Inadequacy of the content of prenatal care and associated factors in a cohort in the northeast of Brazil/Inadequacao do conteudo da assistencia pre-natal e fatores associados em uma coorte no nordeste brasileiro

• Published in: Ciência & saude coletiva 2016-04, p.1227
• Main Authors: Goudard, Marivanda Julia Furtado, Simoes, Vanda Maria Ferreira, Batista, Rosangela Fernandes Lucena, Queiroz, Rejane Christine de Souza, Alves, Maria Tereza Seabra Soares de Brito, Coimbra, Liberata Campos, Ma, Barbieri, Marco Antonio, Nathasje, Ian Favero
• Format: Article
• Language: Spanish
• ISSN: 1413-8123
• DOI: 10.1590/1413-81232015214.12512015

The scope of this study was to analyze the content of prenatal care in Sao Luis, Maranhao, Brazil, and the factors associated with its inadequacy. A cross-sectional study was conducted based on data from the birth cohort of Sao Luis in 2010. The content of prenatal care was defined as inadequate when it did not meet the criteria of the Program for Humanization of Prenatal and Delivery Care, which establishes early initiation of prenatal care, minimum number of medical consultations, basic laboratory tests, tetanus vaccination and obstetric procedures. Poisson regression was used to observe associations of the variables with the outcome. The inadequacy rate was high (60.2%). The variables associated with inadequacy were: class C socioeconomic status (PR = 1.39; CI = 1.26-1.55); class D/E socioeconomic status (PR = 1.60; CI = 1.43-1.79); unqualified/unemployed mother (PR = 1.24; CI = 1.11-1.37); 5-8 years of schooling (PR = 1.12; CI = 1.06-1.19); 0-4 years of schooling (PR = 1.13; CI = 1.01-1.26); not being religious (PR = 1.10; CI = 1.04-1.17); alcohol use during pregnancy (PR = 1.13; CI = 1.06-1.20), and being attended by the public service (PR = 1.75; CI = 1.54-2.00). The results showed inadequacy and inequality of prenatal care, revealing that women of lower socioeconomic status received lower quality care. Key words Prenatal care, Quality of health care, Socioeconomic factors O objetivo desta pesquisa foi analisar o conteudo da assistencia pre-natal em Sao Luis e os fatores associados com sua inadequacao. Realizou-se estudo transversal baseado em dados da coorte de nascimento de Sao Luis em 2010. O conteudo da assistencia pre-natal foi classificado como inadequado quando nao atendeu aos criterios do Programa de Humanizacao no Pre-Natal e Nascimento (PHPN) que estabelece o inicio precoce, o numero minimo de consultas, os exames laboratoriais basicos, a vacinacao antitetanica e os procedimentos obstetricos. Regressao de Poisson foi utilizada para observar associacoes das variaveis com o desfecho. A taxa de inadequacao foi de 60,2%. O pre-natal inadequado foi associado a classe economica C (RP = 1,39; IC = 1,26-1,55), a D/E (RP = 1,60; IC = 1,43-1,79), a ocupacao da mae nao qualificada/desempregada (RP = 1,24; IC = 1,11-1,37), a escolaridade de 5-8 anos (RP = 1,12; IC = 1,06-1,19) e de 0-4 anos (RP = 1,13; IC = 1,01-1,26), a nao ter religiao (RP = 1,10; IC = 1,04-1,17), ao uso de alcool durante a gestacao (RP = 1,13; IC = 1,06-1,20) e ao atendimento no ser