ESSA - Resumos Indexados à WoS/Scopus
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Browsing ESSA - Resumos Indexados à WoS/Scopus by Author "Barros, Henrique"
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- Equitable perinatal healthcare for migrants, Portugal: comparative analysis of a self-assessment toolPublication . Doetsch, Julia; Almendra, Ricardo; Carrapatoso, Mariana; Teixeira, Cristina; Barros, HenriqueMigration is seen as a common risk factor in obstetricmanagement. Migrants often have a higher risk of experience worse pregnancy outcomes, higher rates of operative delivery, and a higher likelihood to receive less adequate postpartum care when compared to native women. This study evaluates self-perceived assessment of migrant women and hospital directors on equitable migrant friendly perinatal healthcare quality and access during intrapartum and postpartum period at public maternity units across Portuguese mainland between 2017-2019. This cross-sectional study analyses perinatal health data from migrant women over 18 years giving birth in public maternity units from between April 2017 and March 2019 as part of the baMBINO project. Data on the assessments of maternity units’ directors on equitable migrant friendly healthcare was collected in a self-assessment tool. Two standards on healthcare access and on healthcare quality were developed by: 1) scoring 25 and 30 questions, respectively, from 0 (worst) to 5 (best); 2) calculating the average of each score. The OneSample Wilcoxon Test (non-parametric) was applied to compare the assessment of hospital directors with the migrant mothers and the Kruskal-Wallis one-way analysis of variance to test for regional differences. Significant differences between migrant woman and healthcare directors’ assessments on migrant friendly healthcare access and quality of care were found. Directors rated healthcare access with a median score of 2.4, twice as good as migrant women (1.3). Migrant women rated healthcare quality with a median score of 4.0 (directors: 3.2). Significant differences between the regions for quality of care and healthcare access were found. Statistically significant difference between migrants from Portuguese and non-Portuguese speaking countries was identified for healthcare access (p-value <0.001) and healthcare quality (p-value < 0.05).
- Maternal care experience and postpartum depressive symptoms among migrant and native in PortugalPublication . Teixeira, Cristina; Santos, Susana; Guerra, João; Barros, HenriqueMigration is a risk factor for both, poor maternal experience with healthcare services (MEHCS) and postpartum depressive symptoms (PPDS), a matter of concern due to their adverse consequences. We aimed to assess the association between MEHCS and PPDS taking into account the migration status. Methods: This is part of a population-based study (baMBINO project), enrolling native (PT; n = 1568), permanent migrant (PM; n = 676) and temporary migrant (TM; n = 757) women recruited at delivery (2017-2019) in 32 Portuguese public hospitals. MEHCS was assessed based on 39 items of the Migrant Friendly Maternal Care Questionnaire asking about how women have experienced maternal care during pregnancy, during delivery and after birth. Items were grouped into 9 components each one assessing a different issue of MEHCS. For each component women were classified as having ‘‘good’’ or ‘‘less than good’’ experience. PPDS were assessed using the Edinburgh Postnatal Depression Scale (cut-off>12).Multivariate logistic regression model was fitted to estimate the association between MEHCS and PPDS. Adjusted odds ratio (aOR) and respective 95% confidence interval were obtained. Results: PPDS were reported by 3.8%, 5.8% and 8.2% of PT, PM and TM women, respectively (p < 0.001). After adjustment, 4 out 9 components of MEHCS appeared related with PPDS, such that women reporting less than good experience with ‘‘under standing information’’ (aOR = 1.72 95%CI:1.14-2.60), ‘‘decisions according to maternal wishes’’ (aOR = 1.56 95% CI:1.04-2.34), ‘‘time waiting for healthcare’’ (aOR = 1.50 95%CI:1.04-2.18) and ‘‘healthcare provider’s attitudes during pregnancy’’ (aOR = 1.58 95%CI:1.01-2.47) showed higher odds of PPDS than women reporting good experience. Conclusions: Further than the migration status, poor experience with some issues of maternal care seems play a role in the risk of PPDS Key messages: Awareness should be given to maternal care experience. Public health strategies should address factors underlying a positive maternal experience.
- Obstetric interventions among native and migrant women: a survey of episiotomy in PortugalPublication . Lorthe, Elsa; Teixeira, Cristina; Rodrigues, Teresa; Barros, HenriqueIt is unclear whether migrant women experience worse pregnancy outcomes than native women. A better comprehension of obstetric care provision, including controversial interventions such as episiotomy, is important to improve equity of service provision, overall maternal and neonatal health and to support evidence-informed perinatal health policy-making. We aimed to determine if migrant and native women giving birth vaginally have different risks of episiotomy and if the risk differs by migrant sub-groups. Methods: This study is based on a cross-sectional survey of foreign-born women with a random sample of native women, implemented in 32 public maternity units in mainland Portugal. We included 3583 women with vaginal delivery. Migrant status was defined by the woman’s country of birth (migrants, born abroad, vs natives, born in Portugal), then as subgroups of migrants from Brasil, Portuguese-speaking African countries (PSAC) and non Portuguese-speaking countries vs natives. The association between migrant status and episiotomy was assessed using multilevel logistic regression models, stratified by delivery mode, and adjusted for main risk factors of episiotomy. Results: The overall frequencies of episiotomy were 52.6% and 48.2% among the 1707 natives and the 1876 migrants, respectively (p = 0.01). With spontaneous delivery, migrant women had decreased odds of having an episiotomy (adjusted OR 0.70 [95% CI 0.58-0.83]), especially those from PSAC (aOR 0.57 [0.46-0.71]). However, with instrumental delivery, migrant women had increased odds of episiotomy (aOR 2.47 [95% CI 1.50-4.07]), especially those from Brasil (aOR 3.24 [1.18-8.92]) and non Portuguese-speaking countries (aOR 3.75 [1.827.71]). Conclusions: These results suggest non-medically justified differential care during childbirth and highlight the importance of developing evidence-based recommendations for episiotomy use, in a country with a high frequency of medical intervention during delivery. Key messages: Portugal displays a high frequency of medical interventions during delivery, including episiotomy, highlighting the need for developing evidence-based recommendations. Migrant and native women have different risks of episiotomy, suggesting non-medically justified differential care
- Satisfaction with maternal care in migrants and natives: a population-based study from PortugalPublication . Muralova, Ana; Teixeira, Cristina; Barros, HenriqueWomen’s satisfaction is an indicator of maternal healthcare quality. As migrant population contributed for 8.8% of births in Portugal in 2016, maternal care providers should evaluate the effect of multicultural diversity in women’s satisfaction. The aim of this paper is to assess the degree of maternal satisfaction with care during labour and delivery by migrant groups in Portugal. Methods: This is a part of the baMBINO project, an ongoing populationbased study enrolling native and foreign-born women recruited in 32 Portuguese public hospitals during admission for delivery. For this analysis, foreign-born women (n = 1385) were classified into long-term (LT, >8 years) and recent (RM) migrants from Portuguese Speaking African Countries (PSAC), Brazil (B) and Non-Portuguese Speaking Countries (NPSC). Such groups were compared with native women (n = 1167) for the prevalence of satisfaction with healthcare received, time spent by the professionals in providing explanations, how professionals were respectful, helpful and encouraging. Multivariate logistic regression models were used. Results: There was variation between groups for the prevalence of satisfaction with healthcare received (p<0.001) from 90.8% (B-RM) to 98.1% (PSAC-RM); time spent by professionals to provide explanations (p<0.004) from 88,3%(NPSC-RM) to 93,2% (PSAC-RM); how professionals were helpful (p = 0.035) from 94,3% (B-RM) to 98,6% (B-LTM), respectful (p = 0.038) from 93.6% (B-RM) to 98.4% (NPSC-LT) and encouraging (p = 0.002) from 88.7% (B-RM) to 96.5% (BLT). Differences remained after adjusting for maternal age, educational level, mode of delivery and complications. Conclusions: Although the prevalence of satisfied women is high, there is heterogeneity in the satisfaction with some aspects of maternal care between groups of migrant women. Key messages: Professionals should be aware about the effect of cultural background in women’s satisfaction with care. It is important to consider significance of determinants of satisfaction to improve care for migrants.