Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women

Abstract

Objective The present study aimed to evaluate the antenatal care adequacy for women who gave birth at the University Hospital of Santa Catarina in Florianopolis (Brazil) during the COVID-19 pandemic, and to evaluate the association of adequacy with sociodemographic, clinical, and access characteristics. Methods Data were collected between October and December 2020, including 254 patients who delivered in the University Hospital from Federal University of Santa Catarina and answered our questionnaires. Additional data were obtained from patients' antenatal booklets. Antenatal care was classified as adequate, intermediate, or inadequate according to the number of appointments, gestational age at the beginning of follow-up, and tests results. We carried out a descriptive statistical analysis and a bivariate/with odds ratio analysis on maternal sociodemographic, clinical and health access variables that were compared with antenatal adequacy. Results Antenatal care was considered adequate in 35.8% of cases, intermediate in 46.8%, and inadequate in 17.4%. The following maternal variables were associated with inadequate prenatal care (intermediate or inadequate prenatal care): having black or brown skin colour, having two or more children, being of foreign nationality, not being fluent in Portuguese, and using illicit drugs during pregnancy; the clinical variables were more than 6 weeks between appointments, and not attending high-risk antenatal care; as for access, the variables were difficulties in attending or scheduling appointments, and attending virtual appointments only. Conclusion In a sample of pregnant women from a teaching hospital in Florianópolis during the COVID-19 pandemic, antenatal care was considered adequate in 35.8%, intermediate in 46.8%, and inadequate in 17.4% of cases.

Changes in prenatal testing during the COVID-19 pandemic

“…Studies have reported efforts to align in-person visits with essential obstetric testing, yet the frequency with which such testing was completed during the height of the pandemic is rarely described ( 3 ). There are also reports of combining ultrasound-based tests (e.g., first trimester dating ultrasound with an ultrasound to measure nuchal translucency) and examining completion of third trimester testing for HIV, syphilis, and routine urine collection as a marker of the adequacy of prenatal care ( 2 , 9 ). Yet, despite the importance of second trimester testing in the ongoing management of a pregnancy and associated implications for the infant, from identification of birth defects to glucose monitoring after birth, the frequency and timing of such testing during the pandemic remains unknown.…”

Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women

“…We enthusiastically read the analysis conducted in the study Adequacy of Prenatal Care During The COVID-19 Pandemic: An Observational Study with Postpartum Women, 1 published in volume 44 issue #4 of the Brazilian Journal of Gynecology and Obstetrics in 2022, and would like to bring some considerations about the topic.…”

“…3 4 However, the few current studies analyzing the quality of prenatal care in this region differ from the data made available by the Ministry of Health (MH). 1 5 Thus, it is pertinent to emphasize that this study has great value by making a careful analysis of this assistance.…”

“…As the authors point out in the limitations of the study, the diversity of criteria used to evaluate the quality of prenatal care makes a more complete and comparative analysis of the data difficult. 1 The Brazilian government uses criteria with few variables for prenatal care adequacy, using the Kotelchuck index, 6 which takes into account only the date of prenatal care initiation and the number of appointments. Thus, the data found in national studies differ from the MH database.…”

“…According to the study by Martin et al, 1 in the year 2020, amid the COVID-19 pandemic, 35.8% of prenatal care were considered adequate, 46.8% intermediate, and 17.4% inadequate. In the previous year, according to the MH, 79.3% of prenatal care for Southern Brazil were considered adequate.…”