Coimbra Liberata C, Silva Antônio A M, Mochel Elba G, Alves Maria T S S B, Ribeiro Valdinar S, Aragão Vânia M F, Bettiol Heloisa
Departamento de Enfermagem, Universidade Federal do Maranhão, São Luís, MA, Brasil.
Rev Saude Publica. 2003 Aug;37(4):456-62. doi: 10.1590/s0034-89102003000400010. Epub 2003 Aug 20.
To identify factors associated with inadequacy of prenatal care utilization in urban community.
A cross-sectional study of a systematic sample stratified by maternity hospital, consisting of hospital births in the municipality of São Luís, Brazil, was carried out from March 1997 to February 1998. Socioeconomic and demographic factors, reproductive health, morbidity during pregnancy, and utilization of prenatal care services were studied. Mothers answered a standardized questionnaire before hospital discharge. The adequacy of prenatal care utilization was analyzed by means of two indexes: APNCU (Adequacy of Prenatal Care Utilization) and a new index based on the recommendations of the Brazilian Ministry of Health.
There were interviewed 2,831 women who delivered at 10 public and private maternity hospitals. The inadequacy of prenatal care utilization was 49.2% according to the APNCU index and 24.5% when determined by the Brazilian index. Prenatal care at public services, low maternal schooling, low income, having no partner, and absence of maternal diseases during pregnancy were associated with inadequacy of prenatal care use according to both indexes. High parity and maternal age of 35 years or more were also associated with inadequacy, whereas primiparity, morbidity, and young maternal age (<20 years) seemed to protect from inadequacy when the Brazilian index was used.
Prenatal care showed low coverage in the municipality of São Luís. The inadequacy of prenatal care utilization was associated with several factors linked to social inequality.
确定城市社区产前保健利用不足的相关因素。
1997年3月至1998年2月，在巴西圣路易斯市进行了一项横断面研究，该研究以妇产医院为分层变量进行系统抽样，纳入在该市医院分娩的产妇。研究了社会经济和人口因素、生殖健康、孕期发病率以及产前保健服务的利用情况。母亲们在出院前回答了一份标准化问卷。通过两个指标分析产前保健利用的充分性：APNCU（产前保健利用充分性）和一个基于巴西卫生部建议的新指标。
对在10家公立和私立妇产医院分娩的2831名妇女进行了访谈。根据APNCU指标，产前保健利用不足率为49.2%，而根据巴西指标确定时为24.5%。根据这两个指标，公共服务中的产前保健、母亲受教育程度低、收入低、没有伴侣以及孕期无母体疾病均与产前保健利用不足有关。高胎次以及母亲年龄在35岁及以上也与利用不足有关，而初产、发病情况以及年轻母亲年龄（<20岁）在使用巴西指标时似乎可预防利用不足。
圣路易斯市的产前保健覆盖率较低。产前保健利用不足与若干与社会不平等相关的因素有关。
