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Lessa MSDA, Nascimento ER, Coelho EDAC, Soares IDJ, Rodrigues QP, Santos CADST, Nunes IM. Prenatal care of Brazilian women: racial inequalities and their implications for care. CIENCIA & SAUDE COLETIVA 2022; 27:3881-3890. [PMID: 36134794 DOI: 10.1590/1413-812320222710.01282022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/20/2022] [Indexed: 11/21/2022] Open
Abstract
The study aimed to characterize women that attended prenatal care in Brazil according to ethnicity/skin color and sociodemographic variables and to verify the association between the indicators of the prenatal care process and the women's ethnicity/skin color. This was a population based, cross-sectional study carried out with data from the National Health Survey of 2013. A bivariate analysis was performed using the multilevel logistic regression model, estimating the odds ratio and the respective 95% confidence intervals to test the association between the indicators of the adequate prenatal care process and the women's ethnicity/skin color. The findings showed that black women have a lower chance of starting prenatal care before 12 weeks of gestation, having 6 or more consultations, performing the HIV test, performing the VDRL exam or receiving advice related to care during gestation and childbirth. Inequalities were identified in the healthcare of Brazilian women during prenatal care, related to ethnicity/skin color and other sociodemographic characteristics. It was concluded that being of black ethnicity and living in a socially disadvantaged area entails disadvantages for women regarding access to a prenatal care considered to be adequate according to the criteria established by the Brazilian Ministry of Health.
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Affiliation(s)
- Millani Souza de Almeida Lessa
- Instituto de Saúde Coletiva, Universidade Federal da Bahia. R. Basílio da Gama s/n, Canela. 40110-040 Salvador BA Brasil.
| | | | | | | | - Quessia Paz Rodrigues
- Hospital Geral Roberto Santos, Secretaria da Saúde do Estado da Bahia. Salvador BA Brasil
| | | | - Isa Maria Nunes
- Escola de Enfermagem, Universidade Federal da Bahia. Salvador BA Brasil
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Lessa MSDA, Nascimento ER, Coelho EDAC, Soares IDJ, Rodrigues QP, Santos CADST, Nunes IM. Prenatal care of Brazilian women: racial inequalities and their implications for care. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-812320222710.01282022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract The study aimed to characterize women that attended prenatal care in Brazil according to ethnicity/skin color and sociodemographic variables and to verify the association between the indicators of the prenatal care process and the women’s ethnicity/skin color. This was a population based, cross-sectional study carried out with data from the National Health Survey of 2013. A bivariate analysis was performed using the multilevel logistic regression model, estimating the odds ratio and the respective 95% confidence intervals to test the association between the indicators of the adequate prenatal care process and the women’s ethnicity/skin color. The findings showed that black women have a lower chance of starting prenatal care before 12 weeks of gestation, having 6 or more consultations, performing the HIV test, performing the VDRL exam or receiving advice related to care during gestation and childbirth. Inequalities were identified in the healthcare of Brazilian women during prenatal care, related to ethnicity/skin color and other sociodemographic characteristics. It was concluded that being of black ethnicity and living in a socially disadvantaged area entails disadvantages for women regarding access to a prenatal care considered to be adequate according to the criteria established by the Brazilian Ministry of Health.
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Tomasi E, de Assis TM, Muller PG, da Silveira DS, Neves RG, Fantinel E, Thumé E, Facchini LA. Evolution of the quality of prenatal care in the primary network of Brazil from 2012 to 2018: What can (and should) improve? PLoS One 2022; 17:e0262217. [PMID: 35041716 PMCID: PMC8765636 DOI: 10.1371/journal.pone.0262217] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 12/20/2021] [Indexed: 11/19/2022] Open
Abstract
The article describes the temporal evolution of prenatal quality indicators in the primary health care network in Brazil and investigates regional differences. This study used data from the external evaluation of Brazil's National Program for Improving Primary Care Access and Quality (PMAQ) with health teams participating in Cycles I, II and III of the Program, carried out respectively in 2012, 2013/14 and 2017/18. The number of visits, physical examination procedures, guidelines and request for laboratory tests were investigated. There was a positive evolution for tests-HIV, syphilis, blood glucose and ultrasound, and for all tests, guidance on feeding and weight gain of the baby and examination of the oral cavity. The indicators that performed the worst were: performance of tetanus vaccine, six or more visits, receiving guidance on exclusive breastfeeding and care for the newborn, and the procedures-all, measurement of uterine height, gynecological exam and cervix cancer prevention. These changes had a varied behavior between the regions of the country.
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Affiliation(s)
- Elaine Tomasi
- Department of Social Medicine–Universidade Federal de Pelotas, Pelotas, Brazil
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
- Postgraduate Programme in Family Health (PROFSAÚDE), Universidade Federal de Pelotas, Pelotas, Brazil
| | | | | | - Denise Silva da Silveira
- Department of Social Medicine–Universidade Federal de Pelotas, Pelotas, Brazil
- Postgraduate Programme in Family Health (PROFSAÚDE), Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Everton Fantinel
- Department of Social Medicine–Universidade Federal de Pelotas, Pelotas, Brazil
- Postgraduate Programme in Nursing, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Elaine Thumé
- Postgraduate Programme in Family Health (PROFSAÚDE), Universidade Federal de Pelotas, Pelotas, Brazil
- Postgraduate Programme in Nursing, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Luiz Augusto Facchini
- Department of Social Medicine–Universidade Federal de Pelotas, Pelotas, Brazil
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
- Postgraduate Programme in Family Health (PROFSAÚDE), Universidade Federal de Pelotas, Pelotas, Brazil
- Postgraduate Programme in Nursing, Universidade Federal de Pelotas, Pelotas, Brazil
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Binsfeld L, Gomes MADSM, Kuschnir R. Malformações congênitas de abordagem cirúrgica imediata no Estado do Rio de Janeiro, Brasil: análise para a organização do cuidado em rede. CAD SAUDE PUBLICA 2022; 38:e00109521. [DOI: 10.1590/0102-311x00109521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/13/2021] [Indexed: 11/21/2022] Open
Abstract
Resumo: Este trabalho teve como objetivo realizar uma análise da frequência dos casos, distribuição regional e análise do perfil dos estabelecimentos em que ocorreram nascimentos com malformações congênitas de abordagem cirúrgica imediata no Estado do Rio de Janeiro, Brasil. É um estudo descritivo, de abordagem quantitativa, que utilizou como fonte de informação as bases de dados sobre nascidos vivos e o cadastro nacional de estabelecimentos de saúde. Os dados analisados apontam uma grande dispersão dos nascimentos com malformações congênitas, sendo que a grande maioria das unidades de saúde registrou menos de um nascimento/ano. Essas unidades também não têm infraestrutura com capacidade potencial para que os cuidados neonatais cirúrgicos ocorram no mesmo local do parto. A manutenção dessa configuração de dispersão dos nascimentos e estruturação dos serviços de saúde resulta em perdas de oportunidades tanto do ponto de vista da qualidade e segurança - não contribui para o alcance do volume mínimo de procedimentos/ano definido por especialistas para a potencialização dos resultados na atenção de casos cirúrgicos neonatais - quanto de economia de escala e acesso oportuno. Com base na análise e classificação das unidades, utilizando os critérios de volume de atendimento e capacidade instalada potencial, foi possível apontar caminhos para a definição de unidades de referência e a organização da rede de atenção.
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Dea BD, Andrade F, Silva Junior MF. Self-perceived evaluation of prenatal care: a hierarchical analysis by the users of Primary Health Care services in Brazil. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2021. [DOI: 10.1590/1806-93042021000200014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objective: to analyze the factors associated with positive self-perceived evaluation of prenatal care among users of Primary Health Care (PHC). Methods: the analytical cross-sectional study was carried out with secondary data from the 3rd Module of the 2nd cycle (2013 / 2014) of the External Evaluation of the Improvement of Access and Quality of Primary Care Program (PMAQ-AB – Portuguese acronym), collected from users in the Basic Health Units (BHU) that joined the PMAQ-AB in Brazil. The hierarchical analysis was performed using a theoretical model and logistic regression was performed between the self-perceived evaluation (positive - very good/good or negative - regular/poor/very bad) and the sociodemographic characteristics, prenatal care and health service evaluation (p<0.05). Results: the sample consisted of 9,922 women and 81.7% rated care as very good/good. In the final model, positive evaluation was associated to women with incomplete higher education or over (OR=1.05; CI95%=1.01-1.09; p=0.010), who underwent the VDRL exam (OR=1.07; CI95%=1.01-1.14; p=0.020), consultation with the same professional (OR=1.07; CI95%=1.02-1.12; p=0.010), received guidance on the gynecological preventive exam (OR=1.05; CI95%=1.01-1.08; p=0.007), believed that guidance helped with pregnancy and child care (OR=1.24; CI95%=1.05-1.46; p=0.012), evaluated the BHU structure as very good/good (OR=1.19; CI95%=:1.14-1.24; p<0.001) and would not change BHU or team (OR=1.62; CI95%=1.48-1.68; p<0.001). Conclusion: the positive evaluation of prenatal care was associated with sociodemographic factors, prenatal care and health service evaluation.
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Alves MTSSDBE, Chagas DCD, Santos AMD, Simões VMF, Ayres BVDS, Santos GLD, Silva AAMD. Racial inequality in obstetric good practices and interventions in labor and birth care in Rede Cegonha. CIENCIA & SAUDE COLETIVA 2020; 26:837-846. [PMID: 33729340 DOI: 10.1590/1413-81232021263.38982020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/26/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to evaluate the racial inequality on childbirth care at the Rede Cegonha (Stork Network) using obstetric good practice and interventions indicators. Racial inequality, measured by the total effect of ethnicity/skin color in the crude model, was seen in many indicators. After adjusting for mediators, such as age, schooling, parity, high-risk hospital, and geographic macro-regions, the persistent direct effect suggests racial discrimination against black women with lower partograph completion (PR 0.88; 95% CI 0.80-0.95). Black women stayed less in lithotomy (PR 0.93; 95% CI 0.89-0.98), performed less episiotomy (PR 0.81; 95% CI 0.68 - 0.96), and had less episiotomy suturing pain (PR 0.66; 95% CI 0.51 - 0.87) when compared to white women, suggesting more good practice applied to black women. However, according to the interventionist care model still adopted by many professionals, these practices are routine, and lower achievement in black women would be better interpreted as evidence of racial discrimination against these women. For other outcomes, the ethnicity/skin color effect disappeared after adjusting for mediators, suggesting mitigation or disappearance of the skin color effect in some practices/interventions in childbirth.
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Affiliation(s)
| | - Deysianne Costa das Chagas
- Centro de Ciências da Saúde, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil.
| | - Alcione Miranda Dos Santos
- Centro de Ciências da Saúde, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil.
| | - Vanda Maria Ferreira Simões
- Centro de Ciências da Saúde, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil.
| | | | | | - Antônio Augusto Moura da Silva
- Centro de Ciências da Saúde, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil.
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Costa JC, Maia MFS, Victora CG. Ciência & Saúde Coletiva - 25 years: contributions to pregnancy, delivery, and childhood studies. CIENCIA & SAUDE COLETIVA 2020; 25:4813-4830. [PMID: 33295503 DOI: 10.1590/1413-812320202512.21642020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/24/2020] [Indexed: 11/22/2022] Open
Abstract
We reviewed the scientific production on maternal health and the health of children under ten years of age, published in Journal Ciência & Saúde Coletiva during the last 25 years, focusing on quantitative studies. The authors' characteristics, populations under study, thematic areas, and methodology are described. A total of 170 publications were identified and grouped into 12 major themes. Pregnancy, delivery, and puerperium were the subject of 47 studies, followed by child anthropometric assessments (29), breastfeeding (24), and mortality (13). The selected publications represented 3.5% of the total original papers published by the Journal since its creation in 1996 and about 5% of the publications in the 2015-2020 period. The primary data sources were health service records, information systems, and population surveys. The cross-sectional design was used in 113 of the 170 articles, and 70% covered only one municipality. The Southeast and Northeast Regions of Brazil were the target of most studies, and the North Region was the least represented. The publications reflect the complexity of maternal and child health themes, with a particular focus on the importance of the Unified Health System and showing how open access data can contribute to public health research.
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Affiliation(s)
- Janaína Calu Costa
- Centro Internacional de Equidade em Saúde, Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Marechal Deodoro 1160, Centro. 96020-220 Pelotas RS Brasil.
| | - Maria Fatima Santos Maia
- Centro Internacional de Equidade em Saúde, Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Marechal Deodoro 1160, Centro. 96020-220 Pelotas RS Brasil.
| | - Cesar Gomes Victora
- Centro Internacional de Equidade em Saúde, Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Marechal Deodoro 1160, Centro. 96020-220 Pelotas RS Brasil.
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Saavedra JS, Cesar JA, Linhares AO. Prenatal care in Southern Brazil: coverage, trend and disparities. Rev Saude Publica 2019; 53:40. [PMID: 31066818 PMCID: PMC6542475 DOI: 10.11606/s1518-8787.2019053000968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/15/2018] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To estimate coverage, examine trend and assess the disparity reduction regarding household income during prenatal care between mothers living in Rio Grande, state of Rio Grande do Sul, in 2007, 2010, 2013 and 2016. METHODS This study included all recent mothers living in this municipality, between 1/1 and 12/31 of those years, who had a child weighing more than 500 grams or 20 weeks of gestational age in one of the only two local maternity hospitals. Trained interviewers applied, still in the hospital and up to 48 hours after delivery, a unique and standardized questionnaire, seeking to investigate maternal demographic and reproductive characteristics, the socioeconomic conditions of the family and the assistance received during pregnancy and childbirth. To assess the adequacy of prenatal care, the criteria proposed by Takeda were used, which considers only the number of prenatal appointments and gestational age at initiation, and by Silveira et al., who in addition to these two variables, considers the achievement of some laboratory tests. Chi-square tests were used to compare proportions and assess the linear trend. RESULTS The total of 10,669 recent mothers were included in this survey (96.8% of the total). Prenatal coverage substantially increased between 2007 and 2016. According to Takeda, it rose from 69% to 80%, while for Silveira et al., it increased from 21% to 55%. This improvement occurred for all income groups (p < 0.01). The disparity between the extreme categories of income reduced, according to Takeda, and increased according to Silveira et al. CONCLUSIONS The provision of prenatal care, considering only the number of appointments and the early start, occurred in greater proportion among the poorest. However, only the richest recent mothers were contemplated with more elaborate care, such as laboratory tests, which increased the disparities in the provision of prenatal care.
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Affiliation(s)
- Janaina S Saavedra
- Universidade Federal do Rio Grande. Faculdade de Medicina. Programa de Pós-Graduação em Ciências da Saúde. Rio Grande, RS, Brasil
| | - Juraci A Cesar
- Universidade Federal do Rio Grande. Faculdade de Medicina. Programa de Pós-Graduação em Ciências da Saúde. Rio Grande, RS, Brasil.,Universidade Federal do Rio Grande. Faculdade de Medicina. Programa de Pós-Graduação em Saúde Pública. Rio Grande, RS, Brasil
| | - Angélica O Linhares
- Universidade Federal de Pelotas. Faculdade de Nutrição. Programa de Pós-Graduação em Nutrição e Alimentos. Pelotas, RS, Brasil
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Santos LAV, Lara MO, Lima RCR, Rocha AF, Rocha EM, Glória JCR, Ribeiro GDC. História gestacional e características da assistência pré-natal de puérperas adolescentes e adultas em uma maternidade do interior de Minas Gerais, Brasil. CIENCIA & SAUDE COLETIVA 2018; 23:617-625. [DOI: 10.1590/1413-81232018232.10962016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 05/20/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo O objetivo desta pesquisa foi analisar a história gestacional e as características da assistência pré-natal de puérperas adolescentes e adultas em uma maternidade localizada em uma cidade de Minas Gerais, referência para a macrorregião de saúde do Jequitinhonha. Trata-se de um estudo transversal descritivo. Entrevistou-se 327 puérperas, entre maio de 2013 a março de 2014, utilizando um instrumento semiestruturado. Predominou o número de puérperas adultas com uma amostra de 255. Com relação ao pré-natal, 324 puérperas realizaram as consultas. Quanto ao local de realização do pré-natal, 79,2% das adolescentes, realizaram no serviço público de saúde, enquanto entre as adultas essa porcentagem foi de 60,4%. Quanto ao tipo de parto, 54,7% das puérperas o tiveram normal e 45% cesárea. Entre as adolescentes, houve uma maior porcentagem de parto normal comparado às adultas, e esse dado teve relação estatisticamente significativa com a idade da puérpera. Com relação à idade gestacional no momento do parto, 85,9% tiveram seus partos a termo; 13,5% pré-termo e 0,6% pós-termo. Evidenciou-se que as puérperas adolescentes estiveram em desvantagem em relação às demais mães no que diz respeito tanto às características socioeconômicas quanto na assistência recebida no pré-natal.
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Guimarães AS, Mantovani SAS, Oliart-Guzmán H, Martins AC, Filgueira-Júnior JA, Santos AP, Braña AM, Branco FLCC, Pereira TM, Delfino BM, Ramalho AA, Oliveira CSM, Araújo TS, de Lara Estrada CHM, Arróspide N, Muniz PT, Codeço CT, da Silva-Nunes M. Prenatal care and childbirth assistance in Amazonian women before and after the Pacific Highway Construction (2003-2011): a cross-sectional study. BMC WOMENS HEALTH 2016; 16:37. [PMID: 27412559 PMCID: PMC4944242 DOI: 10.1186/s12905-016-0316-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 07/07/2016] [Indexed: 11/10/2022]
Abstract
Background Attention to prenatal care and child delivery is important for the health of women and children, but in the Amazon these indicators tend to be historically unfavorable, in part by geographical and political isolation. In 2003 both Brazilian and Peru governments have finished paving an international road connecting remotes areas in the Brazilian Amazon to the Pacific coast in Peru. Methods The situation of prenatal care and child delivery with mothers of children under 5 years old living in the urban area of Assis Brasil, Acre was assessed in two cross-sectional studies performed in 2003 and 2011, corresponding to the period before and after the Pacific highway construction. Results In 2003, most mothers were of black/Afro-American ethnicity, or “pardos” (the offspring of a Caucasian with a African descendant) (77.69 %), had more than 4 years of schooling (73.40 %) and had a mean age of 22.18 years. In 2011, the number of as a migration of indigenous women increased from 0 to 14.40 % of the respondents, because of migration from communities along the rivers to urban areas, with no other significant changes in maternal characteristics. No significant improvement in childbirth assistance was noticed between 1997 and 2011; only the percentage of in-hospital vaginal deliveries performed by doctors increased from 17.89 to 66.26 % (p <0.001) during this period. Access to prenatal care was associated with white ethnicity in 2003, and higher socioeconomic level and white ethnicity in 2011, while the higher number of prenatal visits was associated with higher maternal education and higher socioeconomic levels in 2011. Vaginal child delivery at a hospital facility was associated with maternal age in 2003, and year of birth, being of white ethnicity and higher level of education in 2011. Conclusions The indicators of prenatal care and child delivery were below the national average, showing that geographical isolation still affects women’s health care in the Amazon, despite the construction of the highway and governmental health protocols adopted during this period.
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Affiliation(s)
- Andréia S Guimarães
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - Saulo A S Mantovani
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - Humberto Oliart-Guzmán
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - Antonio C Martins
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - José Alcântara Filgueira-Júnior
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - Ana Paula Santos
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - Athos Muniz Braña
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - Fernando Luís Cunha Castelo Branco
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - Thasciany Moraes Pereira
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - Breno Matos Delfino
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - Alanderson A Ramalho
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - Cristieli S M Oliveira
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - Thiago S Araújo
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | | | - Nancy Arróspide
- Instituto Nacional de Salud, Cápac Yupanqui, Jesus María, Lima 11, 1400, Peru
| | - Pascoal T Muniz
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil
| | - Cláudia T Codeço
- Programa de Computação Cientifica, Fundação Osvaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Mônica da Silva-Nunes
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil.
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Melo EC, Oliveira RRD, Mathias TADF. Factors associated with the quality of prenatal care: an approach to premature birth. Rev Esc Enferm USP 2015; 49:540-9. [DOI: 10.1590/s0080-623420150000400002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVETo assess the quality of prenatal care in mothers with premature and term births and identify maternal and gestational factors associated with inadequate prenatal care.METHODCross-sectional study collecting data with the pregnant card, hospital records and interviews with mothers living in Maringa-PR. Data were collected from 576 mothers and their born alive infants who were attended in the public service from October 2013 to February 2014, using three different evaluation criteria. The association of prenatal care quality with prematurity was performed by univariate analysis and occurred only at Kessner criteria (CI=1.79;8.02).RESULTSThe indicators that contributed most to the inadequacy of prenatal care were tests of hemoglobin, urine, and fetal presentation. After logistic regression analysis, maternal and gestational variables associated to inadequate prenatal care were combined prenatal (CI=2.93;11.09), non-white skin color (CI=1.11;2.51); unplanned pregnancy (CI=1.34;3.17) and multiparity (CI=1.17;4.03).CONCLUSIONPrenatal care must follow the minimum recommended protocols, more attention is required to black and brown women, multiparous and with unplanned pregnancies to prevent preterm birth and maternal and child morbimortality.
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