{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T20:37:55Z","timestamp":1757450275854,"version":"3.40.5"},"reference-count":0,"publisher":"Universidad del Valle","issue":"3","license":[{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":["colombiamedica.univalle.edu.co"],"crossmark-restriction":true},"short-container-title":["Colomb Med"],"abstract":"<jats:p>\r\n\r\nObjetivos:\r\nDeterminar el efecto contextual de los l\u00edmites pol\u00edtico administrativo de los departamentos, en la posibilidad individual de ces\u00e1rea en el a\u00f1o 2016 y, las caracter\u00edsticas individuales y contextuales asociadas a la misma.\r\n\r\n\r\nM\u00e9todos:\r\nEstudio transversal de una cohorte de nacimientos. Se realiz\u00f3 un an\u00e1lisis multinivel utilizando como fuente la base de datos de los certificados de nacimientos de Colombia desde el 1 de enero al 31 de diciembre de 2016. Se elaboraron tres modelos log\u00edsticos multinivel, con las gestantes en el primer nivel y el departamento como segundo nivel. El primer modelo incluy\u00f3 solo el departamento como efecto aleatorio, seguido de otro con variables individuales y el \u00faltimo incluy\u00f3 tambi\u00e9n las variables de contexto.\r\n\r\n\r\nResultados:\r\nLa proporci\u00f3n de ces\u00e1reas fue de 45.5% (IC 95%: 45.4-45.6), con un rango de 5% al 76%. El coeficiente de partici\u00f3n de varianza fue de 15%, indicando la existencia de una considerable desigualdad geogr\u00e1fica en la posibilidad del parto por ces\u00e1rea. La regi\u00f3n a la que pertenecen los departamentos explic\u00f3 71 % de la varianza entre departamentos. En particular, la regi\u00f3n Caribe se asoci\u00f3 de manera positiva con la posibilidad de ces\u00e1reas comparado con la regi\u00f3n Andina (OR:3.88, IC 95%: 2.65-5.67).\r\n\r\n\r\nConclusiones:\r\nEl an\u00e1lisis multinivel de la heterogeneidad individual mostr\u00f3 que el departamento juega un papel importante en la posibilidad de partos por ces\u00e1reas. Nuestros resultados sugieren que intervenciones con enfoque de universalismo proporcional son necesarias para reducir el parto por ces\u00e1rea con \u00e9nfasis en los departamentos de mayor riesgo y en la regi\u00f3n Caribe e Insular\r\n\r\n\r\n\u00a0<\/jats:p>","DOI":"10.25100\/cm.v52i3.4411","type":"journal-article","created":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T13:54:48Z","timestamp":1645192488000},"page":"e2044411","update-policy":"https:\/\/doi.org\/10.25100\/cm.crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["An\u00e1lisis multinivel del efecto del lugar de nacimiento en la proporci\u00f3n de partos por ces\u00e1rea en Colombia"],"prefix":"10.25100","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8245-0811","authenticated-orcid":false,"given":"Merida","family":"Rodriguez-Lopez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3972-0174","authenticated-orcid":false,"given":"Elsa Lorena","family":"Correa-Avenda\u00f1o","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7998-3668","authenticated-orcid":false,"given":"Ana Maria","family":"Martinez-Avila","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8379-9708","authenticated-orcid":false,"given":"Juan","family":"Merlo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10728","published-online":{"date-parts":[[2021,6,29]]},"container-title":["Colombia Medica"],"original-title":[],"link":[{"URL":"https:\/\/colombiamedica.univalle.edu.co\/index.php\/comedica\/article\/download\/4411\/6000","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/colombiamedica.univalle.edu.co\/index.php\/comedica\/article\/download\/4411\/6002","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/colombiamedica.univalle.edu.co\/index.php\/comedica\/article\/download\/4411\/6001","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/colombiamedica.univalle.edu.co\/index.php\/comedica\/article\/download\/4411\/6000","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T17:59:01Z","timestamp":1722967141000},"score":1,"resource":{"primary":{"URL":"https:\/\/colombiamedica.univalle.edu.co\/index.php\/comedica\/article\/view\/4411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,29]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,6,29]]}},"URL":"https:\/\/doi.org\/10.25100\/cm.v52i3.4411","relation":{},"ISSN":["1657-9534","0120-8322"],"issn-type":[{"type":"electronic","value":"1657-9534"},{"type":"print","value":"0120-8322"}],"subject":[],"published":{"date-parts":[[2021,6,29]]},"assertion":[{"value":"Yes","name":"crosschecked","label":"CrossChecked"},{"value":"Yes","name":"peer_reviewed","label":"Peer Reviewed"}]}}