Rosa Maria Soares Madeira Domingues1, Elaine Fernandes Viellas2, Marcos Augusto Bastos Dias3, Jacqueline Alves Torres4, Mariza Miranda Theme-Filha2, Silvana Granado Nogueira da Gama2, Maria do Carmo Leal2. 1. Laboratório de Pesquisa Clínica em DST/Aids, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil, rosa.domingues@ini.fiocruz.br. 2. Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil. 3. Instituto Nacional da Mulher, da Criança e do Adolescente Fernandes Fiqueiras, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil. 4. Agência Nacional de Saúde Suplementar, Rio de Janeiro, RJ, Brasil.
Abstract
OBJECTIVE: To verify the degree of adequacy of prenatal care in Brazil and to determine whether it is associated with sociodemographic characteristics of women. METHODS: This nationwide hospital-based study was performed with 23 894 women in 2011 and 2012. Data were obtained from interviews with puerperal women and from the prenatal card recording prenatal care appointments. Adequate prenatal care was defined as that started no later than the 12th gestational week, with performance of at least six consultations (with number of consultations adjusted for gestational age at delivery), record in the prenatal card of at least one result for each of the recommended routine prenatal tests, and guidance regarding the maternity hospital for delivery. Multivariate logistic regression was performed to verify the association between maternal characteristics and the adequacy of prenatal care. RESULTS: Early onset of prenatal care was observed in 53.9% of participants, adequate number of consultations in 73.2%, record of at least one of each recommended test in 62.9%, guidance regarding maternity hospital in 58.7%, and overall adequate prenatal care in 21.6%. Less adequate prenatal care was observed in women who were younger, black, multiparous, who did not have a partner, without paid employment, having fewer years of formal schooling, belonging to lower socioeconomic classes, and living in the North and Northeast of Brazil. After adjustment of maternal characteristics, no differences were observed between public or private health care services regarding adequacy of prenatal care. CONCLUSIONS: Even though the coverage of prenatal care is virtually universal in Brazil, regional and social differences in the access and adequacy of care still persist. The implementation of strategies to facilitate early access to prenatal care is essential.
OBJECTIVE: To verify the degree of adequacy of prenatal care in Brazil and to determine whether it is associated with sociodemographic characteristics of women. METHODS: This nationwide hospital-based study was performed with 23 894 women in 2011 and 2012. Data were obtained from interviews with puerperal women and from the prenatal card recording prenatal care appointments. Adequate prenatal care was defined as that started no later than the 12th gestational week, with performance of at least six consultations (with number of consultations adjusted for gestational age at delivery), record in the prenatal card of at least one result for each of the recommended routine prenatal tests, and guidance regarding the maternity hospital for delivery. Multivariate logistic regression was performed to verify the association between maternal characteristics and the adequacy of prenatal care. RESULTS: Early onset of prenatal care was observed in 53.9% of participants, adequate number of consultations in 73.2%, record of at least one of each recommended test in 62.9%, guidance regarding maternity hospital in 58.7%, and overall adequate prenatal care in 21.6%. Less adequate prenatal care was observed in women who were younger, black, multiparous, who did not have a partner, without paid employment, having fewer years of formal schooling, belonging to lower socioeconomic classes, and living in the North and Northeast of Brazil. After adjustment of maternal characteristics, no differences were observed between public or private health care services regarding adequacy of prenatal care. CONCLUSIONS: Even though the coverage of prenatal care is virtually universal in Brazil, regional and social differences in the access and adequacy of care still persist. The implementation of strategies to facilitate early access to prenatal care is essential.
Authors: Maria do Carmo Leal; Ana Paula Esteves-Pereira; Marcos Nakamura-Pereira; Jacqueline Alves Torres; Mariza Theme-Filha; Rosa Maria Soares Madeira Domingues; Marcos Augusto Bastos Dias; Maria Elizabeth Moreira; Silvana Granado Gama Journal: Reprod Health Date: 2016-10-17 Impact factor: 3.223
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Authors: Maria do Carmo Leal; Ana Paula Esteves-Pereira; Elaine Fernandes Viellas; Rosa Maria Soares Madeira Domingues; Silvana Granado Nogueira da Gama Journal: Rev Saude Publica Date: 2020-01-20 Impact factor: 2.106