Risk factors for adverse perinatal outcomes in imprisoned pregnant women: a systematic review

BACKGROUND: Imprisoned pregnant women constitute an important obstetric group about whom relatively little is known. This systematic review was conducted to identify the risk factors associated with adverse pregnancy outcome present in this group of women. METHODS: The review was conducted according to a prespecified protocol. Studies of any design were included if they described information on any of the pre-specified risk factors. We calculated the results as summary percentages or odds ratios where data was available on both cases and population controls. RESULTS: The search strategy identified 27 relevant papers of which 13 met the inclusion criteria, involving 1504 imprisoned pregnant women and 4571 population control women. Imprisoned women are more likely to be single, from an ethnic minority, and not to have completed high school. They are more likely to have a medical problem which could affect the pregnancy outcome and yet less likely to receive adequate antenatal care. They are also more likely to smoke, drink alcohol to excess and take illegal drugs. CONCLUSION: Imprisoned women are clearly a high risk obstetric group. These findings have important implications for the provision of care to this important group of women

Breast cancer and sexuality

Breast cancer affects a woman's body image and feelings of sexuality. Little is known about the perceptions of spouses to the sensitive topics of sexuality and body image. A qualitative inquiry was undertaken using in-depth interviews. A diagnosis of breast cancer brought some relationships closer. Mastectomy by disturbing body image did obliterate sexual relationships for a significant period of time. Women often felt (wrongly) that their partner would be repulsed by changes. More support in relation to sexuality and body image could improve relationships by identifying and clarifying perceptions, and therefore the quality of life

Saúde sexual e reprodutiva em penitenciária feminina, Espírito Santo, Brasil Sexual and reproductive health of female inmates in Brazil

OBJETIVO: Identificar o perfil sociodemográfico e as condições de saúde das mulheres encarceradas em penitenciária feminina. MÉTODOS: Foi realizado estudo descritivo de março a setembro de 1997, em penitenciária feminina do Estado do Espírito Santo. Todas as presidiárias foram convidadas a participar da pesquisa. Participaram 121 mulheres com idade superior a 18 anos, avaliadas por meio de entrevista aplicada, explorando informações sociodemográficas, clínicas e criminais, registradas em questionário estruturado, seguida de exame clínico-ginecológico. RESULTADOS: Um total de 121 mulheres foram incluídas. A média de idade das participantes foi de 30,2 anos (DP 8,98) e de escolaridade, 4,8 anos (DP 3,50). Todas já haviam tido atividade sexual pregressa; a idade média do primeiro coito foi de 15,2 anos (DP 2,55), variando de nove a 27 anos; e 28% apresentavam história de doença sexualmente transmissível (DST). Doze (9,9%) mulheres estavam grávidas no momento da entrevista. História de gravidez na adolescência foi freqüente. A maioria não adotava nenhum método contraceptivo e nem fazia uso de preservativos. Laqueadura tubária foi observada em 19,8% e citologia cervical anormal em 26,9%. CONCLUSÕES: O conhecimento sobre problemas de saúde existentes dentro do sistema carcerário pode contribuir para fortalecer e ampliar o papel de reabilitação que lhe é conferido. Entretanto, somente a cooperação entre os órgãos de saúde pública e o sistema penitenciário pode produzir resultados eficientes.<br>OBJECTIVE: To describe the sociodemographic profile and health problems of inmates in a women's prison. METHODS: A descriptive study was conducted from March to September 1997 in a women's prison in the state of Espírito Santo, Brazil. All inmates were invited to participate in the study. A total of 121 women aged more than 18 years were interviewed. A structured questionnaire was used to collect data on sociodemographics, clinical and criminal past history. Following the interview, subjects underwent clinical and gynecological examination. RESULTS: Of 121 women included in the study, the mean age was 30.2 years (SD 8.98) and the mean of schooling was 4.8 years (SD 3.50). All participants reported previous sexual activity, the mean age of the first sexual intercourse was 15.2 years (SD 2.55) ranging from 9 to 27 years. Previous STDs were reported by 28%; 12 (9.9%) were pregnant at the time. Teenage pregnancy was often reported. Most women reported no use of either any contraceptive methods or condoms. Tubal ligation was seen in 19.8% and abnormal Pap smear in 26.9%. CONCLUSIONS: Knowledge about health problems inside the prison system can contribute to promoting and increasing social rehabilitation. However, effective results could be seen only with collaboration between public health authorities and the prison system