ABSTRACT
BACKGROUND: The reproductive health of Roma women has been poorly studied. It is important to determine the follow-up care received by Roma women from pregnancy to the first postpartum visit, together with neonatal outcomes, to improve prenatal care and maternal-child outcomes. OBJECTIVE: The aim of this study was to examine differences in prenatal care and maternal-infant outcomes between Roma and non-Roma women. METHODS: A retrospective longitudinal study was conducted in 122 pregnant women (28 Roma and 94 non-Roma women) recruited from seven primary care centers in three districts of Asturias (Spain). Sociodemographic variables, prenatal control, birth characteristics, feeding, and neonatal outcomes (gestational age, weight, and APGAR [appearance, pulse, grimace, activity, and respiration]) were collected from the electronic medical records. Prenatal care was assessed using three indices: the Kessner index, the Modified Adequacy of Prenatal Care Utilization Spanish Index, and an ad hoc index that considered adherence to the recommendations for pregnant women in Spain. RESULTS: Compared with non-Roma women, advanced maternal age (≥35 years) and primigravida were less common among Roma women. Roma women visited the dentist less often, smoked more, and underwent group B streptococcus screening less frequently. No differences were found in the number of prenatal visits between Roma and non-Roma women. Consequently, there were no differences between the Kessner index and the Modified Adequacy of Prenatal Care Utilization Spanish Index. Using the ad hoc index, the non-Roma women more frequently had adequate prenatal visits. There were no differences in birth characteristics, type of feeding, and neonatal outcomes. DISCUSSION: Overall, prenatal care was slightly worse in Roma women; however, this did not imply worse neonatal health outcomes. Both study groups had similar birth characteristics and immediate puerperium, including feeding.
Subject(s)
Pregnancy Outcome , Prenatal Care , Infant, Newborn , Pregnancy , Female , Humans , Adult , Retrospective Studies , Longitudinal Studies , Gestational AgeABSTRACT
Objetivo: Explorar la asociación entre la limitación auditiva y la fragilidad social en una muestra de personas mayores de España. Método: Estudio transversal con una muestra de 445 personas (190 hombres y 255 mujeres) de 65 y más años de edad no institucionalizadas, reclutadas de centros de atención primaria en España. La limitación auditiva se determinó de forma autoinformada utilizando tres preguntas. Se consideró que existía fragilidad social cuando la persona presentó dos o más de las siguientes condiciones: vivir solo/a, ausencia de persona que brinde ayuda, contacto infrecuente con la familia, contacto infrecuente con amistades, falta de confidente y falta de ayuda para las actividades cotidianas en los últimos 3 meses. Para estudiar la asociación entre la limitación auditiva y la fragilidad social se realizaron modelos de regresión logística ajustados por posibles factores de confusión, incluyendo la presencia de fragilidad física. Resultados: La edad media de los/las participantes fue de 76,2 años (77,5 años para las mujeres). El 54,4% presentaban limitación auditiva y el 23,2% fueron considerados/as frágiles sociales. La limitación auditiva se asoció con la fragilidad social ( odds ratio ajustada [ORa]=1,78; intervalo de confianza del 95% [IC95%]: 1,043,06). No obstante, la asociación fue dependiente del sexo (p de interacción=0,041) y en los análisis estratificados la asociación solo se halló en las mujeres (ORa=3,21; IC95%: 1,447,17).Conclusiones: La limitación auditiva se asoció con fragilidad social en las mujeres, pero no en los hombres. Se precisan estudios longitudinales que confirmen esta asociación y ayuden a entender el efecto diferencial del sexo. (AU)
Objective: To explore the association between hearing loss and social frailty in a sample of Spanish older adults recruited from primary health care network.Method: Crosssectional study on a sample of 445 noninstitutionalized adults aged 65 or more years (190 men and 255 women), recruited from primary care centers in Spain. Three selfreported hearing impairment questions were used to assess hearing loss. Social frailty was deemed to exist when the person presented two or more of the following conditions: living alone, absence of a person to provide help, infrequent contact with family, infrequent contact with friends, lack of confident and lack of help for daily activities in the last 3 months. To study the association between hearing loss and social frailty we used logistic regression models adjusted for potential confounders, including physical frailty. Results: The mean age of participants was 76.2 years (77.5 years for women). More than half of the participants (54.4%) reported hearing loss and the frequency of social frailty was 23.2%. Hearing loss was associated with social frailty (adjusted odds ratio [aOR]=1.78; 95% confidence interval [95%CI]: 1.043.06). However, the association was sexdependent (p for interaction=0.041). In stratified analysis, the association was only found in women (aOR=3.21; 95%CI: 1.447.17). Conclusions: Hearing loss was associated with social frailty in women, but not in men. Longitudinal studies are needed to confirm this association and to understand the differential effect of gender. (AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Interpersonal Relations , Frailty/epidemiology , Hearing Loss/epidemiology , Spain , Cross-Sectional Studies , Aging , Frail ElderlyABSTRACT
OBJECTIVE: To explore the association between hearing loss and social frailty in a sample of Spanish older adults recruited from primary health care network. METHOD: Cross-sectional study on a sample of 445 non-institutionalized adults aged 65 or more years (190 men and 255 women), recruited from primary care centers in Spain. Three self-reported hearing impairment questions were used to assess hearing loss. Social frailty was deemed to exist when the person presented two or more of the following conditions: living alone, absence of a person to provide help, infrequent contact with family, infrequent contact with friends, lack of confident and lack of help for daily activities in the last 3 months. To study the association between hearing loss and social frailty we used logistic regression models adjusted for potential confounders, including physical frailty. RESULTS: The mean age of participants was 76.2 years (77.5 years for women). More than half of the participants (54.4%) reported hearing loss and the frequency of social frailty was 23.2%. Hearing loss was associated with social frailty (adjusted odds ratio [aOR]=1.78; 95% confidence interval [95%CI]: 1.04-3.06). However, the association was sex-dependent (p for interaction=0.041). In stratified analysis, the association was only found in women (aOR=3.21; 95%CI: 1.44-7.17). CONCLUSIONS: Hearing loss was associated with social frailty in women, but not in men. Longitudinal studies are needed to confirm this association and to understand the differential effect of gender.
