Luana P Marmitt1,2, Marcos F Cordeiro3, Juraci A Cesar4. 1. Universidade Federal do Rio Grande (FURG), Rua General Osorio, Rio Grande, RS, 96201-900, Brazil. luanamarmitt@gmail.com. 2. Universidade do Oeste de Santa Catarina (Unoesc), Rua Getúlio Vargas, 2125-Bairro Flor da Serra, Joaçaba, SC, 89600-000, Brazil. luanamarmitt@gmail.com. 3. Universidade do Oeste de Santa Catarina (Unoesc), Rua Getúlio Vargas, 2125-Bairro Flor da Serra, Joaçaba, SC, 89600-000, Brazil. 4. Universidade Federal do Rio Grande (FURG), Rua General Osorio, Rio Grande, RS, 96201-900, Brazil.
Abstract
OBJECTIVES: This study aimed to measure the prevalence, to describe the trend over time, and to evaluate socioeconomic inequalities in the occurrence of episiotomies in 2007, 2010, 2013, and 2016 in the municipality of Rio Grande, in Southern Brazil. METHODS: We included all women who had vaginal delivery in each of the studied years. All the information was obtained through a questionnaire applied at maternity wards within 48 h after delivery. The outcome consisted of episiotomy. A chi-square test was used to evaluate the linear trend. Absolute and relative inequalities were assessed from household income and schooling of the women through the Slope Index of Inequality and Relative Index of Inequality, respectively. RESULTS: This study included 4,521 parturients. The episiotomy rate in the period fell from 71.0% (95%CI: 68.4-73.5) in 2007 to 40.1% (95%CI: 37.3-42.8) in 2016, and it was more frequent among women with higher income and higher schooling. We observed a reduction in the rate of episiotomy in all income and schooling levels, and this was more evident among women in the lowest socioeconomic levels. Absolute inequality declined, while relative inequality remained unchanged. CONCLUSIONS FOR PRACTICE: Despite the significant reduction in the rate of episiotomy, its occurrence remains high. Women with higher income and education, therefore with lower risk for complications during childbirth, were the most frequently submitted to this procedure. Routine use of episiotomy must be reevaluated, especially among pregnant women with better socioeconomic status.
OBJECTIVES: This study aimed to measure the prevalence, to describe the trend over time, and to evaluate socioeconomic inequalities in the occurrence of episiotomies in 2007, 2010, 2013, and 2016 in the municipality of Rio Grande, in Southern Brazil. METHODS: We included all women who had vaginal delivery in each of the studied years. All the information was obtained through a questionnaire applied at maternity wards within 48 h after delivery. The outcome consisted of episiotomy. A chi-square test was used to evaluate the linear trend. Absolute and relative inequalities were assessed from household income and schooling of the women through the Slope Index of Inequality and Relative Index of Inequality, respectively. RESULTS: This study included 4,521 parturients. The episiotomy rate in the period fell from 71.0% (95%CI: 68.4-73.5) in 2007 to 40.1% (95%CI: 37.3-42.8) in 2016, and it was more frequent among women with higher income and higher schooling. We observed a reduction in the rate of episiotomy in all income and schooling levels, and this was more evident among women in the lowest socioeconomic levels. Absolute inequality declined, while relative inequality remained unchanged. CONCLUSIONS FOR PRACTICE: Despite the significant reduction in the rate of episiotomy, its occurrence remains high. Women with higher income and education, therefore with lower risk for complications during childbirth, were the most frequently submitted to this procedure. Routine use of episiotomy must be reevaluated, especially among pregnant women with better socioeconomic status.
Authors: Aluísio J D Barros; Iná S Santos; Alicia Matijasevich; Marlos Rodrigues Domingues; Mariângela Silveira; Fernando C Barros; Cesar G Victora Journal: Rev Saude Publica Date: 2011-06-10 Impact factor: 2.106
Authors: Juraci A Cesar; Alicia Matijasevich; Iná S Santos; Aluísio J D Barros; Juvenal S Dias-da-Costa; Fernando C Barros; Cesar G Victora Journal: Cad Saude Publica Date: 2008 Impact factor: 1.632
Authors: Silvana Granado Nogueira da Gama; Elaine Fernandes Viellas; Jacqueline Alves Torres; Maria Helena Bastos; Odaléa Maria Brüggemann; Mariza Miranda Theme Filha; Arthur Orlando Correa Schilithz; Maria do Carmo Leal Journal: Reprod Health Date: 2016-10-17 Impact factor: 3.223