Leal Maria do Carmo, Gama Silvana Granado Nogueira da, Ratto Katia Maria Netto, Cunha Cynthia Braga da
Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
Cad Saude Publica. 2004;20 Suppl 1:S63-72. doi: 10.1590/s0102-311x2004000700007. Epub 2004 May 20.
The Kotelchuck index (KI) was modified and used to evaluate prenatal care provided in the City of Rio de Janeiro, Brazil, in a sample of 9,920 post-partum women following singleton deliveries. Ordinal logistic regression (OLR) and multivariate linear regression (LMR) were used to estimate the importance of demographic, psychosocial, and obstetric factors for modified KI and the effects on birth weight (BW), respectively. Only 38.5% of the sample was classified as having received adequate or intensive prenatal care. After adjusting for other predictors, the explanatory variables for KI were: mother's schooling, living with the newborn's father, attempted abortion, diabetes mellitus, satisfaction with pregnancy, skin color, parity, age, and place of residence. BW was associated with the modified KI, even after controlling for socio-demographic, behavioral, and biological variables. Adequate utilization of prenatal care in the City of Rio de Janeiro contributed to the prevention of low BW, and the mothers who used prenatal services less presented worse conditions in terms of socioeconomic status, schooling, family support, and obstetric risk.
科特尔查克指数（KI）经过修改后，用于评估巴西里约热内卢市为9920名单胎分娩后的产后妇女提供的产前护理情况。采用有序逻辑回归（OLR）和多元线性回归（LMR）分别估计人口统计学、心理社会和产科因素对修改后的KI的重要性以及对出生体重（BW）的影响。样本中只有38.5%的人被归类为接受了充分或强化的产前护理。在对其他预测因素进行调整后，KI的解释变量为：母亲的教育程度、与新生儿父亲同住、人工流产史、糖尿病、对怀孕的满意度、肤色、产次、年龄和居住地。即使在控制了社会人口统计学、行为和生物学变量之后，BW仍与修改后的KI相关。里约热内卢市充分利用产前护理有助于预防低出生体重，而较少使用产前服务的母亲在社会经济地位、教育程度、家庭支持和产科风险方面的情况较差。
