascer e tipo de hospital
    FapUNIFESP (SciELO) ; 2022
    In:  Cadernos de Saúde Pública Vol. 38, No. 6 ( 2022)
    Details
    In: Cadernos de Saúde Pública, FapUNIFESP (SciELO), Vol. 38, No. 6 ( 2022)
    Abstract: This study aimed to describe cesarean and repeated cesarean section rates in Brazil according to gestational age (GA) at birth and type of hospital. This is an ecologic study using data from the Brazilian Information System on Live Births and the 2017 National Registry of Health Facilities. Overall and repeated cesarean section rates were calculated and analyzed according to GA, region of residence, and type of hospital. Spearman correlations were performed between cesarean and repeated cesarean section rates by GA subgroups at birth (≤ 33, 34-36, 37-38, 39-41, and ≥ 42 weeks) and analyzed according to the type of hospital. Overall and repeated cesarean section rates were 55.1% and 85.3%, respectively. More than 60% of newborns between 37-38 weeks were delivered via cesarean section. Private hospitals in all regions showed the highest cesarean section rates, especially those in the Central-West Region, with more than 80% at all GAs. The overall cesarean section rate was highly correlated with all cesarean section rates of GA subgroups (r 〉 0.7, p 〈 0.01). Regarding repeated cesarean sections, the overall rate was strongly correlated with the rates of 37-38 and 39-41 weeks in public/mixed hospitals, differing from private hospitals, which showed moderate correlations. This finding indicates the decision for cesarean section is not based on clinical factors, which can cause unnecessary damage to the health of both the mother and the baby. Then, changes in the delivery care model, strengthening public policies, and encouragement of vaginal delivery after a cesarean section in subsequent pregnancies are important strategies to reduce cesarean section rates in Brazil.
    Type of Medium: Online Resource
    ISSN: 1678-4464 , 0102-311X
    Uniform Title: Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital
    URL: Article
    DOI: 10.1590/0102-311xpt073621
    Language: Portuguese , English
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2022
    detail.hit.zdb_id: 2027139-6
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital
    FapUNIFESP (SciELO) ; 2022
    In:  Cadernos de Saúde Pública Vol. 38, No. 6 ( 2022)
    Details
    In: Cadernos de Saúde Pública, FapUNIFESP (SciELO), Vol. 38, No. 6 ( 2022)
    Abstract: O objetivo deste estudo foi descrever as taxas de cesariana e cesariana recorrente no Brasil segundo a idade gestacional (IG) ao nascer e o tipo de hospital. Trata-se de um estudo ecológico, utilizando dados do Sistema de Informação sobre Nascidos Vivos e do Cadastro Nacional de Estabelecimentos de Saúde de 2017. As taxas de cesariana geral e recorrente foram calculadas e analisadas de acordo com a IG, região de residência e tipo de hospital. Foram realizadas correlações de Spearman entre as taxas de cesariana e cesariana recorrente por subgrupos de IG ao nascer (≤ 33, 34-36, 37-38, 39-41 e ≥ 42 semanas), analisadas segundo o tipo de hospital. Verificaram-se taxas de cesariana geral e recorrente de 55,1% e 85,3%, respectivamente. Mais de 60% dos recém-nascidos entre 37-38 semanas ocorreram via cesariana. Os hospitais privados de todas as regiões concentraram as maiores taxas de cesariana, sobretudo os do Centro-oeste, com mais de 80% em todas as IG. A taxa geral de cesariana foi altamente correlacionada com todas as taxas de cesariana dos subgrupos de IG (r 〉 0,7, p 〈 0,01). Quanto à cesariana recorrente, verificou-se forte correlação com as taxas de 37-38 e 39-41 semanas no hospital público/misto, diferindo do hospital privado, que apresentou correlações moderadas. Isso indica que a decisão pela cesariana não é pautada em fatores clínicos, o que pode causar danos desnecessários à saúde da mulher e do bebê. Conclui-se que mudanças no modelo de atenção ao parto, fortalecimento de políticas públicas e maior incentivo do parto vaginal após cesárea em gestações subsequentes são estratégias importantes para a redução das cesarianas no Brasil.
    Type of Medium: Online Resource
    ISSN: 1678-4464 , 0102-311X
    Uniform Title: Variações das taxas de cesariana e cesariana recorrente no Brasil segundo idade gestacional ao nascer e tipo de hospital
    URL: Article
    DOI: 10.1590/0102-311xen073621
    Language: English , Portuguese
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2022
    detail.hit.zdb_id: 2027139-6
    Location Call Number Limitation Availability
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Avaliação das informações do Sistema de Informações sobre Nascidos Vivos (SINASC), Brasil
    FapUNIFESP (SciELO) ; 2019
    In:  Cadernos de Saúde Pública Vol. 35, No. 10 ( 2019)
    Details
    In: Cadernos de Saúde Pública, FapUNIFESP (SciELO), Vol. 35, No. 10 ( 2019)
    Abstract: Abstract: This study is a quantitative and qualitative assessment of data from the Brazilian Information System on Live Births (SINASC) in Brazil. Coverage of the data by municipality was estimated as the ratio between reported and estimated live births. Data quality in the SINASC was assessed via probabilistic linkage with the database from the Birth in Brazil study, 2011-2012, and kappa coefficients of agreement were calculated. In 2013, data coverage was high and homogeneous in all states of Brazil. However, the analysis according to municipalities (counties) showed greater spatial heterogeneity. As for completeness of information in SINASC, kappa coefficients were statistically different from zero for all the tested variables (p 〈 0.001), and marginal distributions of all the variables were similar in the two databases. Gestational age was the variable with the worst agreement, with a kappa value of 0.461. The indicator that describes the inconsistencies, measured by the sum of the square of the differences between the reported and expected prematurity rates by birthweight bracket, showed the highest value in the North of Brazil and the lowest in the South, pointing to geographic inequalities in measurement of gestational age.
    Type of Medium: Online Resource
    ISSN: 1678-4464 , 0102-311X
    URL: Article
    DOI: 10.1590/0102-311x00214918
    Language: Portuguese
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2019
    detail.hit.zdb_id: 2027139-6
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  • 4
    Online Resource
    Online Resource
    Redução das iniquidades sociais no acesso às tecnologias apropriadas ao parto na Rede Cegonha
    FapUNIFESP (SciELO) ; 2021
    In:  Ciência & Saúde Coletiva Vol. 26, No. 3 ( 2021-03), p. 823-835
    Details
    In: Ciência & Saúde Coletiva, FapUNIFESP (SciELO), Vol. 26, No. 3 ( 2021-03), p. 823-835
    Abstract: Abstract This article compares the findings of “Avaliação da Rede Cegonha” (ARC – Stork Network Assessment), an evaluative study on the Rede Cegonha (RC – Stork Network) program, with Nascer no Brasil (NB – Born in Brazil), a national survey on labor and birth, conducted in 2011-12, before the start implementation of RC. ARC was conducted in 2017, in 606 maternity hospitals involved in RC and NB included a sample with national representation of 266 hospitals. In the current analysis, we included the 136 SUS hospitals that participated in both studies, totaling 3,790 and 12,227 puerperal women. We perform comparisons of best practices and interventions in the management of labor and delivery using Pearson’s chi-square test for independent samples. The prevalence of best practices was, on average, 150% higher in ARC than in NB, with a greater relative increase in less developed regions, for older, brown and black women and less educated. Regarding interventions, there was an average reduction of 30% between NB and ARC, with a greater relative reduction in less developed regions and less educated women. There was a significant improvement in the scenario of care for labor and childbirth, with a reduction in regional, educational and racial inequalities in access to appropriate technologies, suggesting that the RC intervention was effective.
    Type of Medium: Online Resource
    ISSN: 1678-4561 , 1413-8123
    URL: Article
    DOI: 10.1590/1413-81232021263.06642020
    Language: Portuguese
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2021
    detail.hit.zdb_id: 2078799-6
    SSG: 7,36
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