Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing?

Background. In Spain, the Strategy for Assistance in Normal Childbirth (SANC) promoted a model of care, which respects the physiological birth process and discards unnecessary routine interventions, such as episiotomies. We evaluated the rate of episiotomy use and perineal trauma as indicators of ho...

Descripción completa

Detalles Bibliográficos
Autores: Escuriet Peiró, Ramón, 1968-, Pueyo, María Jesús, Perez-Botella, Mercedes, Espada, Xavi, Salgado i Gispert, Isabel, Gómez, Analía, Biescas, Herminia, Espiga, Isabel, White, Joanna, Fernández, Rosa, Fusté, Josep, Ortún Rubio, Vicente
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2015
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/25445
Acceso en línea:http://hdl.handle.net/10230/25445
http://dx.doi.org/10.1186/s12913-015-0753-z
Access Level:acceso abierto
Palabra clave:Maternitat
Episiotomy
Perineal trauma
Maternity services organisation
id ES_7ce138bf4f2f1cc7e46d76fb47d16b6b
oai_identifier_str oai:recercat.cat:10230/25445
network_acronym_str ES
network_name_str España
repository_id_str
spelling Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing?Escuriet Peiró, Ramón, 1968-Pueyo, María JesúsPerez-Botella, MercedesEspada, XaviSalgado i Gispert, IsabelGómez, AnalíaBiescas, HerminiaEspiga, IsabelWhite, JoannaFernández, RosaFusté, JosepOrtún Rubio, VicenteMaternitatEpisiotomyPerineal traumaMaternity services organisationBackground. In Spain, the Strategy for Assistance in Normal Childbirth (SANC) promoted a model of care, which respects the physiological birth process and discards unnecessary routine interventions, such as episiotomies. We evaluated the rate of episiotomy use and perineal trauma as indicators of how selective introduction of the SANC initiative has impacted childbirth outcomes in hospitals of Catalonia./nMethods. Cross-sectional study of all singleton vaginal term deliveries without instrument registered in the Minimum Basic Data Set (MBDS) of Catalonia in 2007, 2010 and 2012. Hospitals were divided into types according to funding (public or private), and four strata were differentiated according to volume of births attended./nEpisiotomies and perineal injury were considered dependent variables. The relationship between qualitative variables was analysed using the chi-squared test, and Student’s t-test was used for quantitative variables. Comparison of proportions was performed on the two hospital groups between 2007 and 2012 using a Z-test. Logistic regression models were used to analyse the relationship between episiotomy or severe perineal damage and maternal age, volume of births and hospital type, obtaining odds ratios (OR) and 95% confidence intervals (CI)./nResults. The majority of normal singleton term deliveries were attended in public hospitals, where maternal age was lower than for women attended in private hospitals. Analysis revealed a statistically significant (P < 0.001) decreasing trend in episiotomy use in Catalonia for both hospital types. Private hospitals appeared to be associated with increased episiotomy rate in 2007 (OR = 1.099, CI: 1,057–1,142), 2010 (OR = 1.528, CI: 1,472–1,587) and 2012 (OR = 1.459, CI: 1,383–1,540), and a lower rate of severe perineal trauma in 2007 (OR = 0.164, CI: 0.095–0.283), 2010 (OR = 0.16, CI: 0.110–0.232) and 2012 (OR = 0.19, CI: 0.107–0.336). Regarding severe perineal injury, when independent variables were adjusted, maternal age ceased to have a significant correlation in 2012 (OR = 0.994, CI: 0.970–1.018)./nConclusions. Episiotomy procedures during normal singleton vaginal term deliveries in Catalonia has decreased steadily since 2007. Study results show a stable incidence trend below 1% for severe perineal trauma over the study period.BioMed Central201520152015info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/25445http://dx.doi.org/10.1186/s12913-015-0753-zreponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésBMC Health Services Research. 2015;15:95© 2015 Escuriet et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.http://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessoai:recercat.cat:10230/254452026-05-29T05:05:01Z
dc.title.none.fl_str_mv Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing?
title Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing?
spellingShingle Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing?
Escuriet Peiró, Ramón, 1968-
Maternitat
Episiotomy
Perineal trauma
Maternity services organisation
title_short Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing?
title_full Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing?
title_fullStr Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing?
title_full_unstemmed Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing?
title_sort Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing?
dc.creator.none.fl_str_mv Escuriet Peiró, Ramón, 1968-
Pueyo, María Jesús
Perez-Botella, Mercedes
Espada, Xavi
Salgado i Gispert, Isabel
Gómez, Analía
Biescas, Herminia
Espiga, Isabel
White, Joanna
Fernández, Rosa
Fusté, Josep
Ortún Rubio, Vicente
author Escuriet Peiró, Ramón, 1968-
author_facet Escuriet Peiró, Ramón, 1968-
Pueyo, María Jesús
Perez-Botella, Mercedes
Espada, Xavi
Salgado i Gispert, Isabel
Gómez, Analía
Biescas, Herminia
Espiga, Isabel
White, Joanna
Fernández, Rosa
Fusté, Josep
Ortún Rubio, Vicente
author_role author
author2 Pueyo, María Jesús
Perez-Botella, Mercedes
Espada, Xavi
Salgado i Gispert, Isabel
Gómez, Analía
Biescas, Herminia
Espiga, Isabel
White, Joanna
Fernández, Rosa
Fusté, Josep
Ortún Rubio, Vicente
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Maternitat
Episiotomy
Perineal trauma
Maternity services organisation
topic Maternitat
Episiotomy
Perineal trauma
Maternity services organisation
description Background. In Spain, the Strategy for Assistance in Normal Childbirth (SANC) promoted a model of care, which respects the physiological birth process and discards unnecessary routine interventions, such as episiotomies. We evaluated the rate of episiotomy use and perineal trauma as indicators of how selective introduction of the SANC initiative has impacted childbirth outcomes in hospitals of Catalonia./nMethods. Cross-sectional study of all singleton vaginal term deliveries without instrument registered in the Minimum Basic Data Set (MBDS) of Catalonia in 2007, 2010 and 2012. Hospitals were divided into types according to funding (public or private), and four strata were differentiated according to volume of births attended./nEpisiotomies and perineal injury were considered dependent variables. The relationship between qualitative variables was analysed using the chi-squared test, and Student’s t-test was used for quantitative variables. Comparison of proportions was performed on the two hospital groups between 2007 and 2012 using a Z-test. Logistic regression models were used to analyse the relationship between episiotomy or severe perineal damage and maternal age, volume of births and hospital type, obtaining odds ratios (OR) and 95% confidence intervals (CI)./nResults. The majority of normal singleton term deliveries were attended in public hospitals, where maternal age was lower than for women attended in private hospitals. Analysis revealed a statistically significant (P < 0.001) decreasing trend in episiotomy use in Catalonia for both hospital types. Private hospitals appeared to be associated with increased episiotomy rate in 2007 (OR = 1.099, CI: 1,057–1,142), 2010 (OR = 1.528, CI: 1,472–1,587) and 2012 (OR = 1.459, CI: 1,383–1,540), and a lower rate of severe perineal trauma in 2007 (OR = 0.164, CI: 0.095–0.283), 2010 (OR = 0.16, CI: 0.110–0.232) and 2012 (OR = 0.19, CI: 0.107–0.336). Regarding severe perineal injury, when independent variables were adjusted, maternal age ceased to have a significant correlation in 2012 (OR = 0.994, CI: 0.970–1.018)./nConclusions. Episiotomy procedures during normal singleton vaginal term deliveries in Catalonia has decreased steadily since 2007. Study results show a stable incidence trend below 1% for severe perineal trauma over the study period.
publishDate 2015
dc.date.none.fl_str_mv 2015
2015
2015
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/25445
http://dx.doi.org/10.1186/s12913-015-0753-z
url http://hdl.handle.net/10230/25445
http://dx.doi.org/10.1186/s12913-015-0753-z
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv BMC Health Services Research. 2015;15:95
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869411622331613184
score 15.812455

Similares en LA Referencia