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      Provisión de métodos anticonceptivos en el posparto inmediato en México, 2018-19 Translated title: Provision of immediate postpartum contraceptive methods in Mexico, 2018-19

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          Abstract

          Resumen: Objetivo: Analizar la anticoncepción posparto (APP) y tipo de método anticonceptivo recibido según características sociodemográficas y de atención del parto de las mujeres. Material y métodos: Se analizaron datos de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2018-19 en 4 548 mujeres de 12-49 años que tuvieron un parto. Se ajustaron modelos de regresión logística (n=4 544) y multinomial (n=2 903) con variables dependientes APP y tipo de anticonceptivo recibido. Resultados: Se encontró que 65% de las mujeres recibieron APP, y 56.8% de las adolescentes un método reversible de larga duración (43.7% DIU y 13.1% implantes). Ser indígena, tener un hijo, o recibir atención en los servicios estatales de salud/IMSS-Prospera o privadas, se asocia con menores posibilidades de APP. Conclusiones: Se identificaron progresos en la cobertura de APP en las adolescentes. Persisten brechas de acuerdo con el aseguramiento en salud tanto en la recepción de APP como en el tipo de método recibido.

          Translated abstract

          Abstract: Objective: To identify sociodemographic and health services factors associated with receipt of immediate postpartum (IPP) contraception and the type of contraceptive method received. Materials and methods: We used the National Health and Nutrition Survey (Ensanut), 2018-19, which contains information on 4 548 women aged 12-49 years who gave birth. We described receipt of IPP contraception and method type and used multivariable logistic (n=4 544) and multinomial regression (n=2 903) to examine receipt of any modern method and type of method. Results: 65% of women received IPP contraception. 56.8% of adolescents received long-acting reversible contraception (43.7% IUD & 13.1% implant). Being indigenous, having only one child, or receiving care in State Health Services/IMSS-Prospera or private sector facilities were associated with lower odds of receiving IPP contraception. Conclusions: We identify progress in the IPP contraception coverage among adolescents. Disparities persist in receipt of IPP contraception by type of health insurance.

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          Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: Cross-sectional study.

          This study was undertaken to determine whether adolescent pregnancy is associated with increased risks of adverse pregnancy outcomes. We studied 854,377 Latin American women who were younger than 25 years during 1985 through 2003 using information recorded in the Perinatal Information System database of the Latin American Center for Perinatology and Human Development, Montevideo, Uruguay. Adjusted odds ratios were obtained through logistic regression analysis. After an adjustment for 16 major confounding factors, adolescents aged 15 years or younger had higher risks for maternal death, early neonatal death, and anemia compared with women aged 20 to 24 years. Moreover, all age groups of adolescents had higher risks for postpartum hemorrhage, puerperal endometritis, operative vaginal delivery, episiotomy, low birth weight, preterm delivery, and small-for-gestational-age infants. All adolescent mothers had lower risks for cesarean delivery, third-trimester bleeding, and gestational diabetes. In Latin America, adolescent pregnancy is independently associated with increased risks of adverse pregnancy outcomes.
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            Effects of birth spacing on maternal health: a systematic review.

            The objective of the study was to explore the association between birth spacing and risk of adverse maternal outcomes. The study was a systematic review of observational studies that examined the relationship between interpregnancy or birth intervals and adverse maternal outcomes. Twenty-two studies met the inclusion criteria. Overall, long interpregnancy intervals, possibly longer than 5 years, are independently associated with an increased risk of preeclampsia. There is emerging evidence that women with long interpregnancy intervals are at increased risk for labor dystocia and that short intervals are associated with increased risks of uterine rupture in women attempting a vaginal birth after previous cesarean delivery and uteroplacental bleeding disorders (placental abruption and placenta previa). Less clear is the association between short intervals and other adverse outcomes such as maternal death and anemia. Long interpregnancy intervals are independently associated with an increased risk of preeclampsia. Both short and long interpregnancy intervals seem to be related to other adverse maternal outcomes, but more research is needed.
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              WHO guidelines on preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries.

              Adolescent pregnancy and its consequences represent a major public health concern in many low-middle income countries of the world. The World Health Organization has recently developed evidence-based guidelines addressing six areas: preventing early marriage; preventing early pregnancy through sexuality education, increasing education opportunities and economic and social support programs; increasing the use of contraception; reducing coerced sex; preventing unsafe abortion; and increasing the use of prenatal care childbirth and postpartum care. In each of these areas, World Health Organization recommends directions for future research. The summary concludes with a brief look at global and regional initiatives that provide a window of opportunity for stepping up action in this important area.
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                Author and article information

                Journal
                spm
                Salud Pública de México
                Salud pública Méx
                Instituto Nacional de Salud Pública (Cuernavaca, Morelos, Mexico )
                0036-3634
                December 2020
                : 62
                : 6
                : 637-647
                Affiliations
                [4] Cuernavaca Morelos orgnameInstituto Nacional de Salud Pública orgdiv1Centro de Información para Decisiones en Salud Pública Mexico
                [1] Cuernavaca Morelos orgnameInstituto Nacional de Salud Pública orgdiv1Centro de Investigación en Salud Poblacional Mexico
                [5] Ciudad de México orgname Mexico
                [3] Cuernavaca Morelos orgnameInstituto Nacional de Salud Pública orgdiv1Centro de Investigación en Sistemas de Salud Mexico
                [2] Ciudad de México orgnameCentro de Investigación y Docencia Económicas Mexico
                [6] Portland Oregon orgnameOHSU/PSU School of Public Health orgdiv1Oregon Health and Science University Health Systems and Policy orgdiv2Department of Obstetrics and Gynecology Estados Unidos
                Article
                S0036-36342020000600637 S0036-3634(20)06200600637
                10.21149/11850
                33620962
                2fe9e1d0-868d-4342-b3e9-5b4a8dcd0685

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 13 July 2020
                : 25 September 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 11
                Product

                SciELO Mexico

                Categories
                Artículos originales

                Mexico,anticonceptivos,posparto,adolescentes,adultas,servicios de salud,México,contraceptives,postpartum,adolescents,adults,health services

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