Escola Nacional de Saúde Pública, Fiocruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
Instituto Nacional de Infectologia Evandro Chagas, Fiocruz. Rio de Janeiro RJ Brasil.
Cien Saude Colet. 2021 Mar;26(3):875-886. doi: 10.1590/1413-81232021263.34662020. Epub 2020 Oct 29.
This study aims to evaluate the birthplace of preterm infants with less than 34 gestational weeks at birth by type of neonatal care service in maternity hospitals of the "Rede Cegonha" and estimate the maternal factors associated with the inadequate place of birth for gestational age. This national cross-sectional study was performed in 2016/2017 to evaluate health establishments with the Rede Cegonha's action plan. Information was analyzed from 303 puerperae and the respective health establishments of their births. Newborns were classified by gestational age at birth (<30 and 30-33 weeks) and health establishments as hospitals with neonatal intensive care service, hospitals with intermediate neonatal care service, and hospitals without neonatal care service. Ministerial Ordinance N° 930/2012 was used to classify the birthplace as appropriate for the newborn's gestational age. Preterm birth prevalence was 37.3 at less than 30 weeks' gestation and 66.8 at 30-33 weeks. Birth in inappropriate services for the newborn's gestational age occurred in 6.3%, with significant regional and social differences. Inequalities in access to neonatal care for preterm infants persist in the "Rede Cegonha" despite advances.
本研究旨在通过“Rede Cegonha”的产科医院中新生儿护理服务类型评估出生时胎龄不足 34 周的早产儿的出生地，并估计与胎龄不足的出生地点相关的产妇因素。这项全国性的横断面研究于 2016/2017 年进行，以评估具有 Rede Cegonha 行动计划的卫生机构。从 303 名产妇及其分娩的相应卫生机构中分析了信息。根据出生时的胎龄（<30 周和 30-33 周）和卫生机构将新生儿分类为新生儿重症监护服务的医院、具有中级新生儿护理服务的医院和没有新生儿护理服务的医院。根据第 930/2012 号部级法令将出生地点分类为适合新生儿胎龄的地点。早产发生率在胎龄不足 30 周时为 37.3%，在 30-33 周时为 66.8%。在不适合新生儿胎龄的服务中出生的情况占 6.3%，存在显著的地区和社会差异。尽管取得了进展，但在“Rede Cegonha”中，早产儿获得新生儿护理的机会仍然存在不平等。
