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Perdas fetais espontâneas e voluntárias no Brasil em 1999-2000: um estudo de fatores associados Spontaneous and voluntary fetal losses in Brazil in 1999-2000: a study of associated factors

By Carla Jorge Machado, Ana Christina de Lacerda Lobato, Victor Hugo Melo and Mark Drew Crosland Guimarães

Abstract

Apesar de ilegal no Brasil, cerca de 31% das gesta&#231;&#245;es terminam em aborto. A maioria dos abortamentos provocados &#233; realizada por pessoas n&#227;o capacitadas, e em condi&#231;&#245;es inseguras, resultando em aumento da mortalidade feminina. O presente estudo utilizou dados de uma amostra representativa de 3.047 pu&#233;rperas, de 1999-2000, de corte transversal, parte de estudo multic&#234;ntrico nacional sobre soropreval&#234;ncia de s&#237;filis no Brasil. Destas, foram analisadas 1.838 pu&#233;rperas com pelo menos uma gravidez anterior &#224; gravidez de refer&#234;ncia. Os desfechos estudados foram perdas fetais pr&#233;vias (volunt&#225;ria e espont&#226;nea) e aus&#234;ncia de perda fetal pr&#233;via. A an&#225;lise foi conduzida por meio de regress&#227;o log&#237;stica multinomial. Os resultados indicaram alto n&#250;mero de perdas fetais por mulher (at&#233; seis) e 31% das perdas foram volunt&#225;rias. A aus&#234;ncia de pr&#233;-natal, a hist&#243;ria de DST na gravidez de refer&#234;ncia e a aus&#234;ncia de filhos vivos aumentaram a ocorr&#234;ncia de perdas fetais. Para as perdas volunt&#225;rias, a ra&#231;a/cor n&#227;o branca, mais de um parceiro no ano anterior e idade precoce &#224; primeira rela&#231;&#227;o sexual tamb&#233;m concorreram para o aumento da ocorr&#234;ncia. Caracter&#237;sticas de vulnerabilidade destas mulheres devem ser consideradas em programas de planejamento familiar e de aconselhamento de mulheres, focalizando aquelas que j&#225; tiveram abortos, para a redu&#231;&#227;o do n&#250;mero e consequ&#234;ncias deste procedimento.<br>Despite its illegality in Brazil, about 31% of all pregnancies end in abortion. Most abortions are performed by unskilled personnel and under unsafe conditions, resulting in increased female mortality. This study used data from a cross-sectional representative sample of 3,047 puerperal women, in 1999-2000, part of a national multicenter study on the prevalence of syphilis in Brazil. Of these, 1,838 women with at least one previous pregnancy before the reference pregnancy were included in the analysis. The outcomes studied were voluntary prior fetal loss, spontaneous prior fetal loss, and no prior fetal loss. The analysis was carried out using multinomial logistic regression. The results indicated a high number of fetal losses per woman (up to six); and 31% of the losses were voluntary. The absence of prenatal care, history of STD in the reference pregnancy, and absence of living children were factors that increased the odds of fetal loss. For voluntary fetal loss, being non-white, having more than one partner in the previous year, and an early age at first sexual intercourse also increased the odds of fetal loss. These data confirm the public health relevance of abortion in Brazil. Characteristics related to women&#180;s vulnerability should be considered in family planning programs in order to reduce the number of abortions and their consequences. Counseling must also be provided, targeting women with a previous abortion

Topics: Aborto, Perdas fetais voluntárias, Brasil, Puérperas, Abortion, Voluntary fetal loss, Brazil, Puerperous women, Public aspects of medicine, RA1-1270, Medicine, R, DOAJ:Public Health, DOAJ:Health Sciences
Publisher: Associação Brasileira de Pós-Graduação em Saúde Coletiva
Year: 2013
OAI identifier: oai:doaj.org/article:3c18d16e62ab4fb8a9fa835f7f4a1343
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