Womenʼs assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic: Results from the IMAgiNE EURO study

Marina Ruxandra Otelea; Anca Angela Simionescu; Ilaria Mariani; Emanuelle Pessa Valente; Michaela Iuliana Nanu; Ioana Nanu; Claudia Mariana Handra; Benedetta Covi; Marzia Lazzerini; Karolina Linden; Mehreen Zaigham; IMAgiNE EURO study group

doi:10.1002/ijgo.14482

Womenʼs assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic: Results from the IMAgiNE EURO study

Marina Ruxandra Otelea, Anca Angela Simionescu, Ilaria Mariani, Emanuelle Pessa Valente, Michaela Iuliana Nanu, Ioana Nanu, Claudia Mariana Handra, Benedetta Covi, Marzia Lazzerini, Karolina Linden (Contributor), Mehreen Zaigham (Contributor), IMAgiNE EURO study group

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To assess women's perceptions of the quality of maternal and newborn care (QMNC) received in hospitals in Romania during the COVID-19 pandemic by mode of birth. Methods: A validated anonymous online questionnaire based on WHO quality measures. Subgroup analysis of spontaneous vaginal birth (SVB), emergency cesarean, and elective cesarean and multivariate analyses were performed, and QMNC indexes were calculated. Maternal age, educational level, year of birth, mother born in Romania, parity, type of hospital, and type of professionals assisting the birth were used for multivariate analysis. Results: A total of 620 women completed the survey. Overall, several quality measures suggested gaps in QMNC in Romania, with the lowest QMNC indexes reported for provision of care and availability of resources. Women who had either elective or emergency cesarean compared with those who had SVB more frequently lacked early breastfeeding (OR 2.04 and 2.13, respectively), skin-to-skin contact (OR 1.73 and 1.75, respectively), rooming-in (OR 2.07 and 1.96, respectively), and exclusive breastfeeding at discharge (OR 2.27 and 1.64, respectively). Compared with elective cesarean, emergency cesarean had higher odds of ineffective communication by healthcare providers (OR 1.65), lack of involvement in choices (OR 1.58), insufficient emotional support (OR 2.07), and no privacy (OR 2.06). Compared with other modes of birth, a trend for lower QMNC indexes for emergency cesarean was observed for all domains, while for elective cesarean the QMNC index for provision of care was significantly lower. Conclusion: Quality indicators of perinatal care remain behind targets in Romania, with births by cesarean the most affected. ClinicalTrials.gov identifier: NCT04847336.

Original language	English
Pages (from-to)	126-136
Number of pages	11
Journal	International Journal of Gynecology and Obstetrics
Volume	159
Issue number	S1
DOIs	https://doi.org/10.1002/ijgo.14482
Publication status	Published - 2022 Dec

Bibliographical note

Funding Information:
This work was supported by the Ministry of Health, Rome, Italy, in collaboration with the Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy. We gratefully acknowledge all women who took the time to answer the questionnaire despite the burden of the COVID-19 pandemic. We would also like to thank the following colleagues for their assistance with translation and dissemination of the Romanian questionnaire: Sinziana Ionita-Ciurez, Ana Maita, Cristina Biciila, Raluca Dumitrescu (members of SAMAS Association). Special thanks to the IMAgiNE EURO study group for their contribution to the development of this project and support for this manuscript.

Funding Information:
This work was supported by the Ministry of Health, Rome, Italy, in collaboration with the Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy. We gratefully acknowledge all women who took the time to answer the questionnaire despite the burden of the COVID‐19 pandemic. We would also like to thank the following colleagues for their assistance with translation and dissemination of the Romanian questionnaire: Sinziana Ionita‐Ciurez, Ana Maita, Cristina Biciila, Raluca Dumitrescu (members of SAMAS Association). Special thanks to the IMAgiNE EURO study group for their contribution to the development of this project and support for this manuscript.

Funding Information:
Funding informationThis work was supported by the Ministry of Health, Rome ‐ Italy, in collaboration with the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste ‐ Italy

Publisher Copyright:
© 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Subject classification (UKÄ)

Obstetrics, Gynecology and Reproductive Medicine

Free keywords

breastfeeding
cesarean
childbirth
COVID-19
IMAgiNE EURO
mode of birth
quality of care
Romania

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10.1002/ijgo.14482Licence: CC BY-NC-ND

Cite this

Otelea, M. R., Simionescu, A. A., Mariani, I., Valente, E. P., Nanu, M. I., Nanu, I., Handra, C. M., Covi, B., Lazzerini, M., Linden, K., Zaigham, M., & IMAgiNE EURO study group (2022). Womenʼs assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic: Results from the IMAgiNE EURO study. International Journal of Gynecology and Obstetrics, 159(S1), 126-136. https://doi.org/10.1002/ijgo.14482

@article{61b8fdfbb34d42ce94858a30e81d872a,

title = "Womenʼs assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic: Results from the IMAgiNE EURO study",

abstract = "Objective: To assess women's perceptions of the quality of maternal and newborn care (QMNC) received in hospitals in Romania during the COVID-19 pandemic by mode of birth. Methods: A validated anonymous online questionnaire based on WHO quality measures. Subgroup analysis of spontaneous vaginal birth (SVB), emergency cesarean, and elective cesarean and multivariate analyses were performed, and QMNC indexes were calculated. Maternal age, educational level, year of birth, mother born in Romania, parity, type of hospital, and type of professionals assisting the birth were used for multivariate analysis. Results: A total of 620 women completed the survey. Overall, several quality measures suggested gaps in QMNC in Romania, with the lowest QMNC indexes reported for provision of care and availability of resources. Women who had either elective or emergency cesarean compared with those who had SVB more frequently lacked early breastfeeding (OR 2.04 and 2.13, respectively), skin-to-skin contact (OR 1.73 and 1.75, respectively), rooming-in (OR 2.07 and 1.96, respectively), and exclusive breastfeeding at discharge (OR 2.27 and 1.64, respectively). Compared with elective cesarean, emergency cesarean had higher odds of ineffective communication by healthcare providers (OR 1.65), lack of involvement in choices (OR 1.58), insufficient emotional support (OR 2.07), and no privacy (OR 2.06). Compared with other modes of birth, a trend for lower QMNC indexes for emergency cesarean was observed for all domains, while for elective cesarean the QMNC index for provision of care was significantly lower. Conclusion: Quality indicators of perinatal care remain behind targets in Romania, with births by cesarean the most affected. ClinicalTrials.gov identifier: NCT04847336.",

keywords = "breastfeeding, cesarean, childbirth, COVID-19, IMAgiNE EURO, mode of birth, quality of care, Romania",

author = "Otelea, {Marina Ruxandra} and Simionescu, {Anca Angela} and Ilaria Mariani and Valente, {Emanuelle Pessa} and Nanu, {Michaela Iuliana} and Ioana Nanu and Handra, {Claudia Mariana} and Benedetta Covi and Marzia Lazzerini and Karolina Linden and Mehreen Zaigham and {IMAgiNE EURO study group}",

note = "Funding Information: This work was supported by the Ministry of Health, Rome, Italy, in collaboration with the Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy. We gratefully acknowledge all women who took the time to answer the questionnaire despite the burden of the COVID-19 pandemic. We would also like to thank the following colleagues for their assistance with translation and dissemination of the Romanian questionnaire: Sinziana Ionita-Ciurez, Ana Maita, Cristina Biciila, Raluca Dumitrescu (members of SAMAS Association). Special thanks to the IMAgiNE EURO study group for their contribution to the development of this project and support for this manuscript. Funding Information: This work was supported by the Ministry of Health, Rome, Italy, in collaboration with the Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy. We gratefully acknowledge all women who took the time to answer the questionnaire despite the burden of the COVID‐19 pandemic. We would also like to thank the following colleagues for their assistance with translation and dissemination of the Romanian questionnaire: Sinziana Ionita‐Ciurez, Ana Maita, Cristina Biciila, Raluca Dumitrescu (members of SAMAS Association). Special thanks to the IMAgiNE EURO study group for their contribution to the development of this project and support for this manuscript. Funding Information: Funding informationThis work was supported by the Ministry of Health, Rome ‐ Italy, in collaboration with the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste ‐ Italy Publisher Copyright: {\textcopyright} 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.",

year = "2022",

month = dec,

doi = "10.1002/ijgo.14482",

language = "English",

volume = "159",

pages = "126--136",

journal = "International Journal of Gynecology and Obstetrics",

issn = "0020-7292",

publisher = "Wiley-Blackwell",

number = "S1",

}

Otelea, MR, Simionescu, AA, Mariani, I, Valente, EP, Nanu, MI, Nanu, I, Handra, CM, Covi, B, Lazzerini, M, Linden, K, Zaigham, M & IMAgiNE EURO study group 2022, 'Womenʼs assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic: Results from the IMAgiNE EURO study', International Journal of Gynecology and Obstetrics, vol. 159, no. S1, pp. 126-136. https://doi.org/10.1002/ijgo.14482

Womenʼs assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic: Results from the IMAgiNE EURO study. / Otelea, Marina Ruxandra; Simionescu, Anca Angela; Mariani, Ilaria et al.
In: International Journal of Gynecology and Obstetrics, Vol. 159, No. S1, 12.2022, p. 126-136.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Womenʼs assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic

T2 - Results from the IMAgiNE EURO study

AU - Otelea, Marina Ruxandra

AU - Simionescu, Anca Angela

AU - Mariani, Ilaria

AU - Valente, Emanuelle Pessa

AU - Nanu, Michaela Iuliana

AU - Nanu, Ioana

AU - Handra, Claudia Mariana

AU - Covi, Benedetta

AU - Lazzerini, Marzia

AU - IMAgiNE EURO study group

A2 - Linden, Karolina

A2 - Zaigham, Mehreen

N1 - Funding Information: This work was supported by the Ministry of Health, Rome, Italy, in collaboration with the Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy. We gratefully acknowledge all women who took the time to answer the questionnaire despite the burden of the COVID-19 pandemic. We would also like to thank the following colleagues for their assistance with translation and dissemination of the Romanian questionnaire: Sinziana Ionita-Ciurez, Ana Maita, Cristina Biciila, Raluca Dumitrescu (members of SAMAS Association). Special thanks to the IMAgiNE EURO study group for their contribution to the development of this project and support for this manuscript. Funding Information: This work was supported by the Ministry of Health, Rome, Italy, in collaboration with the Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy. We gratefully acknowledge all women who took the time to answer the questionnaire despite the burden of the COVID‐19 pandemic. We would also like to thank the following colleagues for their assistance with translation and dissemination of the Romanian questionnaire: Sinziana Ionita‐Ciurez, Ana Maita, Cristina Biciila, Raluca Dumitrescu (members of SAMAS Association). Special thanks to the IMAgiNE EURO study group for their contribution to the development of this project and support for this manuscript. Funding Information: Funding informationThis work was supported by the Ministry of Health, Rome ‐ Italy, in collaboration with the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste ‐ Italy Publisher Copyright: © 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

PY - 2022/12

Y1 - 2022/12

N2 - Objective: To assess women's perceptions of the quality of maternal and newborn care (QMNC) received in hospitals in Romania during the COVID-19 pandemic by mode of birth. Methods: A validated anonymous online questionnaire based on WHO quality measures. Subgroup analysis of spontaneous vaginal birth (SVB), emergency cesarean, and elective cesarean and multivariate analyses were performed, and QMNC indexes were calculated. Maternal age, educational level, year of birth, mother born in Romania, parity, type of hospital, and type of professionals assisting the birth were used for multivariate analysis. Results: A total of 620 women completed the survey. Overall, several quality measures suggested gaps in QMNC in Romania, with the lowest QMNC indexes reported for provision of care and availability of resources. Women who had either elective or emergency cesarean compared with those who had SVB more frequently lacked early breastfeeding (OR 2.04 and 2.13, respectively), skin-to-skin contact (OR 1.73 and 1.75, respectively), rooming-in (OR 2.07 and 1.96, respectively), and exclusive breastfeeding at discharge (OR 2.27 and 1.64, respectively). Compared with elective cesarean, emergency cesarean had higher odds of ineffective communication by healthcare providers (OR 1.65), lack of involvement in choices (OR 1.58), insufficient emotional support (OR 2.07), and no privacy (OR 2.06). Compared with other modes of birth, a trend for lower QMNC indexes for emergency cesarean was observed for all domains, while for elective cesarean the QMNC index for provision of care was significantly lower. Conclusion: Quality indicators of perinatal care remain behind targets in Romania, with births by cesarean the most affected. ClinicalTrials.gov identifier: NCT04847336.

AB - Objective: To assess women's perceptions of the quality of maternal and newborn care (QMNC) received in hospitals in Romania during the COVID-19 pandemic by mode of birth. Methods: A validated anonymous online questionnaire based on WHO quality measures. Subgroup analysis of spontaneous vaginal birth (SVB), emergency cesarean, and elective cesarean and multivariate analyses were performed, and QMNC indexes were calculated. Maternal age, educational level, year of birth, mother born in Romania, parity, type of hospital, and type of professionals assisting the birth were used for multivariate analysis. Results: A total of 620 women completed the survey. Overall, several quality measures suggested gaps in QMNC in Romania, with the lowest QMNC indexes reported for provision of care and availability of resources. Women who had either elective or emergency cesarean compared with those who had SVB more frequently lacked early breastfeeding (OR 2.04 and 2.13, respectively), skin-to-skin contact (OR 1.73 and 1.75, respectively), rooming-in (OR 2.07 and 1.96, respectively), and exclusive breastfeeding at discharge (OR 2.27 and 1.64, respectively). Compared with elective cesarean, emergency cesarean had higher odds of ineffective communication by healthcare providers (OR 1.65), lack of involvement in choices (OR 1.58), insufficient emotional support (OR 2.07), and no privacy (OR 2.06). Compared with other modes of birth, a trend for lower QMNC indexes for emergency cesarean was observed for all domains, while for elective cesarean the QMNC index for provision of care was significantly lower. Conclusion: Quality indicators of perinatal care remain behind targets in Romania, with births by cesarean the most affected. ClinicalTrials.gov identifier: NCT04847336.

KW - breastfeeding

KW - cesarean

KW - childbirth

KW - COVID-19

KW - IMAgiNE EURO

KW - mode of birth

KW - quality of care

KW - Romania

U2 - 10.1002/ijgo.14482

DO - 10.1002/ijgo.14482

M3 - Article

C2 - 36530009

AN - SCOPUS:85144447880

SN - 0020-7292

VL - 159

SP - 126

EP - 136

JO - International Journal of Gynecology and Obstetrics

JF - International Journal of Gynecology and Obstetrics

IS - S1

ER -

Womenʼs assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic: Results from the IMAgiNE EURO study

Abstract

Bibliographical note

Subject classification (UKÄ)

Free keywords

Access to Document

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