Monguilhott Juliana Jacques da Costa, Brüggemann Odaléa Maria, Freitas Paulo Fontoura, d'Orsi Eleonora
Departamento Acadêmico de Saúde e Serviços, Instituto Federal de Educação, Ciência e Tecnologia de Santa Catarina, Florianópolis, SC, Brasil.
Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil.
Rev Saude Publica. 2018;52:1. doi: 10.11606/s1518-8787.2018052006258. Epub 2018 Jan 18.
OBJECTIVE To analyze if the presence of a companion favors the use of best practices in the delivery care in the South region of Brazil. METHODS This is a cross-sectional analysis of the longitudinal study Nascer no Brasil. We analyzed data from 2,070 women from the South region of Brazil who went into labor. The data were collected between February and August 2011, by interviews and medical records. We performed a bivariate and multivariate analysis, calculating the crude and adjusted prevalence ratios using Poisson regression with robust variance estimation. The level of significance adopted was 5%. RESULTS Most women had a companion during labor (51.7%), but few remained during delivery (39.4%) or cesarean section (34.8%). Less than half of the women had access to several recommended practices, while non-recommended practices continue to be performed. In the model adjusted for age, education level, source of payment for the delivery, parity, and score of the Brazilian Association of Market Research Institutes, the presence of a companion was statistically associated with a greater supply of liquids and food (aPR = 1.34), dietary prescription (aPR = 1.34), use of non-pharmacological methods for pain relief (aPR = 1.37), amniotomy (aPR = 1.10), epidural or spinal analgesia (aPR = 1.84), adoption of non-lithotomy position in the delivery (aPR = 1.77), stay in the same room during labor, delivery, and postpartum (aPR = 1.62), skin-to-skin contact in the delivery (aPR = 1.81) and cesarean section (PR = 2.43), as well as reduced use of the Kristeller maneuver (aPR = 0.67), trichotomy (aPR = 0.59), and enema (aPR = 0.49). CONCLUSIONS In the South region of Brazil, most women do not have access to the best practices in addition to undergoing several unnecessary interventions. The presence of a companion is associated with several beneficial practices and the reduction in some interventions, although other interventions are not impacted.
目的 分析在巴西南部地区,陪伴人员的存在是否有助于在分娩护理中采用最佳实践。方法 这是对纵向研究“巴西出生”的横断面分析。我们分析了来自巴西南部地区2070名分娩妇女的数据。数据于2011年2月至8月通过访谈和医疗记录收集。我们进行了双变量和多变量分析,使用具有稳健方差估计的泊松回归计算粗患病率和调整患病率比值。采用的显著性水平为5%。结果 大多数妇女在分娩时有陪伴人员(51.7%),但很少有人在分娩期间(39.4%)或剖宫产时(34.8%)一直陪伴。不到一半的妇女能获得几种推荐的做法,而不推荐的做法仍在实施。在根据年龄、教育水平、分娩费用支付来源、产次和巴西市场研究机构协会评分进行调整的模型中,陪伴人员的存在与更多的液体和食物供应(调整后患病率比值[aPR]=1.34)、饮食处方(aPR=1.34)、使用非药物方法缓解疼痛(aPR=1.37)、人工破膜(aPR=1.10)、硬膜外或脊髓镇痛(aPR=1.84)、分娩时采用非截石位(aPR=1.77)、分娩、分娩期间和产后在同一房间(aPR=1.62)、分娩时皮肤接触(aPR=1.81)和剖宫产时(患病率比值[PR]=2.43)相关,同时减少了克里斯特勒手法(aPR=0.67)、会阴切开术(aPR=0.59)和灌肠(aPR=0.49)的使用。结论 在巴西南部地区,大多数妇女除了接受一些不必要的干预外,无法获得最佳实践。陪伴人员的存在与几种有益的做法以及一些干预措施的减少有关,尽管其他干预措施不受影响。