Halpern R, Barros F C, Victora C G, Tomasi E
Departamento Materno Infantil, Faculdade de Medicina, Universidade Federal de Pelotas. CP 464, Pelotas, RS 96001-970, Brasil.
Cad Saude Publica. 1998 Jul-Sep;14(3):487-92. doi: 10.1590/s0102-311x1998000300004.
All 5304 births in the hospitals of Pelotas, Rio Grande do Sul, Brazil in 1993 were studied. Neonates were examined and their mothers were interviewed regarding sociodemographic conditions, family income, reproductive health, and medical care during pregnancy. Ninety-five per cent of women received prenatal care. The mean number of physician visits during pregnancy was 7 and the majority of the women (84.7%) began visits before the fifth month of pregnancy. Women who did not receive prenatal care were from the lowest socioeconomic stratum and were mostly adolescents or over 40 years of age. Incidence of low birth weight in this group was 2.5 times that of the group with more than five visits (p>0.001). Perinatal mortality rate was 50.6/1000 in the group without prenatal care and 15.8/1000 in the group with more than five visits. With regard to utilization of health care, the study shows that twenty-five per cent of women with high gestational risk received inadequate prenatal care. The rate was less than 10% in the group of women with low gestational risk. These results suggest the need for improvement in the quality of prenatal care with special attention for mothers with high gestational risk.
对1993年巴西南里奥格兰德州佩洛塔斯市各医院出生的5304名婴儿进行了研究。对新生儿进行了检查，并就社会人口状况、家庭收入、生殖健康以及孕期医疗护理等问题对他们的母亲进行了访谈。95%的女性接受了产前护理。孕期看医生的平均次数为7次，大多数女性（84.7%）在怀孕第五个月之前就开始就诊。未接受产前护理者来自社会经济最底层，大多为青少年或40岁以上的女性。该组低体重儿的发生率是就诊次数超过5次的组的2.5倍（p>0.001）。未接受产前护理组的围产儿死亡率为50.6‰，就诊次数超过5次的组为15.8‰。关于医疗保健的利用情况，该研究表明，25%的高危妊娠女性接受的产前护理不足。低危妊娠女性组的这一比例低于10%。这些结果表明需要提高产前护理质量，尤其要关注高危妊娠的母亲。
