medigraphic.com
Instituto Nacional de Salud Pública

2024, Number 1

<< Back Next >>

salud publica mex 2024; 66 (1)

Pregnancy interruption in Chile 2018-2020: role of sociodemographic and health variables on women’s decision

Saldias-Fernández MA, González-Santa-Cruz A, Parra-Giordano D

Language: Spanish
References: 34
Page: 17-24
PDF size: 313.30 Kb.


ABSTRACT

Objective. To identify sociodemographic and health factors among those who required benefits associated with the voluntary termination of pregnancy (IVE). Materials and methods. Retrospective cross-sectional design from official records by health centers between 2018-2020. Analysis with descriptive statistics and multiple logistic regression models. Results. Association between IVE and cause of rape vs. the risk of the life of the woman (aPR [adjusted prevalence ratio]=1.16 [95%CI: 1.11,1.21]); Fonasa level A (Fondo Nacional de Salud) (aPR=0.79 [95%CI: 0.67,0.93]), B (aPR= 0.79 [95%CI: 0.67,0.93]) and C vs. Isapre (Institución de Salud Previsional) (aPR= 0.73 [95%CI: 0.58,0.93]). As the level of care increases, from primary to tertiary level, the probability of terminating the pregnancy would increase (aOR [adjusted odds ratio]= 0.59 [95%CI: 0.36,0.99]; aOR= 0.58 [95%CI: 0.35,0.96]). Conclusion. National IVE estimates are provided. It highlights that different socio-sanitary determinants are essential to consider promoting guidelines and health policies to promote sexual and reproductive rights and reproductive autonomy.


REFERENCES

  1. Kiani Z, Simbar M, Dolatian M, Zayeri F. Structural equation modeling ofpsychosocial determinants of health for the empowerment of Iranian womenin reproductive decision making. BMC Womens Health. 2020;20(1):1-9 [citado mayo 15, 2023]. Disponible en: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-020-0893-0/

  2. Byrne ME, Omoluabi E, OlaOlorun FM, Moreau C, Bell SO. Determinantsof women’s preferred and actual abortion provision locations in Nigeria.Reproductive Health. 2021;18:1-9 [citado mayo 15, 2023]. Disponible en:https://link.springer.com/article/10.1186/s12978-021-01290-w

  3. Rubin R. Medical–legal partnerships: how legal services can dramaticallyimprove health outcomes, and the missed opportunity to help womenseeking abortions. Family Court Review. 2019;57(4):569-82. https://doi.org/10.1111/fcre.12449

  4. Danet-Danet A. Experiencias emocionales en la interrupción voluntariadel embarazo. Gac Sanit. 2022;35:361-73. https://doi.org/10.1016/j.gaceta.2020.02.006

  5. Egli D, Aftab W, Hawkes S, Abu-Raddad L, Buse K, Rabbani F, et al. Thesocial and structural determinants of sexual and reproductive health andrights in migrants and refugees: a systematic review of reviews. East MediterrHealth J. 2021;27(12):1203-13. https://doi.org/10.26719/emhj.20.101

  6. Nandagiri R, Coast E, Strong J. COVID-19 and abortion: making structuralviolence visible. Int Perspect Sex Reprod Health. 2020;46(Supp 1):83-9.https://doi.org/10.1363/46e1320

  7. Chareka S, Crankshaw TL, Zambezi P. Economic and social dimensionsinfluencing safety of induced abortions amongst young women who sellsex in Zimbabwe. Sex Reprod Health Matters. 2021;29(1):121-32. https://doi.org/10.1080/26410397.2021.1881209

  8. Ministerio de Salud. Regula la despenalización de la interrupciónvoluntaria del embarazo en tres causales. Chile: Biblioteca del CongresoNacional de Chile, 2017 [citado mayo 15, 2023]. Disponible en: https://www.bcn.cl/leychile/navegar?idNorma=1108237

  9. Muñoz P, Parrini J, Dresdner R, Jiménez M. Dilemas clínicos en laconstitución de la tercera causal de la interrupción voluntaria del embarazo.Rev Med Chil. 2021;149(5):758-64. http://doi.org/10.4067/s0034-98872021000500758

  10. Ministerio de Salud. Norma técnica nacional de acompañamientoy de atención integral a la mujer que se encuentra en alguna de lastres causales que regula la ley 21.230. Chile: Gobierno de Chile, 2018[citado mayo 15, 2023]. Disponible en: https://www.minsal.cl/wp-content/uploads/2018/02/NORMA-IVE-ACOMPANAMIENTO_02.pdf

  11. Cvetkovic-Vega A, Maguiña JL, Soto A, Lama-Valdivia J, López LEC.Estudios transversales. Rev Fac Med Hum. 2021;21(1):179-85. https://doi.org/10.25176/rfmh.v21i1.3069

  12. Aguilera X, Castillo C, Covarrubias T, Delgado I, Fuentes R, GómezMI, et al. Estructura y funcionamiento del sistema de salud chileno.Serie de Salud Poblacional N° 2. Chile: Universidad del Desarrollo,2019 [citado febrero 6, 2023]. Disponible en: https://repositorio.udd.cl/bitstreams/6e067481-91e0-495a-9b96-fd48064f383b/download

  13. Ochoa J, Yunkor Y. El estudio descriptivo en la investigación científica.Acta Jurídica Peruana. 2019;2(2) [citado mayo 15, 2023]. Disponible en:http://201.234.119.250/index.php/AJP/article/view/224/191

  14. Greenland S, Senn SJ, Rothman KJ, Carlin JB, Poole C, Goodman SN,et al. Statistical tests, P values, confidence intervals, and power: a guide tomisinterpretations. Eur J Epidemiol. 2016;31:337-50 [citado mayo 15, 2023].Disponible en: https://link.springer.com/article/10.1007/s10654-016-0149-3

  15. Saldías-Fernández MA, González-Santa Cruz A, Parra-Giordano D.Material Suplementario Sección 1 y 2. Interrupción del embarazo enChile 2018-2020: rol de las variables sociodemográficas y sanitariassobre la decisión de la mujer. Figshare, 2023:1-18 https://doi.org/10.6084/m9.figshare.22866770

  16. Bastos LS, Oliveira R de VC de, Velasque LDS. Obtaining adjustedprevalence ratios from logistic regression models in cross-sectionalstudies. Cad Saude Publica. 2015;31:487-95. https://doi.org/10.1590/0102-311X00175413

  17. Wilcosky TC, Chambless LE. A comparison of direct adjustmentand regression adjustment of epidemiologic measures. J Chronic Dis.1985;38(10):849-56. https://doi.org/10.1016/0021-9681(85)90109-2

  18. Gelman A, Jakulin A, Pittau MG, Su YS. A weakly informative defaultprior distribution for logistic and other regression models. Ann Appl Stat2008;2(4):1360-83. https://doi.org/10.1214/08-AOAS191

  19. Gelman A, Jakulin A, Pittau MG, Su Y. A default prior distribution forlogistic and other regression models. Ann Appl Stat. 2008;2(4):1360-83[citado mayo 15, 2023]. Disponible en: www.stat.columbia.edu/~gelman/research/unpublished/priors3.pdf

  20. Team RDC. A language and environment for statistical computing. 2009[citado mayo 15, 2023]. Disponible en: http://www R-project org

  21. Gelman A, Greenland S. Are confidence intervals better termed “uncertaintyintervals”? BMJ. 2019;366. https://doi.org/10.1136/bmj.l5381

  22. Correa JC, Valencia M. La separación en regresión logística, unasolución y aplicación. Rev Fac Nac Salud Publica. 2011;29(3):281-8 [citado mayo 15, 2023]. Disponible en: https://www.redalyc.org/pdf/120/12021452008.pdf

  23. Julian Z, Robles D, Whetstone S, Perritt JB, Jackson AV, Hardeman RR,et al. Community-informed models of perinatal and reproductive healthservices provision: a justice-centered paradigm toward equity amongBlack birthing communities. Semin Perinatol. 2020:151267. https://doi.org/10.1016/j.semperi.2020.151267

  24. Barrancos D. La ley abortada: Notas sobre el debate de la interrupciónvoluntaria del embarazo. Salud colectiva. 2018: 14(3):373-6. https://doi.org/10.18294/sc.2018.2025

  25. Quintero LD, Osorio-Osorio H, Bojorquez-Chapela I, Isaza L, Acosta-Reyes J, Fernández-Niño JA. Interrupción voluntaria del embarazo y saludsexual y reproductiva en mujeres migrantes en Barranquilla. Rev PanamSalud Publica. 2023;47:e49. https://doi.org/10.26633/RPSP.2023.49

  26. Bain LE, Zweekhorst MB, de Cock Buning T. Prevalence and determinantsof unintended pregnancy in sub–saharan Africa: a systematicreview. Afr J Reprod Health. 2020;24(2):187-205 [citado mayo 15,2023]. Disponible en: https://www.ajol.info/index.php/ajrh/article/view/197977/186718

  27. Cárdenas-Arias EF, Escudero-Cardona DE, Noreña-Mosquera EA.Safety of voluntary interruption of pregnancy (VIP) in two healthcareinstitutions in Medellín, Colombia, in 2019. Historical cohort. Rev ColombObstet Ginecol. 2022;73(1):39-47. https://doi.org/10.18597/rcog.3760

  28. Organización Mundial de la Salud. Aborto. Ginebra: OMS, 2021 [citadomayo 15, 2023]. Disponible en: https://www.who.int/es/news-room/factsheets/detail/abortion

  29. Smith SN, Karreman E, Jabs C. Continuation of contraception followingtermination of pregnancy in a Canadian urban centre. J Obstet GynaecolCan. 2022;44(1):48-53. https://doi.org/10.1016/j.jogc.2021.07.012

  30. Cabezas DD, Guzmán MI, Bravo PE. Normativas que regulan lainterrupción del embarazo por violación en Latinoamérica: Análisis comparadodesde un enfoque de derechos. Cuad Med Soc. 2022;62(3):17-9.https://doi.org/10.56116/cms.v62.n3.2022.373

  31. Center for Reproductive Rights. Adolescents Need Safe and LegalAbortion. Center for Reproductive Rights, 2005 [citado mayo 15, 2023].Disponible en: https://reproductiverights.org/wp-content/uploads/2020/12/pub_bp_tk_adolescents.pdf

  32. González AI, Moreno DJ, Grass DE. Interrupción voluntaria del embarazoen Latinoamérica, superando barreras. Salud UIS. 2021;53. https://doi.org/10.18273/saluduis.53.e:21013

  33. Barral R, Kelley MA, Harrison ME, Svetaz MV, Efevbera Y, Bhave S, et al.Dismantling inequities in adolescent and young adult health through asexual and reproductive health justice approach. Semin Reprod Med.2022;40(01/02):131-45. https://doi.org/10.1055/s-0042-1742347

  34. Ireland H, Tran NT, Dawson A. The role of social capital in women’ssexual and reproductive health and rights in humanitarian settings: asystematic review of qualitative studies. Conflict and Health. 2021;15(1):1-12 [citado mayo 15, 2023]. Disponible en: https://conflictandhealth.biomedcentral.com/articles/10.1186/s13031-021-00421-1




2020     |     www.medigraphic.com