Influencia de factores no médicos para el nacimiento por cesárea en un hospital privado / Influence of non-medical factors for cesarean birth in a private hospital

RESUMEN

Resumen OBJETIVO: Encontrar los factores no médicos que intervienen en el criterio del obstetra para elegir que la vía de nacimiento sea por parto o cesárea. MATERIALES Y MÉTODOS: Estudio transversal, retrospectivo, observacional y analítico, efectuado en pacientes atendidas entre 2016 y 2019 en el Hospital Ángeles Lomas, con más de 24 semanas de embarazo y que lo terminaron mediante parto o cesárea. Criterio de exclusión embarazos múltiples. Variable dependiente nacimiento por parto o cesárea. Variables independientes sexo del obstetra, consultorio en el mismo hospital o externo, disponibilidad de asistente médico, mes del año, día de la semana y periodo vacacional. RESULTADOS: Se incluyeron 3906 nacimientos, 1495 cesáreas (38.3%) y 2411 partos (61.7%). Se observó mayor riesgo de cesárea, con significación estadística en nacimientos atendidos por obstetras externos (OR = 3.81; IC95% 3.07-4.73), nacimientos atendidos por obstetras del mismo hospital sin asistente médico (OR = 1.75; IC95% 1.48-2.08), obstetras mujeres (OR = 2.55; IC95% 2.06-3.16), abril vs diciembre (OR = 1.44; IC95%1.04-1.98) y miércoles vs domingos (OR = 1.55; IC95%1.14-2.05). Se registraron más cesáreas en el periodo prevacacional vs vacacional (OR = 1.51; IC95% 0.94-2.43) sin diferencia estadísticamente significativa. CONCLUSIONES: Existen factores no médicos que aumentan la frecuencia de cesárea. Los relacionados con el obstetra incluyen no tener el consultorio en el mismo hospital y carecer de asistente médico.

ABSTRACT

Abstract OBJECTIVE: To find the non-medical factors that intervene in the obstetrician's criteria for choosing a birth canal or Cesarean section. MATERIALS AND METHODS: Transversal, retrospective, observational and analytical study carried out on patients attended between 2016 and 2019 at Hospital Ángeles Lomas (Mexico City), with more than 24 weeks of pregnancy and who finished it by vaginal delivery or cesarean section. Exclusion criterion Multiple pregnancies. Dependent variable birth by delivery or cesarean section. Independent variables sex of the obstetrician, office in the same hospital or outside, availability of medical assistant, month of the year, day of the week and vacation period. RESULTS: 3906 births, 1495 cesarean sections (38.3%) and 2411 deliveries (61.7%) were included. A higher risk of cesarean section was observed, with statistical significance in births attended by external obstetricians (OR = 3.81; CI95% 3.07-4.73), births attended by obstetricians at the same hospital without a physician's assistant (OR = 1. 75; CI95% 1.48-2.08), female obstetricians (OR = 2.55; CI95% 2.06-3.16), April vs. December (OR = 1.44; CI95%1.04-1.98) and Wednesday vs More cesarean sections were recorded in the pre-vacation vs. vacation period (OR = 1.51; IC95% 0.94-2.43) with no statistically significant difference. CONCLUSIONS: There are non-medical factors that increase the frequency of cesarean section. Those related to the obstetrician included not having the office in the same hospital and not having a medical assistant.