A case-control study was conducted to assess the effectiveness of antenatal care in preventing intrauterine growth retardation (IUGR) and low birth weight due to preterm delivery (PD), using data from 1837 births which took place in 25 hospitals in Mexico City during 1984. Women with an inadequate number of visits for gestational age had 63% greater odds of IUGR (95% CI: 1.01, 2.65) and 51% greater odds of PD (95% CI: 1.02, 2.23) than women with an adequate number. The content of antenatal visits showed no independent effect on the prevention of IUGR. Women having had poor content showed a PD OR of 1.76 (95% IC: 1.33, 2.34). An important reduction in the incidence of births with IUGR and PD could be expected if women could attend an adequate number of antenatal visits (11 and 9% reductions, respectively). Eighteen per cent of the PD births would probably be prevented if antenatal care could include at least six procedures: blood pressure, height and weight, urine and blood samples, and pelvic examination.
This study analyzes the potential economic benefits of identifying and treating patients with so-called prediabetes and prehypertension through the Mexican prevention program known by its Spanish acronym PREVENIMSS. The results show that for each US dollar invested in prevention, $84-$323 would be saved over a twenty-year period. For this and other reasons, providing preventive care for prediabetes and prehypertension patients is better than the current routine care model, in which care is provided in most cases when the disease has progressed substantially. Yet data show that screening and preventive care services are still not being used widely enough in Mexico, are provided too late, or are not sufficiently targeted to the most at-risk individuals. Investing in preventive care for patients with prediabetes and prehypertension is cost saving.
This paper analyzes the validity and reliability of a method proposed by HERMAN et al [8] used to classify avoidable neonatal deaths. This method is based on a list of amenable medical conditions with an a priori decision about the avoidance of deaths. The results obtained using this method are compared to those derived from the discussion of individual cases by a committee created ex profeso. The population under study includes all neonatal deaths occurred at a third level hospital in Mexico City, from January 1, 1987 to July 31, 1994 (n = 1337). Only 56% of neonatal deaths could follow HERMAN's classification (n = 749). Poor concordance (Cohen's Kappa = 0.30) between the two methods was found. A high proportion of deaths (72.7%) was classified ambiguously (as possibly preventable), and also a considerable proportion of deaths could not be classified (44%). High sensitivity (96%) was found for the small percentage of cases in which avoidance was determined by the method under assessment (15%). A priori classification is useful for developing rough quality indicators at the regional level but not at hospital settings.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.