Patient safety and quality of care in maternal health data from the Born in Brazil National Survey

• Grant number: 11/18534-6
• Support type: Scholarships abroad - Research
• Effective date (Start): February 01, 2012
• Effective date (End): January 31, 2013
• Field of knowledge: Health Sciences - Collective Health - Public Health
• Principal researcher: Carmen Simone Grilo Diniz
• Grantee: Carmen Simone Grilo Diniz
• Host: Jane Sandall
• Home Institution: Faculdade de Saúde Pública (FSP). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Research place: King's College London, England

Abstract

In the last two decades, Brazil made remarkable advances in maternal and child health, including high coverage of antenatal consultations, universal coverage of deliveries assisted in health care facilities by trained professionals, and significant improvement of maternal social indicators (education, income, fertility). Nevertheless, there was inconsistent decrease in maternal mortality, together with an increase in low birth weight and preterm births. These negative outcomes can be attributed to several causes, including the inappropriate use of technology in perinatal care. The objectives of this project are to evaluate the quality of care and safe use of technology in perinatal care in the data of the National Survey Born in Brazil. We will analyze the association of adverse maternal and neonatal outcomes with the use of episiotomy and forceps, patterns of induction and acceleration of labor and delivery, the presence of companions, and management of pre-eclampsia, in public and private sectors in Sao Paulo. Methodology: The National Survey Born in Brazil is a nationwide hospital-based study, with face to face interviews of mothers in the immediate postpartum and by telephone 45 to 60 days after delivery, extraction of data from hospital records of health institutions which recorded 500 births / year or more in 2007. The sample design is probabilistic, in two stages, the first corresponds to the health facilities and the second to postpartum women and their newborns. In the five Brazilian Macro-regions the institutions were selected according to criteria: Capital / Interior, Public / Private / Joint /, and with and without NICU. All States of the Federation will take part of the sample, with a total of 23,520 pairs of mothers and newborns, 4,500 of them in the State of São Paulo. Motivation and relevance: the safety and quality care are areas of growing importance in maternal and newborn health, especially with regard to the paradox of the indicators do not improve in spite of universal access to services. The centers target in this research program (Division of Women's Health and Patient Safety and Quality of Care Research Center) are two of the leading research institutes on the subject, and the collaborator at the center is one of the main authors in the field. We plan to stay for one year (2012) to jointly analyze the outcomes and participate in courses, which will later be adapted and offered at USP. Form of analysis of results: the prevalence will be estimated and confidence intervals for safety-related outcomes of this study, taking into account the sampling strategy used. The association between demographic and socioeconomic variables of postpartum women, frequency of use of surgery and medication, and obstetrical and neonatal complications, will be investigated in bivariate analysis, stratified and multivariate models. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

HELOISA DE OLIVEIRA SALGADO; DENISE YOSHIE NIY; CARMEN SIMONE GRILO DINIZ. Groggy and with tied hands: the first contact with the newborn according to women that had an unwanted c-section. Revista brasileira de crescimento e desenvolvimento humano, v. 23, n. 2, p. 190-197, 2013.