Contreras-Sánchez Saúl Eduardo, Doubova Svetlana, Mejía-Chávez Martha Ivette, Infante-Castañeda Claudia, Pérez-Cuevas Ricardo
Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Unidad de Investigación Epidemiológica y en Servicios de Salud. Ciudad de México, México.
Instituto Mexicano del Seguro Social, Hospital de Gineco Obstetricia No. 4 "Luis Castelazo Ayala", Servicio de Complicaciones de la Segunda Mitad del Embarazo. Ciudad de México, México.
Rev Med Inst Mex Seguro Soc. 2022 Feb 1;60(1):4-11.
Postnatal care is essential to identify and treat at the appropriate time adverse health events in the puerperium. In Mexico, the factors that affect postnatal care have not been documented.
To identify the factors associated with the lack of postnatal care.
Cross-sectional study of 202 women of reproductive age affiliated with six primary care clinics of the Mexican Institute for Social Security. We analyzed these factors: (1) sociodemographic: age, education, schooling, distance between home and clinic; (2) psychosocial: social support; (3) obstetric and gynecologic: number of pregnancies, type of delivery, presence of comorbidity and suspected depression, and (4) health services: deficient prenatal control and incomplete postpartum hospital care. We performed multiple Poisson regression with a robust variance.
49.5% of women had postnatal control. Factors associated with a higher probability of lack of postnatal control were: distance ≥ 5 km between home and clinic (adjusted prevalence ratio [aPR] 1.48, 95% confidence interval [95% CI] 1.16-1.88, p = 0.001), poor prenatal care (aPR 1.21, 95% CI 1.001-1.46, p = 0.049), and incomplete postpartum care (aPR 1.42, 95% CI 1.23-1.63, p < 0.001).
The low attendance of postnatal care in primary care clinics highlights the need to seek and implement feasible healthcare alternatives, such as home care or telemedicine, to women who cannot attend to postnatal consultations.
产后护理对于识别和在适当时间治疗产褥期不良健康事件至关重要。在墨西哥，影响产后护理的因素尚未有文献记载。
确定与缺乏产后护理相关的因素。
对隶属于墨西哥社会保障局六个初级保健诊所的202名育龄妇女进行横断面研究。我们分析了这些因素：（1）社会人口学因素：年龄、教育程度、受教育年限、家与诊所之间的距离；（2）心理社会因素：社会支持；（3）妇产科因素：怀孕次数、分娩类型、合并症和疑似抑郁症的存在情况，以及（4）卫生服务因素：产前检查不足和产后住院护理不完整。我们进行了具有稳健方差的多重泊松回归分析。
49.5%的妇女进行了产后检查。与缺乏产后检查可能性较高相关的因素有：家与诊所之间的距离≥5公里（调整患病率比[aPR]为1.48，95%置信区间[95%CI]为1.16 - 1.88，p = 0.001）、产前护理不佳（aPR为1.21，95%CI为1.001 - 1.46，p = 0.049）以及产后护理不完整（aPR为1.42，95%CI为1.23 - 1.63，p < 0.001）。
初级保健诊所产后护理的低就诊率凸显了有必要为无法参加产后咨询的妇女寻求并实施可行的医疗保健替代方案，如家庭护理或远程医疗。
