scholarly journals Changes in contraception use among Brazilian women after childbirth, 2006-2013

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Felisbino-Mendes ◽  
B Barrozo Siqueira

Abstract Introduction There are gaps in knowledge regarding the neglected and vulnerable subgroups of FP actions in Brazil, such as postpartum women and women in general, regardless of their marital status. Objective To assess changes in the prevalence of use and in the contraceptive pattern of Brazilian women up to two years after pregnancy, between 2006 and 2013. Methods Cross-sectional, descriptive and analytical study which used secondary data from national surveys. We studied Brazilian women with up to 2 years postpartum, of reproductive age, sexually active, non-pregnant and menstruating, and compared them with all the other women. We estimated the prevalence of use, contraception pattern of contraception and ranking of modern methods. Percentual change in indicators between the years was evaluated by calculating the difference between estimates. Results 85% of Brazilian women used CM, remaining stable in 2006 and 2013, with a high prevalence of modern methods use. An increase in the use of CM was observed among those with up to six months postpartum (71.0% to 89.0%). Pills and condoms accounted for about 60% of modern methods used in the postpartum period in both surveys. There was an increase in dual protection (2.9% to 10.1%) and contraceptive insecurity (1.6% to 5.7%) and a reduction in sterilization (16.2% to 13.4%) and traditional methods (2.1% to 1.4%). Conclusions Even with the maintenance of a high prevalence of use of CM and with the increase in contraception among women with up to six months postpartum, regional inequalities in access to CM and low prevalence of the use of other methods made available by the Unified Health System (SUS) persist, pointing out the maintenance of the insufficient care, failures in the means to regulate fertility and that public policies still hinder to guarantee the sexual and reproductive rights of the most vulnerable population. Key messages Regional inequalities in access to contraceptive methods and low prevalence of other methods made available by the Unified Health System (SUS) persist. There was an increase in contraception use among women with up to six months postpartum in Brazil.

2020 ◽  
Vol 5 (4) ◽  
pp. 2942-2947
Author(s):  
Karol Fireman de Farias ◽  
Edilson Leite de Moura ◽  
Adriely Ferreira da Silva ◽  
Ithallo Sathio Bessoni Tanabe ◽  
Eloiza Lopes de Lira Tanabe ◽  
...  

ABSTRACT: The aim of this study was to present the circulating HPV genotypes in a population from northeast Brazil. HPV was detected by nested-Polymerase Chain Reaction (nPCR) method using primers MY09/11 and GP5+/6+. HPV sequencing was performed by the method of Sanger. The HPV 16 was the most frequent (35.7%), followed by HPV 58 (14.3%). In conclusion, we identified, in one population from Northeast Brazil, a low prevalence of HPV 18 present in the vaccine provided by Unified Health System and a high prevalence of HPV 58 which is not present in this vaccine. KEYWORDS: HPV, Oncology and Woman Healthy.


2020 ◽  
Author(s):  
Carla Lourenço Tavares de Andrade ◽  
Claudia Cristina de Aguiar Pereira ◽  
Mônica Martins ◽  
Sheyla Maria Lemos Lima ◽  
Margareth Crisóstomo Portela

Objective: To study the profile of hospitalizations due to COVID-19 in the Unified Health System (SUS) in Brazil and to identify factors associated with hospital mortality related to the disease. Methods: Cross-sectional study, based on secondary data on COVID-19 hospitalizations that occurred in SUS, between the last days of February and June. Patients aged 18 years or older, with primary or secondary diagnoses indicative of COVID-19 were included. Bivariate analyses were performed and generalized linear mixed models (GLMM) were estimated with random effects intercept. The modeling followed three steps, including: attributes of the patients; elements of the care process; and characteristics of the hospital and place of hospitalization. Results: 89,405 hospitalizations were observed, of which 24.4% resulted in death. COVID-19 patients hospitalized in SUS were predominantly male (56.5%), with a mean age of 58.9 years. The length of stay ranged from less than 24 hours to 114 days, with a mean of 6.9 (STD=6.5) days. Of the total number of hospitalizations, 22.6% reported ICU use. The chances of hospital death among men were 16.8% higher than among women and increased with age. Black individuals had a higher chance of death. The behavior of the Charlson and Elixhauser indices was consistent with the hypothesis of a higher risk of death among patients with comorbidities, and obesity had an independent effect on increasing this risk. Some states had a higher risk of hospital death from COVID-19, such as Amazonas and Rio de Janeiro. The chances of hospital death were 72.1% higher in municipalities with at least 100,000 inhabitants and being hospitalized in the municipality of residence was a protective factor. Conclusion: There was wide variation in hospital COVID-19 mortality in the SUS, associated with demographic and clinical factors, social inequality and differences in the structure of services and quality of health care.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243126
Author(s):  
Carla Lourenço Tavares de Andrade ◽  
Claudia Cristina de Aguiar Pereira ◽  
Mônica Martins ◽  
Sheyla Maria Lemos Lima ◽  
Margareth Crisóstomo Portela

Objective To study the profile of hospitalizations due to COVID-19 in the Unified Health System (SUS) in Brazil and to identify factors associated with in-hospital mortality related to the disease. Methods Cross-sectional study, based on secondary data on COVID-19 hospitalizations that occurred in the SUS between late February through June. Patients aged 18 years or older with primary or secondary diagnoses indicative of COVID-19 were included. Bivariate analyses were performed and generalized linear mixed models (GLMM) were estimated with random effects intercept. The modeling followed three steps, including: attributes of the patients; elements of the care process; and characteristics of the hospital and place of hospitalization. Results 89,405 hospitalizations were observed, of which 24.4% resulted in death. COVID-19 patients hospitalized in the SUS were predominantly male (56.5%) with a mean age of 58.9 years. The length of stay ranged from less than 24 hours to 114 days, with a mean of 6.9 (±6.5) days. Of the total number of hospitalizations, 22.6% reported ICU use. The odds on in-hospital death were 16.8% higher among men than among women and increased with age. Black individuals had a higher likelihood of death. The behavior of the Charlson and Elixhauser indices was consistent with the hypothesis of a higher risk of death among patients with comorbidities, and obesity had an independent effect on increasing this risk. Some states, such as Amazonas and Rio de Janeiro, had a higher risk of in-hospital death from COVID-19. The odds on in-hospital death were 72.1% higher in municipalities with at least 100,000 inhabitants, though being hospitalized in the municipality of residence was a protective factor. Conclusion There was broad variation in COVID-19 in-hospital mortality in the SUS, associated with demographic and clinical factors, social inequality, and differences in the structure of services and quality of health care.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B L O Luizeti ◽  
E M M Massuda ◽  
L F G Garcia

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.


2020 ◽  
Vol 30 (11) ◽  
pp. 4505-4509
Author(s):  
Anna Różańska-Walędziak ◽  
Paweł Bartnik ◽  
Joanna Kacperczyk-Bartnik ◽  
Krzysztof Czajkowski ◽  
Maciej Walędziak

Abstract Introduction Obesity is associated with hyperestrogenism along with other hormonal abnormalities affecting the menstrual cycle. The most effective and decisive method of obesity treatment is bariatric surgery. The aim of this study was to analyze the impact of bariatric surgery on menstrual cycle, the incidence of menstrual abnormalities, hyperandrogenism manifestation, and contraception use. Materials and Methods It was a cross-sectional study of 515 pre-menopausal women who had undergone bariatric surgery between 1999 and 2017 in a bariatric center. Data was collected via anonymous questionnaire, and the questions covered a 1-year period before the surgery and the last year before questionnaire completion. Results Before the surgery, 38.6% of the patients reported irregular menstruations in comparison with 25.0% after bariatric surgery (RR = 0.65; 95%CI 0.53–0.79). The mean number of menstruations per year did not differ before and after surgery (10.2 ± 3.9 vs 10.4 ± 3.3; p < .45). There were no statistically significant differences in terms of prolonged menstruations, acne, and hirsutism prevalence. A total of 14.4% of patients before surgery reported estrogen-based contraception use in comparison with 15.0% after the surgery (p < .95). There were no significant differences in the frequency of OC use (11.0% before surgery vs 13.6% 12 months after the surgery vs 11.5% at the moment of survey administration; p < 0.46). Conclusion Bariatric surgery improves the regularity of the menstrual cycle in obese women in reproductive age. The lack of any changes in the combined hormonal contraception (CHC) use, especially OC, before and after bariatric surgery may be a result of a possibly low level of contraception counseling.


2014 ◽  
Vol 17 (4) ◽  
pp. 805-817 ◽  
Author(s):  
Edna Cunha Vieira ◽  
Maria do Rosário Gondim Peixoto ◽  
Erika Aparecida da Silveira

OBJECTIVE: To evaluate the prevalence and factors associated with metabolic syndrome in the elderly. METHODS: Cross-sectional study, with 133 individuals randomly selected in the Unified Health System in Goiania, Goiás. The following variables were researched: anthropometric (BMI, waist circumference, fat percentage by Dual X-ray absorptiometry), sociodemographic (gender, age, color, income, marital status and years of schooling), lifestyle (physical activity, smoking and risk alcohol consumption) and food intake (risk and protective foods). The metabolic syndrome was assessed according to harmonized criteria proposed by the World Health Organization (WHO). The combinations were tested by Poisson regression for confounding factors. RESULTS: The prevalence of metabolic syndrome was 58.65% (95%CI 49.8 - 67.1), with 60.5% (95%CI 49.01 - 71.18) for females and 55.7% (95%CI 41.33 - 69.53) for males. Hypertension was the most prevalent component of the syndrome in both men, with 80.8% (95%CI 64.5 - 90.4), and women, with 85.2% (95%CI 75.5 - 92.1). After the multivariate analysis, only the excess of weight measured by body mass index (prevalence ratio = 1.66; p < 0.01) remained associated with the metabolic syndrome. CONCLUSIONS: The prevalence of metabolic syndrome in this sample was high, indicating the need for systematic actions by health workers in the control of risk factors through prevention strategies and comprehensive care to the elderly.


2016 ◽  
Vol 5 (2) ◽  
pp. 14-20
Author(s):  
AHM Hasan ◽  
Fakir Sameul Alam ◽  
Md Tufael Hossain ◽  
Maksuda Begum ◽  
Sultana Sobnam Dipu ◽  
...  

This cross-sectional descriptive study was carried out from January 2015 to March 2016 in villages of 12 Bhavokhali union, Sadar upazila, Mymensingh. The study was done on 408 subjects who were selected purposively. Data were collected on a pre-designed questionnaire by direct interviewing the respondents. Data analysis was done using SPSS version 16. Prevalence of hypertension was 21.32%. Mean age was 39.22 years and standard deviation 14.81 years. Prevalence of hypertension was 46.30% among persons over 60 years of age, 37.11% among persons having family history of hypertension, 61.54% among persons having diabetes mellitus, 43.96% among persons having BMI more than or equal to 25, 29.41% among those having sedentary lifestyle, 22.14% among those having the habit of added salt intake, 33.75% among smokers and 25.95% among persons having the habit of smokeless tobacco intake. Though female had low prevalence of hypertension (18.77%), female working outside had higher prevalence 31.59%. Women of reproductive age group had lower prevalence of hypertension (15.56%) among whom oral contraceptive pill users had increased prevalence of hypertension 16.82%. Prevalence of hypertension found in this study was lower in comparison to global prevalence and results of other studies. CBMJ 2016 July: Vol. 05 No. 02 P: 14-20


2021 ◽  
Author(s):  
Aurore Nishimwe ◽  
Philomene Uwimana ◽  
Liberee Rumagihwa ◽  
Alfred Rutagengwa ◽  
Laetitia Nyirazinyoye ◽  
...  

Abstract Background: Maternal high-risk fertility behaviors have been linked to negative maternal and child health outcomes that include anaemia, undernutrition, and child mortality. In this context, we examined the association between maternal high-risk fertility behavior and pregnancy intention among women of reproductive age in Rwanda.Methods: This cross-sectional study is based on secondary data from the 2014–15 Rwanda Demographic and Health Survey (n=5661). The outcome of interest was pregnancy intention of the last child defined as intended or unintended. Maternal high-risk fertility behaviors were measured using maternal age at delivery, birth order, and birth interval. Chi-square test and multivariable regression models were performed. Results: The prevalence of unintended pregnancy was 46.8% (n=2652). Overall, 35.8% (n=2017) of women experienced single high-risk fertility behavior, while 23.1% (n=1282) of women experienced multiple high-risk fertility behaviors. Compared to women who have not experienced high-risk fertility behavior, the multivariable odds ratio (95% CI) of unintended pregnancy among women in single-risk and multiple-risk fertility behaviors were 2.00 (1.75, 2.28; p <0.001) and 2.49 (2.09, 2.95; p <0. 001.), respectively.Conclusion: Exposure to high-risk fertility behaviors is positively associated with unintended pregnancy among women in Rwanda. Therefore, reproductive and sexual health services should pay special attention to women who are <18 years or >34 years old; who have more than three children already; or have children with less than 24 months’ interval between giving birth.


2018 ◽  
Vol 5 (1) ◽  
pp. 39
Author(s):  
Supanji Raharja ◽  
Ova Emilia ◽  
Poedji Rochjati

Background: Pregnancy at a young age has become an important health problem both in developed and developing countries. Pregnancy at a young age increases the risk of maternal and perinatal morbidity and mortality. This is because adolescent women who are not ready both physically and psychologically to get pregnant.Obsjective: This study aims to identify and analyze labor in young primigravida (<20 years) with pathological labor in hospital Dr.Oen Surakarta.Method: This was an observational analytic study without intervention in the form of comparative cross sectional study conducted in young primigravida group age <20 years and primigravida group age 20 to 34 years old, who underwent labor in hospital delivery room. Dr.Oen Surakarta. This study used secondary data from the medical record of pregnant women who gave birth at RS.Dr.Oen Surakarta from January 1, 2011 to December 31, 201. A comparison between young primigravids (<20 years) in which pathologic pathways were performed with primigravida of reproductive age (20-34 years) experienced pathological labor were conducted.Result and Discussion: The number of deliveries in young primigravida (<20 years) was 61 people (6.65%) whereas in primigravida (21-35 years) there were 856 people (93.34%). Younger primigravids have lower levels of education than the primigravida age of reproductive age (p 0.00, CI 3.557 - 11.227). The younger primigravida has a tendency to give birth outside its residence area compared to primigravida of reproductive age (p 0.00; CI 0.050,178). Unmarried status in the young primigravida is greater than that of primigravida of reproductive age (p 0.00, CI 0.011 - 0,229) .An Antenatal Care on Primigravida reproductive age is more regular than young primigravida (p 0.03; CI 0.255 - 0.97) . Young primigravida tended to have anemia (p = 0.00, OR 8.4 CI 3.22 - 21.93) The risk of prematurity was higher in young primigravids than in the reproductive age primigravida (p 0.01, OR 2.9 CI 1, 16 - 7.25). Younger primigravids have a higher risk for pathologic delivery compared to primigravida of reproductive age (p 0.05 OR 0.56 CI 0.315 - 1.01).Conclusions: There are differences in terms, level of education, marital status, residence, regularity of ANC between young primigravida and prmigravida of reproductive age. The study found that young primigravids have a higher risk of occurrence of anemia, prematurity and pathologic delivery compared with healthy reproductive age primigravids.Keywords: young primigravida, primigravida healthy reproductive age, risk factors


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tania Dehesh ◽  
Elaheh Salarpour ◽  
Neda Malekmohammadi ◽  
Sepideh Arjomand Kermani

Abstract Background Optimal pregnancy spacing is an important incidence in reproductive women’s health. Short or long pregnancy spacing leads to the greatest health, social and economic problems such as increase in maternal and infant mortality and morbidity, and adverse pregnancy outcomes. The aim of this study is to assess the mean of pregnancy spacing and associated factors of pregnancy spacing among women of reproductive age group with recurrent event analysis. Methods The fertility history of 1350 women aged 15–49 years was collected in this cross-sectional study. The women were selected through multistage random sampling method from a list of clinics in 2018. Some predictors were collected from their records and others were collected by face-to-face interview. The recurrent event survival analysis was used to explore the effect of predictors on pregnancy spacing. The R software program was used for analysis. Results There were nine predictors that had significant effect on pregnancy spacing. These predictors included the age of mother at marriage, mother’s BMI, contraception use, breast feeding duration of the previous child, the education level of husband, the sex preference of the mother, presence of abortion or stillbirth in the preceding pregnancies, income sufficiency, and mother’s awareness of optimum pregnancy interval. The most influential predictors; contraception use (HR = 2.34, 95%CI = 1.23 to 2.76, P < 0.001) and income sufficiency (HR = 2.046, 95%CI = 1.61 to 3.02, P = 0.018) lead to longer and son preference of mother (HR = 2.231, 95%CI = 1.24 to 2.81, P = 0.023) lead to shorter pregnancy spacing. Conclusion The up to date contraception tool should be at hand for couples to manage their pregnancy intervals. The unfavorable economic situation of a family leads to long pregnancy spacing. Despite the relative equality of the status of girls and boys in today’s societies, the desire to have a son child is still an important factor in shorter pregnancy spacing. The benefit of optimal pregnancy spacing should be more announced.


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