Influência dos fatores de situação socioeconômica, de aceitação da gravidez e da assistência pré-natal na mortalidade fetal: análise com modelagem de equações estruturais / Influence of socioeconomic situation and acceptance of pregnancy factors and prenatal care on fetal mortality: analysis through structural equation modeling
AUTOR(ES)
Gizelton Pereira Alencar
DATA DE PUBLICAÇÃO
2009
RESUMO
Introduction. The hypothesis about the relations among exposure variables and the fetal death are written as a diagram designed from a conceptual framework given by the researcher. Tests on these relations can be performed using structural equation modeling (SEM). Objective. This study aim to understand the role of socioeconomic situation (SES), non-acceptance of pregnancy (nAoP) and prenatal care on fetal mortality, in region south of the city of São Paulo, in 2000. Methodology. The measurement models were created to the latent variables SES and nAoP, from case-control study on fetal mortality in Sao Paulo city, in 2000. It was tested a model with SES, nAoP, prenatal care, medical complications (hypertension, gestational diabetes, vaginal bleeding), intra-uterine growth retardation (IUGR) on the outcome, performed by SEM. Results. The SES was composed by mothers and household heads years of study, socioeconomic classification index, and income per capita income; The AoP was composed by reactions of mother, father and family, attempted abortion and planned gestation. The final model showed the effect of SES and AoP on fetal death mediated by prenatal care, in a model where medical complications and IUGR also has an effect. Conclusion. The results suggests that negative acceptance of pregnancy and unfavorable socioeconomic situation, mediated by prenatal care, could be minimized improving the quality of prenatal care especially to those who are more social vulnerable.
ASSUNTO(S)
structural equation models binary variables stillbirth pré-natal fatores socioeconomicos fetal mortality socioeconomic factors natimorto prenatal modelos de equações estruturais variáveis binárias mortalidade fetal
