文章基本信息

标题：Prenatal care in the Brazilian public health services
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作者：Maria do Carmo Leal ; Ana Paula Esteves-Pereira ; Elaine Fernandes Viellas 等
期刊名称：Revista de Saúde Pública
印刷版ISSN：0034-8910
出版年度：2020
卷号：54
DOI：10.11606/s1518-8787.2020054001458
语种：English
出版社：Universidade de São Paulo
摘要：OBJECTIVE To verify regional inequalities regarding access and quality of prenatal and birth care in Brazilian public health services and associated perinatal outcomes METHODS Birth in Brazil was a national hospital-based survey conducted between 2011 and 2012, which included 19,117 women with public-funded births. Regional differences in socio-demographic and obstetric characteristics, as well as differences in access and quality of prenatal and birth care were tested by the χ 2 test. The following outcomes were assessed: spontaneous preterm birth, provider-initiated preterm birth, low birth weight, intrauterine growth restriction, Apgar in the 5th min 8, neonatal and maternal near miss. Multiple and non-conditional logistic regressions were used for the analysis of the associated perinatal outcomes, with the results expressed in adjusted odds ratio and 95% confidence interval. RESULTS Regional inequalities regarding access and quality of prenatal and birth care among users of public services are still evident in Brazil. Pilgrimage for birth associated with all perinatal outcomes studied, except for intrauterine growth restriction. The odds ratios ranged between 1.48 (95%CI 1.23–1.78) for neonatal near miss and 1.62 (95%CI 1.27–2.06) for provider-initiated preterm birth. Among women with clinical or obstetric complications, pilgrimage for birth associated with provider-initiated preterm birth and with Apgar in the 5th min 8, odds ratio of 1.98 (95%CI 1.49–2.65) and 2.19 (95%CI 1.31–3.68), respectively. Inadequacy of prenatal care associated with spontaneous preterm birth in both groups of women, with or without clinical or obstetric complications. CONCLUSION Improvements in the quality of prenatal care, appropriate coordination and comprehensive care at the time of birth have a potential to reduce prematurity rates and, consequently, infant morbidity and mortality rates in the country.