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[巴西里约热内卢公共医疗系统中孕妇高血压的产前护理与管理]

[Prenatal care and management of hypertension in pregnant women in the public healthcare system in Rio de Janeiro, Brazil].

作者信息

Vettore Marcelo Vianna, Dias Marcos, Domingues Rosa Maria Soares Madeira, Vettore Mario Vianna, Leal Maria do Carmo

机构信息

Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.

出版信息

Cad Saude Publica. 2011 May;27(5):1021-34. doi: 10.1590/s0102-311x2011000500019.

Abstract

The aim of this study was to assess the adequacy of prenatal care for pregnant women with hypertension as compared to those at low risk. Adequate management of hypertension and associated factors were also investigated. A cross-sectional study was conducted with 1,947 women, 187 of whom with hypertension, in public prenatal care units in Rio de Janeiro, Brazil, in 2007-2008. Demographic and socioeconomic data, obstetric history, and information on adequacy of prenatal care were collected using interviews and prenatal care cards. Adequacy of management of hypertension was evaluated according to performance of health professionals and health services and women's individual characteristics. Chi-square and multivariate logistic regression were used to compare groups and identify factors associated with management of hypertension. Adequacy of prenatal care was 79% and did not differ between groups. Only 27% of pregnant women with hypertension received appropriate management, with poor professional performance. Hypertensive pregnant women with better prenatal care were those with previous neonatal deaths and/or stillbirths and those with 35 years of age and older. Despite adequate use of prenatal care, management of hypertension in pregnant women was inadequate.

摘要

本研究的目的是评估高血压孕妇与低风险孕妇相比,其产前护理是否充分。同时还对高血压及相关因素的适当管理进行了调查。2007年至2008年期间,在巴西里约热内卢的公共产前护理单位对1947名妇女进行了一项横断面研究,其中187名患有高血压。通过访谈和产前护理卡收集了人口统计学和社会经济数据、产科病史以及产前护理充分性的信息。根据卫生专业人员和卫生服务的表现以及妇女的个人特征评估高血压管理的充分性。使用卡方检验和多变量逻辑回归来比较各组并确定与高血压管理相关的因素。产前护理的充分率为79%,各组之间没有差异。只有27%的高血压孕妇得到了适当的管理,专业表现较差。产前护理较好的高血压孕妇是那些有过新生儿死亡和/或死产史的孕妇以及35岁及以上的孕妇。尽管产前护理得到了充分利用,但孕妇高血压的管理仍不充分。

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