evolución de las desigualdades según la clase social en el control del embarazo en barcelona (1994-97 frente a 2000-03) trends in social inequalities in pregnancy care in barcelona (spain), 1994-97 versus 2000-03

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ID: 232839
2007
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Abstract
Objetivo: Describir y comparar las desigualdades según la clase social en el control del embarazo en Barcelona durante 2 períodos. Métodos: Se comparan 2 cuatrienios: 1994-1997 y 2000-2003. La población de estudio son las gestantes de Barcelona y la muestra los controles del Registro de Defectos Congénitos de Barcelona (n = 905 en 1994-1997; n = 927 en 2000-2003). Las fuentes de información son las historias hospitalarias y una encuesta realizada a las madres. Las variables dependientes son: planificación del embarazo, ingesta de ácido fólico antes del embarazo, consumo de tabaco, número de visitas al obstetra, trimestre de primera visita, número de ecografías, ecografía del quinto mes, prueba invasiva y abandono del tabaco. Las variables independientes son la edad y la clase social. Se ajustaron modelos de regresión logística para cada variable dependiente según la clase social y se compararon los resultados entre cuatrienios. Resultados: Tanto las gestantes de clases de ocupación manual como las de no manual presentan mejorías en el segundo cuatrienio en 7 de los 10 indicadores (no son exactamente los mismos en ambas clases). Sin embargo, cuando comparamos las variaciones interclase entre los 2 cuatrienios se registran diferencias en 8 de los 10 indicadores, 7 a favor de las clases más favorecidas y uno a favor de las menos favorecidas. Conclusiones: Excepto para una de las situaciones analizadas (hacer más de 3 ecografías), las clases menos favorecidas presentan peores resultados que las más favorecidas al comparar la tendencia de los indicadores entre los 2 períodos. La distancia entre clases en el ámbito del control de la gestación se acentúa con el tiempo.
Objective: To describe and compare social inequalities in pregnancy care among pregnant women living in Barcelona (Spain) in 2 periods. Methods: Two 4-year periods were compared: 1994-1997 and 2000-2003. The study population consisted of pregnant women living in Barcelona and the control sample was drawn from the Barcelona Birth Defects Registry (n = 905 in 1994-1997; n = 927 in 2000-2003). Medical records and personal interviews with the mothers were used as information sources. The dependent variables were pregnancy planning, prenatal use of folic acid, smoking, the number of obstetric visits, trimester of the first visit, the number of obstetric ultrasound scans, fifth-month diagnostic ultrasound scan, invasive procedures, and smoking cessation. The independent variables were maternal age and social class. Maternal age-adjusted logistic regression models for each dependent variable according to social class were calculated and the results for both 4-year periods were compared. Results: Pregnant women in both manual and non-manual occupational classes showed better results in the second period in 7 out of 10 variables (although the results were not identical in the 2 occupational classes). However, when interclass variations between the 2 periods were compared, differences in 8 out of 10 variables were found: 7 indicators were more favorable in the more privileged classes and only one was more favorable in the less privileged classes. Conclusions: Except for one of the variables analyzed (more than 3 ultrasound scans), the less privileged classes showed poorer results than the more privileged classes when the tendencies in indicators were compared between the two periods. The gap between social classes in pregnancy care is increasing over time.
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Authors ;Angelina Roig;Montserrat Ricart;Montserrat Cunillé;Joan R. Villalbí;Maica Rodríguez-Sanz;Gemma Cano-Serral;Joaquín Salvador;Anna Lladonosa;Carme Borrell
Journal cognition and emotion
Year 2007
DOI
DOI not found
URL
http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-91112007000500003
Keywords
public health pregnancy socioeconomic position care inequalities control trendspublic aspects of medicine

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