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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Describir y comparar las desigualdades seg&#250;n la clase social en el control del embarazo en Barcelona durante 2 per&#237;odos&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se comparan 2 cuatrienios&#58; 1994-1997 y 2000-2003&#46; La poblaci&#243;n de estudio son las gestantes de Barcelona y la muestra los controles del Registro de Defectos Cong&#233;nitos de Barcelona &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>905 en 1994-1997&#59; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>927 en 2000-2003&#41;&#46; Las fuentes de informaci&#243;n son las historias hospitalarias y una encuesta realizada a las madres&#46; Las variables dependientes son&#58; planificaci&#243;n del embarazo&#44; ingesta de &#225;cido f&#243;lico antes del embarazo&#44; consumo de tabaco&#44; n&#250;mero de visitas al obstetra&#44; trimestre de primera visita&#44; n&#250;mero de ecograf&#237;as&#44; ecograf&#237;a del quinto mes&#44; prueba invasiva y abandono del tabaco&#46; Las variables independientes son la edad y la clase social&#46; Se ajustaron modelos de regresi&#243;n log&#237;stica para cada variable dependiente seg&#250;n la clase social y se compararon los resultados entre cuatrienios&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Tanto las gestantes de clases de ocupaci&#243;n manual como las de no manual presentan mejor&#237;as en el segundo cuatrienio en 7 de los 10 indicadores &#40;no son exactamente los mismos en ambas clases&#41;&#46; Sin embargo&#44; cuando comparamos las variaciones interclase entre los 2 cuatrienios se registran diferencias en 8 de los 10 indicadores&#44; 7 a favor de las clases m&#225;s favorecidas y uno a favor de las menos favorecidas&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Excepto para una de las situaciones analizadas &#40;hacer m&#225;s de 3 ecograf&#237;as&#41;&#44; las clases menos favorecidas presentan peores resultados que las m&#225;s favorecidas al comparar la tendencia de los indicadores entre los 2 per&#237;odos&#46; La distancia entre clases en el &#225;mbito del control de la gestaci&#243;n se acent&#250;a con el tiempo&#46;</p>"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To describe and compare social inequalities in pregnancy care among pregnant women living in Barcelona &#40;Spain&#41; in 2 periods&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Two 4-year periods were compared&#58; 1994-1997 and 2000-2003&#46; The study population consisted of pregnant women living in Barcelona and the control sample was drawn from the Barcelona Birth Defects Registry &#40;n&#59;&#61;<span class="elsevierStyleHsp" style=""></span>905 in 1994-1997&#59; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>927 in 2000-2003&#41;&#46; Medical records and personal interviews with the mothers were used as information sources&#46; The dependent variables were pregnancy planning&#44; prenatal use of folic acid&#44; smoking&#44; the number of obstetric visits&#44; trimester of the first visit&#44; the number of obstetric ultrasound scans&#44; fifth-month diagnostic ultrasound scan&#44; invasive procedures&#44; and smoking cessation&#46; The independent variables were maternal age and social class&#46; 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&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Pregnant women in both manual and non-manual occupational classes showed better results in the second period in 7 out of 10 variables &#40;although the results were not identical in the 2 occupational classes&#41;&#46; However&#44; when interclass variations between the 2 periods were compared&#44; differences in 8 out of 10 variables were found&#58; 7 indicators were more favorable in the more privileged classes and only one was more favorable in the less privileged classes&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Except for one of the variables analyzed &#40;more than 3 ultrasound scans&#41;&#44; the less privileged classes showed poorer results than the more privileged classes when the tendencies in indicators were compared between the two periods&#46; The gap between social classes in pregnancy care is increasing over time&#46;</p>"
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Vol. 21. Núm. 5.
Páginas 378-383 (septiembre - octubre 2007)
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Vol. 21. Núm. 5.
Páginas 378-383 (septiembre - octubre 2007)
Originales
Open Access
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
Visitas
1022
Joaquín Salvadora,
Autor para correspondencia
jsalvado@aspb.es

Correspondencia: Joaquín Salvador. Servicio de Sistemas de Información Sanitaria. Agencia de Salud Pública de Barcelona. Pl. Lesseps, 1. 08023 Barcelona. España.
, Gemma Cano-Serrala, Maica Rodríguez-Sanza, Joan R. Villalbía, Montserrat Cunilléa, Montserrat Ricarta, Angelina Roiga, Anna Lladonosab, Carme Borrella
a Servicio de Sistemas de Información Sanitaria, Agencia de Salud Pública de Barcelona, Barcelona, España
b Adknoma Health Research, Barcelona, España
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Información del artículo
Resumen
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.

Palabras clave:
Desigualdades
Nivel socioeconómico
Embarazo
Control
Salud pública
Tendencias
Abstract
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.

Key words:
Inequalities
Socioeconomic position
Pregnancy
Care
Public health
Trends
El Texto completo está disponible en PDF
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Copyright © 2007. Sociedad Española de Salud Pública y Administración Sanitaria
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