title: [Pap smears among pregnant women in Southern Brazil: a representative cross-sectional survey].
abstract: OBJECTIVE
  To determine the prevalence and risk factors associated with failure of voluntary screening for cervical cancer during the gestational period in Rio Grande, Rio Grande do Sul State, Southern Brazil.
  
  
  METHODS
  Previously trained interviewers applied a standardized questionnaire in the maternity to all mothers from this municipality who had delivered from January 1st to December 31st 2010 to obtain information about the demographic characteristics of the pregnant women, family socioeconomic status, and prenatal care received. The χ² test was used to compare proportions and Poisson regression with robust adjustment of variance was used in the multivariate analysis.
  
  
  RESULTS
  Among the 2,288 respondents, 33% were not submitted to the Pap smear during pregnancy. Two thirds of these women stated that they were not aware of the need to perform it, 18% were not screened out of fear or shame, and the rest for other reasons. After adjustment, the highest prevalence ratios (PR) for noncompliance with the Pap smear occurred among young women (PR=1.5; 95%CI 1.25 - 1.80), with lower educational level (PR=1.5; 95%CI 1.12 - 2.12), who were living without a partner (PR=1.4; 95%CI 1.24 - 1.62), smokers (PR=1.2; 95%CI 1.07 - 1.39), who did not plan the current pregnancy (PR=1.3; 95%CI 1,21 - 1.61), who had attended less than six medical visits during the prenatal period (PR=1.4; 95%CI 1.32 - 1.69) and among users of oral contraceptives (PR=1.2; 95%CI 1.04 - 1.38).
  
  
  CONCLUSIONS
  The higher the risk for uterine cervical cancer, the less likely a pregnant woman is to undergo a Pap smear. This definitely contributed to the increased morbidity and mortality from this disease in this setting.
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil.
authors.forename: Juraci Almeida
authors.initials: JA
authors.lastname: Cesar
authors.forename: Gabriela Breitembach
authors.initials: GB
authors.lastname: dos Santos
authors.forename: Andrea Tomais
authors.initials: AT
authors.lastname: Sutil
authors.forename: Carolina Fischer
authors.initials: CF
authors.lastname: Cunha
authors.forename: Samuel de Carvalho
authors.initials: Sde C
authors.lastname: Dumith
mesh_terms: D000328:Adult; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D065006:Papanicolaou Test / Q000706:statistics & numerical data*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D055815:Young Adult