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Article ; Online: Maternal educational level and preterm birth: Exploring inequalities in a hospital-based cohort study.

Granés, Laura / Torà-Rocamora, Isabel / Palacio, Montse / De la Torre, Laura / Llupià, Anna

2023 Volume 18, Issue 4, Page(s) e0283901

Abstract: Preterm birth has been related to inequalities in maternal educational level, but the causal mechanism is not entirely known. Some factors associated with preterm birth and low educational level such as chronic medical conditions, pregnancy complications ...

Abstract	Preterm birth has been related to inequalities in maternal educational level, but the causal mechanism is not entirely known. Some factors associated with preterm birth and low educational level such as chronic medical conditions, pregnancy complications and related-health behaviours could have a mediation role in the pathway. This study aimed to evaluate the association between maternal educational level and preterm birth, analysing the mediation role of these factors. We performed a retrospective cohort study based on hospital electronic records of 10467 deliveries that took place in the Hospital Clínic of Barcelona between 2011 and 2017. Poisson regression was used to obtain crude and adjusted relative risk of preterm birth in women with different educational level and the percentage of change in relative risk was calculated when mediation variables were included in the model. Women with a lower educational level had a higher risk of preterm birth (RR 1.57, 95% CI 1.21, 2.03). The loss of association after the inclusion of body mass index in the model suggests an important mediation role of maternal overweight. Other variables such as smoking, drug use, preeclampsia and genitourinary infections also appear to play a role in the observed inequality between women with different levels of education. Efforts to promote health literacy and to improve preventive interventions, before and during pregnancy, could decrease preterm birth rates and perinatal health inequalities.
MeSH term(s)	Pregnancy ; Humans ; Infant, Newborn ; Female ; Premature Birth/etiology ; Cohort Studies ; Retrospective Studies ; Health Promotion ; Educational Status ; Hospitals
Language	English
Publishing date	2023-04-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0283901
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Exploring women's experiences of participation in shared decision-making during childbirth: a qualitative study at a reference hospital in Spain.

López-Toribio, María / Bravo, Paulina / Llupià, Anna

BMC pregnancy and childbirth

2021 Volume 21, Issue 1, Page(s) 631

Abstract: Background: Women's engagement in healthcare decision-making during childbirth has been increasingly emphasised as a priority in maternity care, since it increases satisfaction with the childbirth experience and provides health benefits for women and ... ...

Abstract	Background: Women's engagement in healthcare decision-making during childbirth has been increasingly emphasised as a priority in maternity care, since it increases satisfaction with the childbirth experience and provides health benefits for women and newborns. The birth plan was developed as a tool to facilitate communication between health professionals and women in Spain, but their value in routine practice has been questioned. Besides, little is known about women's experiences of participation in decision-making in the Spanish context. Thus, this study aimed to explore women's experiences of participation in shared decision-making during hospital childbirth. Methods: An exploratory qualitative study using focus groups was carried out in one maternity unit of a large reference hospital in Barcelona, Spain. Participants were first-time mothers aged 18 years or older who had had a live birth at the same hospital in the previous 12 months. Data collected were transcribed verbatim and analysed using a six-phase inductive thematic analysis process. Results: Twenty-three women participated in three focus groups. Three major themes emerged from the data: "Women's low participation in shared decision-making", "Lack of information provision for shared decision-making", and "Suggestions to improve women's participation in shared decision-making". The women who were willing to take an active role in decision-making encountered barriers to achieving this and some women did not feel prepared to do so. The birth plan was experienced as a deficient method to promote women's participation, as health professionals did not use them. Participants described the information given as insufficient and not offered at a timely or useful point where it could aid their decision-making. Potential improvements identified that could promote women's participation were having a mutually respectful relationship with their providers, the support of partners and other members of the family and receiving continuity of a coordinated and personalised perinatal care. Conclusion: Enhancing women's involvement in shared decision-making requires the acquisition of skills by health professionals and women. The development and implementation of interventions that encompass a training programme for health professionals and women, accompanied by an effective tool to promote women's participation in shared decision-making during childbirth, is highly recommended.
MeSH term(s)	Adult ; Attitude to Health ; Decision Making, Shared ; Female ; Focus Groups ; Hospitals ; Humans ; Parturition/psychology ; Pregnancy ; Professional-Patient Relations ; Qualitative Research ; Spain ; Young Adult
Language	English
Publishing date	2021-09-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2059869-5
ISSN	1471-2393 ; 1471-2393
ISSN (online)	1471-2393
ISSN	1471-2393
DOI	10.1186/s12884-021-04070-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Still using MS Excel? Implementation of the WHO Go.Data software for the COVID-19 contact tracing.

Llupià, Anna / Garcia-Basteiro, Alberto / Puig, Joaquim

Health science reports

2020 Volume 3, Issue 2, Page(s) e164

Keywords	covid19
Language	English
Publishing date	2020-05-08
Publishing country	United States
Document type	Journal Article
ISSN	2398-8835
ISSN (online)	2398-8835
DOI	10.1002/hsr2.164
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Maternal educational level and preterm birth

Laura Granés / Isabel Torà-Rocamora / Montse Palacio / Laura De la Torre / Anna Llupià

PLoS ONE, Vol 18, Iss 4, p e

Exploring inequalities in a hospital-based cohort study.

2023 Volume 0283901

Abstract	Preterm birth has been related to inequalities in maternal educational level, but the causal mechanism is not entirely known. Some factors associated with preterm birth and low educational level such as chronic medical conditions, pregnancy complications and related-health behaviours could have a mediation role in the pathway. This study aimed to evaluate the association between maternal educational level and preterm birth, analysing the mediation role of these factors. We performed a retrospective cohort study based on hospital electronic records of 10467 deliveries that took place in the Hospital Clínic of Barcelona between 2011 and 2017. Poisson regression was used to obtain crude and adjusted relative risk of preterm birth in women with different educational level and the percentage of change in relative risk was calculated when mediation variables were included in the model. Women with a lower educational level had a higher risk of preterm birth (RR 1.57, 95% CI 1.21, 2.03). The loss of association after the inclusion of body mass index in the model suggests an important mediation role of maternal overweight. Other variables such as smoking, drug use, preeclampsia and genitourinary infections also appear to play a role in the observed inequality between women with different levels of education. Efforts to promote health literacy and to improve preventive interventions, before and during pregnancy, could decrease preterm birth rates and perinatal health inequalities.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Still using MS Excel? Implementation of the WHO Go.Data software for the COVID‐19 contact tracing

Anna Llupià / Alberto Garcia‐Basteiro / Joaquim Puig

Health Science Reports, Vol 3, Iss 2, Pp n/a-n/a (2020)

2020

Keywords	Medicine ; R ; covid19
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Factors related to inhibition of lactation by pharmacological means at birth in a Spanish referral hospital (2011-2017).

Llupià, Anna / Torà, Isabel / Lladó, Alba / Cobo, Teresa / Sotoca, Josep Miquel / Puig, Joaquim

Gaceta sanitaria

2021 Volume 36, Issue 1, Page(s) 6–11

Abstract: Objective: To describe the maternal, neonatal and pregnancy characteristics related to inhibition of lactation (IL) with cabergoline.: Method: We assessed 20,965 occasions of breastfeeding initiation, according to data collected from obstetric ... ...

Abstract	Objective: To describe the maternal, neonatal and pregnancy characteristics related to inhibition of lactation (IL) with cabergoline. Method: We assessed 20,965 occasions of breastfeeding initiation, according to data collected from obstetric records at the Hospital Clinic of Barcelona (Spain) between January 2011 and December 2017. Results: IL decreased over the study period from 8.78% to 6.18% (odds ratio [OR]: 0.93 per year; 95% confidence interval [95%CI]: 0.90-0.95). Women with a lower educational level (OR: 2.5; 95%CI: 2.0-3.0), mothers living in more depressed areas (OR: 1.08 per 10 extra points over 100; 95%CI: 1.04-1.12), smokers (OR: 2.2; 95%CI: 1.9-2.6), and those with more children (OR: 1.2 for each sibling; 95%CI: 1.1-1.3), preterm birth (OR: 1.8; 95%CI: 1.4-2.3), multiple births (OR: 1.6; 95%CI: 1.2-2.1) and a higher risk pregnancy (OR: 1.3 per risk point; 95%CI: 1.2-1.4) showed a higher prevalence of IL. Compared to women born in Spain, IL was less likely in all other women with the exception of Chinese women (OR: 7.0; 95%CI: 5.7-8.6). These disparities remained during the study period. Conclusions: Factors related to lower socioeconomic status and poor health were more likely to be associated with IL. The overall use of cabergoline decreased during the study period while inequalities persisted. Taking these inequalities into account is the first step to addressing them.
MeSH term(s)	Breast Feeding ; Child ; Female ; Hospitals ; Humans ; Infant, Newborn ; Lactation ; Pregnancy ; Premature Birth ; Referral and Consultation
Language	English
Publishing date	2021-07-08
Publishing country	Spain
Document type	Journal Article
ZDB-ID	1038713-4
ISSN	1578-1283 ; 0213-9111
ISSN (online)	1578-1283
ISSN	0213-9111
DOI	10.1016/j.gaceta.2021.05.001
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: SARS-CoV-2 transmission in students of public schools of Catalonia (Spain) after a month of reopening.

Llupià, Anna / Borràs-Santos, Alícia / Guinovart, Caterina / Utzet, Mireia / Moriña, David / Puig, Joaquim

PloS one

2021 Volume 16, Issue 5, Page(s) e0251593

Abstract: Introduction: SARS-CoV-2 transmission within schools and its contribution to community transmission are still a matter of debate.: Methods: A retrospective cohort study in all public schools in Catalonia was conducted using publicly available data ... ...

Abstract	Introduction: SARS-CoV-2 transmission within schools and its contribution to community transmission are still a matter of debate. Methods: A retrospective cohort study in all public schools in Catalonia was conducted using publicly available data assessing the association between the number of reported SARS-CoV-2 cases among students and staff in weeks 1-2 (Sept 14-27th, 2020) of the academic year with school SARS-CoV-2 incidence among students in weeks 4-5. A multilevel Poisson regression model adjusted for the community incidence in the corresponding basic health area (BHA) and the type of school (primary or secondary), with random effects at the sanitary region and BHA levels, was performed. Results: A total of 2184 public schools opened on September 14th with 778,715 students. Multivariate analysis showed a significant association between the total number of SARS-CoV-2 cases in a centre in weeks 1-2 and the SARS-CoV-2 school incidence among students in weeks 4-5 (Risk Ratio (RR) 1.074, 95% CI 1.044-1.105, p-value <0.001). The adjusted BHA incidence in the first two weeks was associated with school incidence in weeks 4-5 (RR 1.002, 95% CI 1.002-1.003, p-value <0.001). Secondary schools showed an increased incidence in weeks 4 and 5 (RR primary vs secondary 1.709 95% CI 1.599-1.897, p-value <0.001). Conclusions: Safety measures adopted by schools were not enough to stop related-to-school transmission in students and could be improved. The safest way to keep schools open is to reduce community transmission down to a minimum.
MeSH term(s)	Adolescent ; COVID-19/epidemiology ; COVID-19/transmission ; Child ; Cohort Studies ; Female ; Humans ; Incidence ; Male ; Public Sector ; Retrospective Studies ; SARS-CoV-2/pathogenicity ; Schools/trends ; Spain/epidemiology ; Students
Language	English
Publishing date	2021-05-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0251593
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Still using MS Excel? Implementation of the WHO Go.Data software for the COVID ‐19 contact tracing

Llupià, Anna / Garcia‐Basteiro, Alberto / Puig, Joaquim

Health Science Reports

2020 Volume 3, Issue 2

Keywords	covid19
Language	English
Publisher	Wiley
Publishing country	us
Document type	Article ; Online
ISSN	2398-8835
DOI	10.1002/hsr2.164
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Still using MS Excel? Implementation of the WHO Go.Data software for the COVID-19 contact tracing

Llupià, Anna / Garcia-Basteiro, Alberto / Puig, Joaquim

Heal. Sci. Rep.

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #209551
Database	COVID19

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Article ; Online: Factors related to inhibition of lactation by pharmacological means at birth in a Spanish referral hospital (2011-2017)

Anna Llupià / Isabel Torà / Alba Lladó / Teresa Cobo / Josep Miquel Sotoca / Joaquim Puig

Gaceta Sanitaria, Vol 36, Iss 1, Pp 6-

2022 Volume 11

Abstract: Objective: To describe the maternal, neonatal and pregnancy characteristics related to inhibition of lactation (IL) with cabergoline. Method: We assessed 20,965 occasions of breastfeeding initiation, according to data collected from obstetric records at ... ...

Abstract	Objective: To describe the maternal, neonatal and pregnancy characteristics related to inhibition of lactation (IL) with cabergoline. Method: We assessed 20,965 occasions of breastfeeding initiation, according to data collected from obstetric records at the Hospital Clinic of Barcelona (Spain) between January 2011 and December 2017. Results: IL decreased over the study period from 8.78% to 6.18% (odds ratio [OR]: 0.93 per year; 95% confidence interval [95%CI]: 0.90-0.95). Women with a lower educational level (OR: 2.5; 95%CI: 2.0-3.0), mothers living in more depressed areas (OR: 1.08 per 10 extra points over 100; 95%CI: 1.04-1.12), smokers (OR: 2.2; 95%CI: 1.9-2.6), and those with more children (OR: 1.2 for each sibling; 95%CI: 1.1-1.3), preterm birth (OR: 1.8; 95%CI: 1.4-2.3), multiple births (OR: 1.6; 95%CI: 1.2-2.1) and a higher risk pregnancy (OR: 1.3 per risk point; 95%CI: 1.2-1.4) showed a higher prevalence of IL. Compared to women born in Spain, IL was less likely in all other women with the exception of Chinese women (OR: 7.0; 95%CI: 5.7-8.6). These disparities remained during the study period. Conclusions: Factors related to lower socioeconomic status and poor health were more likely to be associated with IL. The overall use of cabergoline decreased during the study period while inequalities persisted. Taking these inequalities into account is the first step to addressing them. Resumen: Objetivo: Describir las características maternas, neonatales y del embarazo relacionadas con la inhibición de la lactancia (IL) con cabergolina. Método: Se evaluaron 20.965 ocasiones de inicio de lactancia, según los registros obstétricos del Hospital Clínic de Barcelona (2011-2017). Resultados: La IL disminuyó durante el periodo de estudio del 8,78% al 6,18% (odds ratio [OR]: 0,93 anual; intervalo de confianza del 95% [IC95%]: 0,90-0,95). Las mujeres con menor nivel educativo (OR: 2,5; IC95%: 2,0-3,0), las madres que viven en áreas más deprivadas (OR: 1,08 por 10 puntos extra sobre 100; IC95%: 1,04-1,12), las fumadoras ...
Keywords	Lactancia materna ; Desigualdades en el estado de salud ; Determinantes sociales de la salud ; Supresión de la lactancia materna ; Inicio de la lactancia materna ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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