Introducción: El riesgo de prematuridad abarca una amplia variedad de complicaciones al nacer, como enfermedades infecciosas, hemorragia intraventricular, deficiencias neurosensoriales, insuficiencia respiratoria y afectación de otros sistemas, así como problemas de crecimiento y desarrollo. Por tanto, la consecución del Objetivo de Desarrollo del Milenio de reducir la mortalidad infantil, depende en gran medida de la reducción de la mortalidad relacionada con el nacimiento prematuro, lo que lo convierte en uno de los desafíos más importantes para la salud pública moderna. Objetivo: Identificar los factores maternos asociados a prematuridad. Material y Métodos: Se realizó un estudio de tipo caso-control retrospectivo en 2000 recién nacidos vivos de un hospital público de Trujillo, entre el 2015-2019. Se dividieron los grupos según el criterio de edad gestacional. Se analizaron las variables clínicas maternas pareadas según prematuridad o a término, y se realizó un análisis bivariado y multivariado por regresión logística ajustada por confusores. Resultados: Se demostró que el número de controles prenatales menor a cuatro durante la gestación, está asociado a prematuridad (OR 2,65; IC95%: 2,21-3,18). Por otro lado, la ausencia de una infección del tracto urinario (OR 0,73; IC95%: 0,56-0,95), está asociado a menor riesgo de prematuridad. Conclusiones: El número de controles prenatales es un factor asociado importante para parto prematuro, mientras que la ausencia de una ITU puede estar asociada a menor tasa de partos prematuros en gestantes de riesgo.
Background: We aimed to analyze the ethnic disparities in the out-of-pocket (OOP) payment and estimate the gaps related to observable risk factors in the OOP payment on medicines by ethnic conditions during 2014-2016 in Peru.
Methods: We conducted a cross-sectional analytical secondary data analysis using the National Health User Satisfaction Survey. The outcome was the OOP payment in self-reported medications by participants. The ethnic condition was considered using the language participants habitually spoke at home (Spanish, Quechua/other). We collected confounding variables: sex, age, education, health insurance, medical prescription and region of residence. Crude and adjusted regression models were performed to assess the gaps in OPP payment on medications among ethnic conditions. The association measure was the Beta coefficient (β) with 95% confidence intervals (95%CI). The Oaxaca-Blinder decomposition method assessed the OPP payment differential in the two study groups explained by their individual and sociodemographic characteristics.
Results: We analyzed 11,346 surveyed, the mean age was 40.78 years, and 57.67% were women. In the adjusted analysis, there was lower OOP payment in medications in participants speaking Quechua or other languages than those who speak Spanish (β: -0.11; 95%CI: -0.21 to -0.01; p=0.043). In the Oaxaca-Blinder decomposition analysis, a gap of 0.19 USD in the OOP payment in medicines was found, which disadvantages those minority ethnic conditions (p<0.001), and the explained component represents 41.2% of the gap (p<0.05).
Conclusion: There were fewer out-of-pocket payments on medicines for ethnic minorities, and the observable differences explain approximately 40% of these gaps.
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