Analysis of the impact of COVID-19 pandemic on women´s care in an abortion situation in Latin America and the Caribbean

Detalhes bibliográficos
Autor(a) principal: de Leon, Rodolfo Gomez Ponce
Data de Publicação: 2023
Outros Autores: Baccaro, Luiz Francisco, Schweizer, Gonzalo Rubio, Serruya, Suzanne Jacob
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Cadernos Ibero-Americanos de Direito Sanitário (Online)
Texto Completo: https://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/1024
Resumo: Objective: to understand the influence of the COVID-19 pandemic on aspects of quality of care provided to women in abortion situations in sentinel centers of the CLAP MUSA-Network (a multicenter network with international cooperation with the aim of encouraging good practices in Latin America and the Caribbean). Methods: cross-sectional study between January/2017 and December/2021 with women of any age admitted for abortion or miscarriage. We analyzed the total number of cases and the proportion of legal abortions. The dependent variables were complications and use of contraceptives after abortion. The independent variables were COVID-19 pandemic, clinical and sociodemographic data. Statistical analysis was carried out using linear regression, multiple Poisson regression, Cochran-Armitage, chi-square, Mann-Whitney and Cohen tests. Results: we analyzed data from 93689 women assisted in 12 sentinel centers of the CLAP MUSA-Network, 64.55% in the pre-pandemic period (NP) and 35.45% in the pandemic period (PP) (22.73% received post-abortion care and 77.27% legal abortion). We found no differences in the number of cases over the period, regardless of the legal context. We observed a significant increase in the proportion of legal abortions in liberal and moderate contexts. In NP, 46.46% of women underwent medical abortion, while 62.18% of women underwent medical abortion in PP (h-Cohen 0.32). We found no increase in the number of complications during PP. In NP, 79.12% started contraceptives after abortion, while in PP, 70.39% started contraceptives after abortion (h-Cohen 0.20). Conclusion: the COVID-19 pandemic was not associated with a decrease in the number of cases, a decrease in the proportion of legal interruptions, or an increase in complications in sentinel centers of the CLAP MUSA-Network. Submission: 30/04/23|Review: 08/11/23|Approval: 09/11/23
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spelling Analysis of the impact of COVID-19 pandemic on women´s care in an abortion situation in Latin America and the CaribbeanAnálisis del impacto de la pandemia del COVID-19 en la atención de las mujeres en situación de aborto en América Latina y el CaribeAnálise do impacto da pandemia de COVID-19 sobre a atenção a mulheres em situação de aborto na América Latina e CaribeEmbarazo no PlaneadoEmbarazo en AdolescenciaEmbarazo no DeseadoAborto EspontáneoDerechoSalud PúblicaDerecho SanitarioAbortoCOVID-19Pregnancy, UnplannedPregnancy in AdolescencePregnancy, UnwantedAbortion, SpontaneousLawPublic HealthHealth LawAbortionCOVID-19Gravidez não PlanejadaGravidez na AdolescênciaGravidez não DesejadaAborto EspontâneoDireitoSaúde ColetivaDireito SanitárioAbortoCOVID-19Objective: to understand the influence of the COVID-19 pandemic on aspects of quality of care provided to women in abortion situations in sentinel centers of the CLAP MUSA-Network (a multicenter network with international cooperation with the aim of encouraging good practices in Latin America and the Caribbean). Methods: cross-sectional study between January/2017 and December/2021 with women of any age admitted for abortion or miscarriage. We analyzed the total number of cases and the proportion of legal abortions. The dependent variables were complications and use of contraceptives after abortion. The independent variables were COVID-19 pandemic, clinical and sociodemographic data. Statistical analysis was carried out using linear regression, multiple Poisson regression, Cochran-Armitage, chi-square, Mann-Whitney and Cohen tests. Results: we analyzed data from 93689 women assisted in 12 sentinel centers of the CLAP MUSA-Network, 64.55% in the pre-pandemic period (NP) and 35.45% in the pandemic period (PP) (22.73% received post-abortion care and 77.27% legal abortion). We found no differences in the number of cases over the period, regardless of the legal context. We observed a significant increase in the proportion of legal abortions in liberal and moderate contexts. In NP, 46.46% of women underwent medical abortion, while 62.18% of women underwent medical abortion in PP (h-Cohen 0.32). We found no increase in the number of complications during PP. In NP, 79.12% started contraceptives after abortion, while in PP, 70.39% started contraceptives after abortion (h-Cohen 0.20). Conclusion: the COVID-19 pandemic was not associated with a decrease in the number of cases, a decrease in the proportion of legal interruptions, or an increase in complications in sentinel centers of the CLAP MUSA-Network. Submission: 30/04/23|Review: 08/11/23|Approval: 09/11/23Objetivo: comprender la influencia de la pandemia de COVID-19 en aspectos de la calidad de la atención brindada a las mujeres en situación de aborto en los centros centinela de la Red CLAP-MUSA (una red multicéntrica de cooperación internacional con el objetivo de fomentar buenas prácticas en América Latina y el Caribe). Metodología: estudio transversal entre enero/2017 y diciembre/2021 con mujeres de cualquier edad ingresadas para abortos espontáneos o inducidos. Se analizó el número total de casos y la proporción de abortos legales. Las variables dependientes fueron las complicaciones y el uso de anticonceptivos después del aborto. Las variables independientes fueron pandemia de COVID-19, datos clínicos y sociodemográficos. El análisis estadístico se realizó mediante regresión lineal, regresión múltiple de Poisson, pruebas de Cochran-Armitage, chi-cuadrado, Mann-Whitney y Cohen. Resultados: se analizaron datos de 93689 mujeres atendidas en 12 centros centinela de la Red CLAP-MUSA, 64,55% en el período prepandemia (NP) y 35,45% en el período pandemia (PP) (22,73% recibieron atención postaborto y 77,27% aborto legal). No encontramos diferencias en el número de casos durante el período, independientemente del contexto legal. Observamos un aumento significativo en la proporción de abortos legales en contextos liberales y moderados. En NP, el 46,46% de las mujeres se sometieron al aborto con medicamentos, mientras que el 62,18% de las mujeres se sometieron al aborto con medicamentos en PP (h-Cohen 0,32). No encontramos aumento en el número de complicaciones durante el PP. En NP, 79,12% inició anticonceptivos después del aborto, mientras que en PP, 70,39% inició anticonceptivos después del aborto (h-Cohen 0,20). Conclusión: la pandemia de COVID-19 no se asoció con una disminución en el número de casos, una disminución en la proporción de interrupciones legales o un aumento en las complicaciones en los centros centinela de la Red CLAP-MUSA. Acceptación: 30/04/23|Revisión: 08/11/23|Aprobación: 09/11/23Objetivo: compreender a influência da pandemia de COVID-19 nos aspectos da qualidade da assistência prestada às mulheres em situação de abortamento nos centros sentinela da Rede CLAP-MUSA, uma rede multicêntrica com cooperação internacional visando encorajar boas práticas na América Latina e no Caribe. Metodologia: estudo transversal entre janeiro/2017 e dezembro/2021 com mulheres de qualquer idade admitidas por abortamentos espontâneos ou induzidos. Analisamos o número total de casos e a proporção de abortos legais. As variáveis dependentes foram complicações e uso de anticoncepcionais após o aborto. As variáveis independentes foram a pandemia de COVID-19, dados clínicos e sociodemográficos. A análise estatística foi realizada por meio de regressão linear, regressão múltipla de Poisson, testes de Cochran-Armitage, qui-quadrado, Mann-Whitney e Cohen. Resultados: foram analisados dados de 93.689 mulheres, atendidas em 12 centros sentinelas da Rede CLAP-MUSA, 64,55% no período pré-pandêmico (NP) e 35,45% no período pandêmico (PP) (22,73% receberam atendimento pós-aborto e 77,27%, aborto legal). Não encontramos diferenças no número de casos ao longo do período, independentemente do contexto legal. Observamos um aumento significativo na proporção de abortos legais em contextos liberais e moderados. No NP, 46,46% das mulheres realizaram aborto medicamentoso, enquanto 62,18% das mulheres realizaram aborto medicamentoso no PP (h-Cohen 0,32). Não encontramos aumento no número de complicações durante o PP. No NP, 79,12% iniciaram anticoncepcionais após o aborto, enquanto no PP, 70,39% iniciaram anticoncepcionais após o aborto (h-Cohen 0,20). Conclusão: a pandemia de COVID-19 não se associou à diminuição do número de casos, à diminuição da proporção de interrupções legais ou ao aumento de complicações nos centros sentinelas da Rede CLAP-MUSA. Submissão: 30/04/23|Revisão: 08/11/23|Aprovação: 09/11/23Fundação Oswaldo Cruz Brasília2023-12-13info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionTextoTextoinfo:eu-repo/semantics/otherapplication/pdfhttps://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/102410.17566/ciads.v12i4.1024Iberoamerican Journal of Health Law; Vol. 12 No. 4 (2023): (OCT./DEC. 2023); 14-32Cuadernos Iberoamericanos de Derecho Sanitario; Vol. 12 Núm. 4 (2023): (OCT./DEC. 2023); 14-32Cadernos Ibero-Americanos de Direito Sanitário; v. 12 n. 4 (2023): (OUT./DEZ. 2023); 14-322358-18242317-839610.17566/ciads.v12i4reponame:Cadernos Ibero-Americanos de Direito Sanitário (Online)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZenghttps://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/1024/1144Copyright (c) 2023 Rodolfo Gomez Ponce de Leon, Luiz Francisco Baccaro, Gonzalo Rubio Schweizer, Suzanne Jacob Serruya (Autor)https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessde Leon, Rodolfo Gomez PonceBaccaro, Luiz FranciscoSchweizer, Gonzalo RubioSerruya, Suzanne Jacobde Leon, Rodolfo Gomez PonceBaccaro, Luiz FranciscoSchweizer, Gonzalo RubioSerruya, Suzanne Jacobde Leon, Rodolfo Gomez PonceBaccaro, Luiz FranciscoSchweizer, Gonzalo RubioSerruya, Suzanne Jacob2023-12-14T17:29:48Zoai:ojs.cadernos.prodisa.fiocruz.br:article/1024Revistahttp://www.cadernos.prodisa.fiocruz.brPUBhttp://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/oaicadernos.direitosanitario@fiocruz.br2358-18242317-8396opendoar:2023-12-14T17:29:48Cadernos Ibero-Americanos de Direito Sanitário (Online) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.none.fl_str_mv Analysis of the impact of COVID-19 pandemic on women´s care in an abortion situation in Latin America and the Caribbean
Análisis del impacto de la pandemia del COVID-19 en la atención de las mujeres en situación de aborto en América Latina y el Caribe
Análise do impacto da pandemia de COVID-19 sobre a atenção a mulheres em situação de aborto na América Latina e Caribe
title Analysis of the impact of COVID-19 pandemic on women´s care in an abortion situation in Latin America and the Caribbean
spellingShingle Analysis of the impact of COVID-19 pandemic on women´s care in an abortion situation in Latin America and the Caribbean
de Leon, Rodolfo Gomez Ponce
Embarazo no Planeado
Embarazo en Adolescencia
Embarazo no Deseado
Aborto Espontáneo
Derecho
Salud Pública
Derecho Sanitario
Aborto
COVID-19
Pregnancy, Unplanned
Pregnancy in Adolescence
Pregnancy, Unwanted
Abortion, Spontaneous
Law
Public Health
Health Law
Abortion
COVID-19
Gravidez não Planejada
Gravidez na Adolescência
Gravidez não Desejada
Aborto Espontâneo
Direito
Saúde Coletiva
Direito Sanitário
Aborto
COVID-19
title_short Analysis of the impact of COVID-19 pandemic on women´s care in an abortion situation in Latin America and the Caribbean
title_full Analysis of the impact of COVID-19 pandemic on women´s care in an abortion situation in Latin America and the Caribbean
title_fullStr Analysis of the impact of COVID-19 pandemic on women´s care in an abortion situation in Latin America and the Caribbean
title_full_unstemmed Analysis of the impact of COVID-19 pandemic on women´s care in an abortion situation in Latin America and the Caribbean
title_sort Analysis of the impact of COVID-19 pandemic on women´s care in an abortion situation in Latin America and the Caribbean
author de Leon, Rodolfo Gomez Ponce
author_facet de Leon, Rodolfo Gomez Ponce
Baccaro, Luiz Francisco
Schweizer, Gonzalo Rubio
Serruya, Suzanne Jacob
author_role author
author2 Baccaro, Luiz Francisco
Schweizer, Gonzalo Rubio
Serruya, Suzanne Jacob
author2_role author
author
author
dc.contributor.author.fl_str_mv de Leon, Rodolfo Gomez Ponce
Baccaro, Luiz Francisco
Schweizer, Gonzalo Rubio
Serruya, Suzanne Jacob
de Leon, Rodolfo Gomez Ponce
Baccaro, Luiz Francisco
Schweizer, Gonzalo Rubio
Serruya, Suzanne Jacob
de Leon, Rodolfo Gomez Ponce
Baccaro, Luiz Francisco
Schweizer, Gonzalo Rubio
Serruya, Suzanne Jacob
dc.subject.por.fl_str_mv Embarazo no Planeado
Embarazo en Adolescencia
Embarazo no Deseado
Aborto Espontáneo
Derecho
Salud Pública
Derecho Sanitario
Aborto
COVID-19
Pregnancy, Unplanned
Pregnancy in Adolescence
Pregnancy, Unwanted
Abortion, Spontaneous
Law
Public Health
Health Law
Abortion
COVID-19
Gravidez não Planejada
Gravidez na Adolescência
Gravidez não Desejada
Aborto Espontâneo
Direito
Saúde Coletiva
Direito Sanitário
Aborto
COVID-19
topic Embarazo no Planeado
Embarazo en Adolescencia
Embarazo no Deseado
Aborto Espontáneo
Derecho
Salud Pública
Derecho Sanitario
Aborto
COVID-19
Pregnancy, Unplanned
Pregnancy in Adolescence
Pregnancy, Unwanted
Abortion, Spontaneous
Law
Public Health
Health Law
Abortion
COVID-19
Gravidez não Planejada
Gravidez na Adolescência
Gravidez não Desejada
Aborto Espontâneo
Direito
Saúde Coletiva
Direito Sanitário
Aborto
COVID-19
description Objective: to understand the influence of the COVID-19 pandemic on aspects of quality of care provided to women in abortion situations in sentinel centers of the CLAP MUSA-Network (a multicenter network with international cooperation with the aim of encouraging good practices in Latin America and the Caribbean). Methods: cross-sectional study between January/2017 and December/2021 with women of any age admitted for abortion or miscarriage. We analyzed the total number of cases and the proportion of legal abortions. The dependent variables were complications and use of contraceptives after abortion. The independent variables were COVID-19 pandemic, clinical and sociodemographic data. Statistical analysis was carried out using linear regression, multiple Poisson regression, Cochran-Armitage, chi-square, Mann-Whitney and Cohen tests. Results: we analyzed data from 93689 women assisted in 12 sentinel centers of the CLAP MUSA-Network, 64.55% in the pre-pandemic period (NP) and 35.45% in the pandemic period (PP) (22.73% received post-abortion care and 77.27% legal abortion). We found no differences in the number of cases over the period, regardless of the legal context. We observed a significant increase in the proportion of legal abortions in liberal and moderate contexts. In NP, 46.46% of women underwent medical abortion, while 62.18% of women underwent medical abortion in PP (h-Cohen 0.32). We found no increase in the number of complications during PP. In NP, 79.12% started contraceptives after abortion, while in PP, 70.39% started contraceptives after abortion (h-Cohen 0.20). Conclusion: the COVID-19 pandemic was not associated with a decrease in the number of cases, a decrease in the proportion of legal interruptions, or an increase in complications in sentinel centers of the CLAP MUSA-Network. Submission: 30/04/23|Review: 08/11/23|Approval: 09/11/23
publishDate 2023
dc.date.none.fl_str_mv 2023-12-13
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Texto
Texto
info:eu-repo/semantics/other
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/1024
10.17566/ciads.v12i4.1024
url https://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/1024
identifier_str_mv 10.17566/ciads.v12i4.1024
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/1024/1144
dc.rights.driver.fl_str_mv https://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Fundação Oswaldo Cruz Brasília
publisher.none.fl_str_mv Fundação Oswaldo Cruz Brasília
dc.source.none.fl_str_mv Iberoamerican Journal of Health Law; Vol. 12 No. 4 (2023): (OCT./DEC. 2023); 14-32
Cuadernos Iberoamericanos de Derecho Sanitario; Vol. 12 Núm. 4 (2023): (OCT./DEC. 2023); 14-32
Cadernos Ibero-Americanos de Direito Sanitário; v. 12 n. 4 (2023): (OUT./DEZ. 2023); 14-32
2358-1824
2317-8396
10.17566/ciads.v12i4
reponame:Cadernos Ibero-Americanos de Direito Sanitário (Online)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Cadernos Ibero-Americanos de Direito Sanitário (Online)
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repository.name.fl_str_mv Cadernos Ibero-Americanos de Direito Sanitário (Online) - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv cadernos.direitosanitario@fiocruz.br
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