Titre :
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Inequalities in caesarean section : influence of the type of maternity care and social class in an area with a national health system. (2009)
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Auteurs :
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J. SALVADOR ;
BORRELL (C.) : ESP. Universitat Pompeu Fabra. Barcelona. ;
G. CANO-SERRAL ;
LLADONOSA (A.) : ESP. Adknoma. Barcelona. ;
M. RODRIGUEZ-SANZ ;
Ciber de Epidemiologia y Salud Pûblica Ciberesp. ESP ;
Servei de Sistemes d'lnformacio Sanitària. Agència de Salut Pûblica de Barcelona. ESP
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Type de document :
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Article
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Dans :
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Journal of epidemiology and community health (vol. 63, n° 3, 2009)
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Pagination :
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259-261
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Langues:
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Anglais
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Mots-clés :
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Césarienne
;
Soins
;
Inégalité sociale
;
Classe sociale
;
Système santé
;
Thérapeutique
;
Thérapeutique chirurgicale
;
Chirurgie
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Résumé :
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[BDSP. Notice produite par INIST-CNRS CqR0xH8t. Diffusion soumise à autorisation]. Objective : To analyse the impact of social class inequalities and type of maternity unit in the use of caesarean sections (CSs) among residents in an urban area of Southern Europe. Design : This was a cross-sectional study. The study population consisted of 2186 women resident in Barcelona city who gave birth to an infant without any birth defect during 1994-2003. The dependent variable was the type of delivery. Maternal age, social class and type of maternity unit (public or private) were independent variables. Maternal age-adjusted logistic regression models were used. Results : 30% of deliveries ended in CS ; 70% of less privileged women delivered in public maternity units and 72% of more privileged women delivered in private centres. A relationship between CS and social class was observed (OR 1.4 ; 95% Cl 1.1 to 1.7), but disappeared when the analysis was done separately for each stratum of type of maternity unit (both ORs 1.0). In contrast, a relationship between CS and type of maternity unit was found (OR 2.3 ; 95% Cl 1.9 to 2.7), which persisted when the analysis was done separately for each stratum of social class. Conclusion : Although strongly related to higher social class, the main determinant of the high proportion of CSs was delivering in private maternity units.
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