Ribeiro Eleonora R O, Guimarães Alzira Maria D N, Bettiol Heloísa, Lima Danilo D F, Almeida Maria Luiza D, de Souza Luiz, Silva Antônio Augusto M, Gurgel Ricardo Q
Department of Medicine, Federal University of Sergipe, Brazil.
BMC Pregnancy Childbirth. 2009 Jul 22;9:31. doi: 10.1186/1471-2393-9-31.
The aim of prenatal care is to promote good maternal and foetal health and to identify risk factors for adverse pregnancy outcomes in an attempt to promptly manage and solve them. Although high prenatal care attendance is reported in most areas in Brazil, perinatal and neonatal mortalities are disproportionally high, raising doubts about the quality and performance of the care provided. The objective of the present study was to evaluate the adequacy of prenatal care use and the risk factors involved in inadequate prenatal care utilization in the metropolitan area of Aracaju, Northeast Brazil.
A survey was carried out with puerperal women who delivered singleton liveborns in all four maternity hospitals of Aracaju. A total of 4552 singleton liveborns were studied. The Adequacy of Prenatal Care Utilization Index, modified according to the guidelines of the Prenatal Care and Birth Humanization Programme, was applied. Socioeconomic, demographic, biological, life style and health service factors were evaluated by multiple logistic regression.
Prenatal care coverage in Aracaju was high (98.3%), with a mean number of 6.24 visits. Prenatal care was considered to be adequate or intensive in 66.1% of cases, while 33.9% were considered to have inadequate usage. Age < 18 to 34 years at delivery, low maternal schooling, low family income, two or more previous deliveries, maternal smoking during pregnancy, having no partner and prenatal care obtained outside Aracaju were associated with inadequate prenatal care use. In contrast, private service attendance protected from inadequate prenatal care use.
Prenatal care coverage was high. However, a significant number of women still had inadequate prenatal care use. Socioeconomic inequalities, demographic factors and behavioural risk factors are still important factors associated with inadequate prenatal care use.
产前保健的目的是促进孕产妇和胎儿的健康，并识别不良妊娠结局的风险因素，以便及时进行管理和解决。尽管巴西大多数地区报告产前保健就诊率较高，但围产期和新生儿死亡率却不成比例地高，这引发了对所提供保健质量和效果的质疑。本研究的目的是评估巴西东北部阿拉卡茹市大都市区产前保健利用的充分性以及产前保健利用不足所涉及的风险因素。
对在阿拉卡茹市所有四家妇产医院分娩单胎活产儿的产妇进行了一项调查。共研究了4552名单胎活产儿。应用了根据产前保健和分娩人性化计划指南修改的产前保健利用充分性指数。通过多元逻辑回归评估社会经济、人口统计学、生物学、生活方式和卫生服务因素。
阿拉卡茹市的产前保健覆盖率很高（98.3%），平均就诊次数为6.24次。66.1%的病例中产前保健被认为是充分或密集的，而33.9%被认为使用不足。分娩时年龄<18至34岁、母亲受教育程度低、家庭收入低、有两次或更多次既往分娩、孕期母亲吸烟、没有伴侣以及在阿拉卡茹市以外获得产前保健与产前保健利用不足有关。相比之下，接受私人服务可避免产前保健利用不足。
产前保健覆盖率很高。然而，仍有相当数量的妇女产前保健利用不足。社会经济不平等、人口统计学因素和行为风险因素仍然是与产前保健利用不足相关的重要因素。
