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- Childhood circumstances and mode of deliveryPublication . Teixeira, Cristina; Correia, Sofia; Barros, HenriqueObjective To assess the influence of social circumstances at 12 yrs on c-section delivery. Methods Women (n¼6827) were consecutively recruited during the assembling of a birth-cohort. Interviews were used to obtain data on social and demographic characteristics and current pregnancy events. Financial childhood circumstances were classified as low (LF) or high (HF) based on the number of amenities reported. Parents’ education was defined as low (#6 years, LPE) and high (HPE). The effect of participants’ financial socioeconomic conditions on csection risk was computed using logistic regression stratified by parents ‘education. Methods Women (n=6827) were consecutively recruited during the assembling of a birth-cohort. Interviews were used to obtain data on social and demographic characteristics and current pregnancy events. Financial childhood circumstances were classified as low (LF) or high (HF) based on the number of amenities reported. Parents' education was defined as low (≤6 years, LPE) and high (HPE). The effect of participants' financial socioeconomic conditions on c-section risk was computed using logistic regression stratified by parents ‘education. Results Women with both high financial and educational childhood circumstances were significantly older, more educated and more frequently primiparous, with normal or underweight and reporting private antenatal care. The overall c-section rate was 35.6% varying from 32.2% (LF-LE) to 41.3% (HF-HE). After adjustment and considering women in LF-LPE as reference, we obtained OR=0.92; 95% CI 0.66 to 1.28 for LF-HPE group, OR=1.19; 95% CI 1.04 to 1.37 for HF-LPE group and OR=1.38; 95% CI 1.16 to 1.64) for HF-HPE group. Stratifying by parents' education and compared with women in LF group, those in HF group showed higher risk of c-section either in the LPE group (OR=1.19; 95% CI 1.04 to 1.37) or in the HPE group (OR=1.42; 95% CI 0.99 to 2.02). Conclusions Our results suggest that, independently of the parents' education and the current socio-demographic conditions, the childhood financial environment may influence the mode of delivery.
- Maternal care, pregnancy complications and birth outcomes among native and migrant women in PortugalPublication . Teixeira, Cristina; Muralova, Ana; Cancela, Marilyne; Barros, HenriqueMigrants can experience inequalities in care and health outcomes even in countries with universal access to care, regardless of legal status, as it is the case in Portugal. Thus, we assessed the prevalence of late antenatal care, pregnancy complications, obstetric interventions and birth outcomes considering the country of origin of women delivering in Portugal Methods: As part of an ongoing population-based study, enrolling native and foreign-born women recruited in 32 Portuguese public hospitals at delivery, 3884 women were classified in groups according to their country of origin and native country language as Portuguese (PT), Portuguese speaking Latin American Countries (BR), Portuguese speaking African countries (PALOP) and other countries (PNSC) Results: The prevalence (%) varies for late antenatal care (p<0.001), from 14.5 (PT) to 29.8 (PALOP); pre-eclampsia/eclampsia (p = 0.031), from 0.8 (BR) to 2.4 (PALOP); instrumental vaginal birth (p<0.001), from 8.6 (PALOP) to 18.1 (PNSC); C-section before labour (p<0.001), from 11.5 (PNSC) to 15.2 (BR); and C-section during labour (p<0.001), from 15.5 (PNSC) to 21.7 (PALOP). No differences were found for twin pregnancy (p = 0.128), gestational diabetes (p = 0.283), placental disorders (p = 0.743), induced labour (p = 0.138), preterm delivery (p = 0.897) or admission to Neonatal Intensive Care Unit (p = 0.918). Conclusions: Health inequalities in care of migrant pregnant women are particularly evident for those born in African countries with Portuguese as the official language. Key messages: In Portugal women coming from different countries converge in regards to indicators of perinatal health. Speaking the language of the host country does not overcome inequalities of care among migrants.