Comparison of childbirth care models in public hospitals, Brazil

Detalhes bibliográficos
Autor(a) principal: Vogt, Sibylle Emilie
Data de Publicação: 2014
Outros Autores: Silva, Kátia Silveira da, Dias, Marcos Augusto Bastos
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/81154
Resumo: OBJECTIVE To compare collaborative and traditional childbirth care models. METHODS Cross-sectional study with 655 primiparous women in four public health system hospitals in Belo Horizonte, MG, Southeastern Brazil, in 2011 (333 women for the collaborative model and 322 for the traditional model, including those with induced or premature labor). Data were collected using interviews and medical records. The Chi-square test was used to compare the outcomes and multivariate logistic regression to determine the association between the model and the interventions used. RESULTS Paid work and schooling showed significant differences in distribution between the models. Oxytocin (50.2% collaborative model and 65.5% traditional model; p < 0.001), amniotomy (54.3% collaborative model and 65.9% traditional model; p = 0.012) and episiotomy (collaborative model 16.1% and traditional model 85.2%; p < 0.001) were less used in the collaborative model with increased application of non-pharmacological pain relief (85.0% collaborative model and 78.9% traditional model; p = 0.042). The association between the collaborative model and the reduction in the use of oxytocin, artificial rupture of membranes and episiotomy remained after adjustment for confounding. The care model was not associated with complications in newborns or mothers neither with the use of spinal or epidural analgesia. CONCLUSIONS The results suggest that collaborative model may reduce interventions performed in labor care with similar perinatal outcomes.
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spelling Comparison of childbirth care models in public hospitals, Brazil Comparação de modelos de assistência ao parto em hospitais públicos OBJECTIVE To compare collaborative and traditional childbirth care models. METHODS Cross-sectional study with 655 primiparous women in four public health system hospitals in Belo Horizonte, MG, Southeastern Brazil, in 2011 (333 women for the collaborative model and 322 for the traditional model, including those with induced or premature labor). Data were collected using interviews and medical records. The Chi-square test was used to compare the outcomes and multivariate logistic regression to determine the association between the model and the interventions used. RESULTS Paid work and schooling showed significant differences in distribution between the models. Oxytocin (50.2% collaborative model and 65.5% traditional model; p < 0.001), amniotomy (54.3% collaborative model and 65.9% traditional model; p = 0.012) and episiotomy (collaborative model 16.1% and traditional model 85.2%; p < 0.001) were less used in the collaborative model with increased application of non-pharmacological pain relief (85.0% collaborative model and 78.9% traditional model; p = 0.042). The association between the collaborative model and the reduction in the use of oxytocin, artificial rupture of membranes and episiotomy remained after adjustment for confounding. The care model was not associated with complications in newborns or mothers neither with the use of spinal or epidural analgesia. CONCLUSIONS The results suggest that collaborative model may reduce interventions performed in labor care with similar perinatal outcomes. OBJETIVO Comparar os modelos colaborativo e tradicional na assistência ao parto e nascimento. MÉTODOS Estudo transversal realizado com 655 primíparas em quatro hospitais do sistema único de saúde em Belo Horizonte, MG, em 2011 (333 mulheres do modelo colaborativo e 322 do modelo tradicional, incluindo aquelas com trabalho de parto induzido e prematuro). Os dados foram coletados em entrevistas e levantamento de prontuários. Foram aplicados os testes Qui-quadrado para comparação e regressão logística múltipla para determinar associação entre o modelo e os desfechos analisados. RESULTADOS Houve diferenças significativas entre os modelos em relação ao nível de escolaridade e trabalho remunerado. No modelo colaborativo houve menor utilização da ocitocina (50,2% no modelo colaborativo versus 65,5% no modelo tradicional; p < 0,001), da ruptura artificial das membranas (54,3% no modelo colaborativo versus 65,9% no modelo tradicional; p = 0,012) e da taxa de episiotomia (16,1% no modelo colaborativo versus 85,2% no modelo tradicional; p < 0,001), e maior utilização de métodos não farmacológicos para alívio da dor (85,0% no modelo colaborativo versus 78,9% no modelo tradicional; p = 0,042). A associação entre o modelo colaborativo e a redução no uso da ocitocina, da ruptura artificial das membranas e da episiotomia manteve-se após o ajuste para fatores de confundimento. O modelo assistencial não esteve associado a complicações neonatais ou maternas nem à utilização de analgesia de condução. CONCLUSÕES Os resultados sugerem que o modelo colaborativo poderá reduzir as intervenções na assistência ao trabalho de parto e parto com resultados perinatais semelhantes. Universidade de São Paulo. Faculdade de Saúde Pública2014-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/8115410.1590/S0034-8910.2014048004633Revista de Saúde Pública; Vol. 48 No. 2 (2014); 304-313Revista de Saúde Pública; Vol. 48 Núm. 2 (2014); 304-313Revista de Saúde Pública; v. 48 n. 2 (2014); 304-3131518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/81154/84784https://www.revistas.usp.br/rsp/article/view/81154/84785Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessVogt, Sibylle Emilie Silva, Kátia Silveira da Dias, Marcos Augusto Bastos 2014-06-04T13:35:24Zoai:revistas.usp.br:article/81154Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2014-06-04T13:35:24Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Comparison of childbirth care models in public hospitals, Brazil
Comparação de modelos de assistência ao parto em hospitais públicos
title Comparison of childbirth care models in public hospitals, Brazil
spellingShingle Comparison of childbirth care models in public hospitals, Brazil
Vogt, Sibylle Emilie
title_short Comparison of childbirth care models in public hospitals, Brazil
title_full Comparison of childbirth care models in public hospitals, Brazil
title_fullStr Comparison of childbirth care models in public hospitals, Brazil
title_full_unstemmed Comparison of childbirth care models in public hospitals, Brazil
title_sort Comparison of childbirth care models in public hospitals, Brazil
author Vogt, Sibylle Emilie
author_facet Vogt, Sibylle Emilie
Silva, Kátia Silveira da
Dias, Marcos Augusto Bastos
author_role author
author2 Silva, Kátia Silveira da
Dias, Marcos Augusto Bastos
author2_role author
author
dc.contributor.author.fl_str_mv Vogt, Sibylle Emilie
Silva, Kátia Silveira da
Dias, Marcos Augusto Bastos
description OBJECTIVE To compare collaborative and traditional childbirth care models. METHODS Cross-sectional study with 655 primiparous women in four public health system hospitals in Belo Horizonte, MG, Southeastern Brazil, in 2011 (333 women for the collaborative model and 322 for the traditional model, including those with induced or premature labor). Data were collected using interviews and medical records. The Chi-square test was used to compare the outcomes and multivariate logistic regression to determine the association between the model and the interventions used. RESULTS Paid work and schooling showed significant differences in distribution between the models. Oxytocin (50.2% collaborative model and 65.5% traditional model; p < 0.001), amniotomy (54.3% collaborative model and 65.9% traditional model; p = 0.012) and episiotomy (collaborative model 16.1% and traditional model 85.2%; p < 0.001) were less used in the collaborative model with increased application of non-pharmacological pain relief (85.0% collaborative model and 78.9% traditional model; p = 0.042). The association between the collaborative model and the reduction in the use of oxytocin, artificial rupture of membranes and episiotomy remained after adjustment for confounding. The care model was not associated with complications in newborns or mothers neither with the use of spinal or epidural analgesia. CONCLUSIONS The results suggest that collaborative model may reduce interventions performed in labor care with similar perinatal outcomes.
publishDate 2014
dc.date.none.fl_str_mv 2014-04-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/81154
10.1590/S0034-8910.2014048004633
url https://www.revistas.usp.br/rsp/article/view/81154
identifier_str_mv 10.1590/S0034-8910.2014048004633
dc.language.iso.fl_str_mv por
eng
language por
eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/81154/84784
https://www.revistas.usp.br/rsp/article/view/81154/84785
dc.rights.driver.fl_str_mv Copyright (c) 2017 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2017 Revista de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 48 No. 2 (2014); 304-313
Revista de Saúde Pública; Vol. 48 Núm. 2 (2014); 304-313
Revista de Saúde Pública; v. 48 n. 2 (2014); 304-313
1518-8787
0034-8910
reponame:Revista de Saúde Pública
instname:Universidade de São Paulo (USP)
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instname_str Universidade de São Paulo (USP)
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reponame_str Revista de Saúde Pública
collection Revista de Saúde Pública
repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
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