Publicação
Obstetric interventions among native and migrant women: the (over)use of episiotomy in Portugal
| Resumo: | Episiotomy, defined as the incision of the perineum to enlarge the vaginal opening during childbirth, is one of the most commonly performed surgical interventions in the world. We aimed to determine if migrant status is associated with episiotomy, and if individual characteristics mediate this association.Methods: We analyzed data from the Bambino study, a national, prospective cohort of migrant and native women giving birth at a public hospital in mainland Portugal between 2017 and 2019. We included all women with vaginal delivery. The association between migrant status and episiotomy was assessed using multivariable multilevel random-effect logistic regression models. We used path analysis to quantify the direct, indirect and total effects of migrant status on episiotomy.Results: Among 3,583 women with spontaneous delivery, migrant parturients had decreased odds of episiotomy, especially those born in Africa, compared to native Portuguese women. Conversely, with instrumental delivery, migrant women had higher odds of episiotomy. Disparities in episiotomy were largely explained by maternity units' factors, and little by maternal and fetal characteristics.Conclusion: Our results suggest non-medically justified differential episiotomy use during childbirth and highlight the importance of developing evidence-based recommendations for episiotomy use in a country with a high frequency of medical interventions during delivery. |
|---|---|
| Autores principais: | Lorthe, Elsa |
| Outros Autores: | Severo, Milton; Hamwi, Sousan; Rodrigues, Teresa; Teixeira, Cristina; Barros, Henrique |
| Assunto: | Episiotomy Migrant Obstetric interventions Healthcare inequities Perinatal health Reproductive health |
| Ano: | 2024 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Instituto Politécnico de Bragança |
| Idioma: | inglês |
| Origem: | Biblioteca Digital do IPB |
| _version_ | 1867172853224308736 |
|---|---|
| author | Lorthe, Elsa |
| author2 | Severo, Milton Hamwi, Sousan Rodrigues, Teresa Teixeira, Cristina Barros, Henrique |
| author2_role | author author author author author |
| author_facet | Lorthe, Elsa Severo, Milton Hamwi, Sousan Rodrigues, Teresa Teixeira, Cristina Barros, Henrique |
| author_role | author |
| contributor_name_str_mv | Biblioteca Digital do IPB |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Lorthe, Elsa\"},{\"Person.name\":\"Severo, Milton\"},{\"Person.name\":\"Hamwi, Sousan\"},{\"Person.name\":\"Rodrigues, Teresa\"},{\"Person.name\":\"Teixeira, Cristina\",\"Person.identifier.orcid\":\"0000-0001-5194-5141\"},{\"Person.name\":\"Barros, Henrique\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Biblioteca Digital do IPB |
| datacite.creators.creator.creatorName.fl_str_mv | Lorthe, Elsa Severo, Milton Hamwi, Sousan Rodrigues, Teresa Teixeira, Cristina Barros, Henrique |
| datacite.date.Accepted.fl_str_mv | 2024-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2024-04-19T15:16:45Z |
| datacite.date.embargoed.fl_str_mv | 2024-04-19T15:16:45Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Episiotomy Migrant Obstetric interventions Healthcare inequities Perinatal health Reproductive health |
| datacite.titles.title.fl_str_mv | Obstetric interventions among native and migrant women: the (over)use of episiotomy in Portugal |
| dc.contributor.none.fl_str_mv | Biblioteca Digital do IPB |
| dc.creator.none.fl_str_mv | Lorthe, Elsa Severo, Milton Hamwi, Sousan Rodrigues, Teresa Teixeira, Cristina Barros, Henrique |
| dc.date.Accepted.fl_str_mv | 2024-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2024-04-19T15:16:45Z |
| dc.date.embargoed.fl_str_mv | 2024-04-19T15:16:45Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10198/29685 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Springer Nature |
| dc.rights.cclincense.fl_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Episiotomy Migrant Obstetric interventions Healthcare inequities Perinatal health Reproductive health |
| dc.title.fl_str_mv | Obstetric interventions among native and migrant women: the (over)use of episiotomy in Portugal |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Episiotomy, defined as the incision of the perineum to enlarge the vaginal opening during childbirth, is one of the most commonly performed surgical interventions in the world. We aimed to determine if migrant status is associated with episiotomy, and if individual characteristics mediate this association.Methods: We analyzed data from the Bambino study, a national, prospective cohort of migrant and native women giving birth at a public hospital in mainland Portugal between 2017 and 2019. We included all women with vaginal delivery. The association between migrant status and episiotomy was assessed using multivariable multilevel random-effect logistic regression models. We used path analysis to quantify the direct, indirect and total effects of migrant status on episiotomy.Results: Among 3,583 women with spontaneous delivery, migrant parturients had decreased odds of episiotomy, especially those born in Africa, compared to native Portuguese women. Conversely, with instrumental delivery, migrant women had higher odds of episiotomy. Disparities in episiotomy were largely explained by maternity units' factors, and little by maternal and fetal characteristics.Conclusion: Our results suggest non-medically justified differential episiotomy use during childbirth and highlight the importance of developing evidence-based recommendations for episiotomy use in a country with a high frequency of medical interventions during delivery. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://bibliotecadigital.ipb.pt/bitstreams/6679aea5-2097-4a7e-96bf-8aeae16dd9cc/download |
| funding.funder.alternateName_str_mv | FCT |
| funding.funder.identifier_str_mv | http://doi.org/10.13039/501100001871 |
| funding.funder.name_str_mv | Fundação para a Ciência e a Tecnologia |
| funding.name_str_mv | 6817 - DCRRNI ID |
| id | ipb_6ea06284d32d47eac938dec614bd4cbc |
| identifier.url.fl_str_mv | http://hdl.handle.net/10198/29685 |
| instacron_str | ipb |
| institution | Instituto Politécnico de Bragança |
| instname_str | Instituto Politécnico de Bragança |
| language | eng |
| network_acronym_str | ipb |
| network_name_str | Biblioteca Digital do IPB |
| oai_identifier_str | oai:bibliotecadigital.ipb.pt:10198/29685 |
| organization_str_mv | urn:organizationAcronym:ipb |
| person_str_mv | Lorthe, Elsa Severo, Milton Hamwi, Sousan Rodrigues, Teresa Teixeira, Cristina Teixeira, Cristina https://www.ciencia-id.pt/6E12-F2A0-568F 6E12-F2A0-568F http://orcid.org/0000-0001-5194-5141 0000-0001-5194-5141 Barros, Henrique |
| publishDate | 2024 |
| publisher.none.fl_str_mv | Springer Nature |
| reponame_str | Biblioteca Digital do IPB |
| repository_id_str | urn:repositoryAcronym:ipb |
| service_str_mv | urn:repositoryAcronym:ipb |
| spelling | engSpringer Naturept_PTEpisiotomy, defined as the incision of the perineum to enlarge the vaginal opening during childbirth, is one of the most commonly performed surgical interventions in the world. We aimed to determine if migrant status is associated with episiotomy, and if individual characteristics mediate this association.Methods: We analyzed data from the Bambino study, a national, prospective cohort of migrant and native women giving birth at a public hospital in mainland Portugal between 2017 and 2019. We included all women with vaginal delivery. The association between migrant status and episiotomy was assessed using multivariable multilevel random-effect logistic regression models. We used path analysis to quantify the direct, indirect and total effects of migrant status on episiotomy.Results: Among 3,583 women with spontaneous delivery, migrant parturients had decreased odds of episiotomy, especially those born in Africa, compared to native Portuguese women. Conversely, with instrumental delivery, migrant women had higher odds of episiotomy. Disparities in episiotomy were largely explained by maternity units' factors, and little by maternal and fetal characteristics.Conclusion: Our results suggest non-medically justified differential episiotomy use during childbirth and highlight the importance of developing evidence-based recommendations for episiotomy use in a country with a high frequency of medical interventions during delivery.application/pdfpt_PTObstetric interventions among native and migrant women: the (over)use of episiotomy in PortugalLorthe, ElsaSevero, MiltonHamwi, SousanRodrigues, TeresaPersonalTeixeira, CristinaDSpacehttp://dspace.org/items/9037c83c-43c1-4714-ad3e-9f307dd1d89fDSpacehttp://dspace.org/items/9037c83c-43c1-4714-ad3e-9f307dd1d89fTeixeiraCristinaCiência IDhttps://www.ciencia-id.pt6E12-F2A0-568FORCIDhttp://orcid.org0000-0001-5194-5141Researcher IDhttps://www.researcherid.comO-2296-2013Scopus Author IDhttps://www.scopus.com55207402700Scopus Author IDhttps://www.scopus.com56982501700Barros, HenriqueHostingInstitutionOrganizationalBiblioteca Digital do IPBe-mailmailto:dspace@ipb.ptdspace@ipb.ptISSNIsPartOf1661-8556DOIIsPartOf10.3389/ijph.2024.16062962024-04-19T15:16:45Z20242024-01-01T00:00:00ZHandlehttp://hdl.handle.net/10198/29685http://purl.org/coar/access_right/c_abf2open accessEpisiotomyMigrantObstetric interventionsHealthcare inequitiesPerinatal healthReproductive health847527 bytesFundação para a Ciência e a TecnologiaEpidemiology Research Unit - Institute of Public Health, University of Porto6817 - DCRRNI IDCrossref Funder IDhttp://doi.org/10.13039/501100001871literaturehttp://purl.org/coar/resource_type/c_6501journal article2024http://creativecommons.org/licenses/by/4.0/http://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://bibliotecadigital.ipb.pt/bitstreams/6679aea5-2097-4a7e-96bf-8aeae16dd9cc/downloadInternational Journal of Public Health69112 |
| spellingShingle | Obstetric interventions among native and migrant women: the (over)use of episiotomy in Portugal Lorthe, Elsa Episiotomy Migrant Obstetric interventions Healthcare inequities Perinatal health Reproductive health |
| status | SINGLETON |
| subject.fl_str_mv | Episiotomy Migrant Obstetric interventions Healthcare inequities Perinatal health Reproductive health |
| title | Obstetric interventions among native and migrant women: the (over)use of episiotomy in Portugal |
| title_full | Obstetric interventions among native and migrant women: the (over)use of episiotomy in Portugal |
| title_fullStr | Obstetric interventions among native and migrant women: the (over)use of episiotomy in Portugal |
| title_full_unstemmed | Obstetric interventions among native and migrant women: the (over)use of episiotomy in Portugal |
| title_short | Obstetric interventions among native and migrant women: the (over)use of episiotomy in Portugal |
| title_sort | Obstetric interventions among native and migrant women: the (over)use of episiotomy in Portugal |
| topic | Episiotomy Migrant Obstetric interventions Healthcare inequities Perinatal health Reproductive health |
| topic_facet | Episiotomy Migrant Obstetric interventions Healthcare inequities Perinatal health Reproductive health |
| url | http://hdl.handle.net/10198/29685 |
| visible | 1 |