Qualidade da assistência pré-natal no Brasil: revisão de artigos publicados de 2005 a 2015

Nunes, Juliana Teixeira; Gomes, Keila Rejane Oliveira; Mascarenhas, Márcio Dênis Medeiros; Mascarenhas, Márcio Dênis Medeiros

doi:10.1590/1414-462x201600020171

Cited by 96 publications

(125 citation statements)

References 32 publications

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“…6,18 Higher frequency was observed for Caucasian pregnant women (57%) with incomplete elementary schooling (27%). As for occupation, 46% of the Unknown/blank 20 6.90 continue pregnant women were referred to as housewives, in agreement to other studies, 14,15 although this information is often overlooked in the forms. The maternal profiles observed in this study reflects the social context of syphilis, affecting individuals with higher social vulnerabilities, since most of women are not employed and do not have degree.…”

Section: Discussionsupporting

confidence: 84%

Epidemiological profile of patients with congenital and gestational syphilis in a city in the State of São Paulo, Brazil

Maschio-Lima

Machado

Siqueira

et al. 2019

Rev. Bras. Saude Mater. Infant.

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Objectives: to assess the epidemiological profile of congenital and syphilis during pregnancy in residents of São José do Rio Preto in São Paulo State.Methods: ecological study of the epidemiological profile of patients with congenital and gestational syphilis, based on the Sistema de Informação de Agravos de Notificação (Information System for Notifiable Diseases) from 2007 to 2016.Results: there were 396 cases of syphilis reported in pregnant women and 290 of congenital syphilis. In 2016, the rate of detecting syphilis in pregnant women was 13.2 cases/1,000 live births, while congenital syphilis the incidence rate was 6.5 cases/1,000 live births. For gestational syphilis, 54% of the diagnosis was performed in 2 nd or 3 rd trimester and 85% were reported at the primary care. Adequate treatment for pregnant women occurred in 96% of the notifications with 52% of partners treated. In congenital syphilis, 82% of the mothers underwent prenatal care. However, 94% of the pregnant women were treated inadequately while 82% of the partners did not receive any treatment.Conclusions: there has been an increase in the number of cases of gestational syphilis in pregnant women and a decrease in the cases of congenital syphilis from 2014. These results showed that the goal of 0.5 case/1,000 live births proposed by World Health Organization is still far from being achieved in this city.

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Section: Discussionsupporting

confidence: 84%

Epidemiological profile of patients with congenital and gestational syphilis in a city in the State of São Paulo, Brazil

Maschio-Lima

Machado

Siqueira

et al. 2019

Rev. Bras. Saude Mater. Infant.

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“…In Brazil, the prenatal care coverage and number of visits have increased over the past 15 years [17]. However, studies conducted in the country have still revealed flaws in prenatal care, such as difficult access to care, late onset of care, an inadequate number of visits and incomplete performance of procedures, all of which impact perinatal outcomes [18–20]. Such outcomes are below the country’s potential and reflect unfavorable living and healthcare conditions, in addition to historical regional and socioeconomic inequalities [3].…”

Section: Discussionmentioning

confidence: 99%

Neonatal near miss determinants at a maternity hospital for high-risk pregnancy in Northeastern Brazil: a prospective study

Lima

Katz

Kassar

et al. 2018

BMC Pregnancy Childbirth

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BackgroundTo investigate the associations of maternal variables – sociodemographic, obstetrical and maternal near miss (MNM) variables – with neonatal near miss (NNM) using the new concept of NNM formulated by the Centro Latino-Americano de Perinatologia (CLAP) and the corresponding health indicators for NNM.MethodsAn analytical prospective cohort study was performed at maternity hospital for high-risk pregnancy in Northeastern Brazil. Puerperal women whose newborn infants met the selection criteria were subjected to interviews involving pretested questionnaires.Statistical analysis was performed with the Epi Info 3.5.1 program using the Chi square test and Fisher’s exact test when appropriate, with a level of significance of 5%. A bivariate analysis was performed to evaluate differences between the groups. All the variables evaluated in the bivariate analysis were subsequently included in the multivariate analysis. For stepwise logistic regression analysis, a hierarchical model was plotted to assess variable responses and adverse outcomes associated with MNM and NNM variables.ResultsThere were 1002 live births (LB) from June 2015 through May 2016, corresponding to 723 newborn infants (72.2%) without any neonatal adverse outcomes, 221 (22%) NNM cases, 44 (4.4%) early neonatal deaths and 14 (1.4%) late neonatal deaths. The incidence of NNM was 220/1000 LB. Following multivariate analysis, the factors that remained significantly associated with increased risk of NNM were fewer than 6 prenatal care visits (odds ratio (OR): 3.57; 95% confidence interval (CI): 2.57–4.94) and fetal malformations (OR: 8.78; 95% CI: 3.69–20.90). Maternal age older than 35 years (OR: 0.43; 95% CI: 0.23–0.83) and previous cesarean section (OR: 0.45; 95% CI: 0.29–0.68) protected against NNM.ConclusionBased on the large differences between the NNM and neonatal mortality rates found in the present study and the fact that NNM seems to be a preventable precursor of neonatal death, we suggest that all cases of NNM should be audited. Inadequate prenatal care and fetal malformations increased the risk of NNM, while older maternal age and a history of a previous cesarean section were protective factors.

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“…Studies have shown the increase in prenatal care coverage across the country in the last ten years, but the quality of prenatal care has been found to be inadequate. Among the factors that contribute to the low quality of prenatal care, the non-performance of routine laboratory exams, recommended basic procedures, prescriptions and guidelines during consultations were highlighted (3,(10)(11) .…”

Section: Discussionmentioning

confidence: 99%

Prenatal follow-up of high-risk pregnancy in the public service

et al. 2019

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Objective: to analyze the prenatal follow-up of high-risk pregnancy in the public service. Method: an analytical cross-sectional study carried out in a public maternity hospital in the South of Brazil, during the hospitalization of 319 postpartum women using a semistructured tool for transcription of the prenatal card records and interview. The data were analyzed using the Chi-Square test (p≤0.05). Results: the adequacy of prenatal care was high (74%); 22.6% intermediate; 3.4% inefficient. Prenatal care had high coverage (100%), early onset (81.5%) and six or more visits (92.4%), but (77.4%) did not receive information about gestational disease and examinations (69.3%). There was statistical significance between the quality of prenatal care and the place of prenatal care (p=0.005). Conclusion: the need to implement a specific protocol for high-risk gestation and continuous education to the teams was evidenced. RESUMOObjetivo: analisar o acompanhamento pré-natal da gestação de alto risco no serviço público. Método: estudo transversal analítico, realizado em uma maternidade pública no Sul do Brasil, durante internação de 319 puérperas, por meio de instrumento semiestruturado para transcrição dos registros do cartão pré-natal e entrevista. Realizou-se análise dos dados por meio do Teste Qui-Quadrado (p≤0,05). Resultados: a adequação do pré-natal foi alta (74%); 22,6% intermediária; 3,4% ineficiente. O pré-natal teve alta cobertura (100%), início precoce (81,5%) e realização de seis ou mais consultas (92,4%), porém (77,4%) não receberam informação sobre doença gestacional e resultados de exames (69,3%). Houve significância estatística entre a qualidade do pré-natal e o local da realização do pré-natal (p=0,005). Conclusão: evidenciou-se a necessidade de implementação de protocolo específico à gestação de alto risco e educação continuada às equipes. Descritores: Saúde da Mulher; Cuidado Pré-Natal; Gravidez de Alto Risco; Educação em Saúde; Saúde Pública. RESUMENObjetivo: analizar el seguimiento prenatal de la gestación de alto riesgo en el servicio público. Método: el estudio transversal analítico, realizado en una maternidad pública en el Sur de Brasil, durante la internación de 319 puérperas, por medio de un instrumento semiestructurado para la transcripción de los registros de la tarjeta prenatal y la entrevista. Se realizó análisis de los datos por medio del Test Qui-Cuadrado (p≤0,05). Resultados: la adecuación del prenatal fue alta (74%); 22,6% intermedio; 3,4% ineficiente. El prenatal tuvo alta cobertura (100%), inicio precoz (81,5%) y realización de seis o más consultas (92,4%), pero (77,4%) no recibieron información sobre enfermedad gestacional y resultados de exámenes (69,3%). Se observó una significativa estadística entre la calidad del prenatal y el lugar de la realización del prenatal (p=0,005). Conclusión: se evidenció la necesidad de implementación de protocolo específico a la gestación de alto riesgo y educación continuada a los equipos.

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Qualidade da assistência pré-natal no Brasil: revisão de artigos publicados de 2005 a 2015

Cited by 96 publications

References 32 publications

Epidemiological profile of patients with congenital and gestational syphilis in a city in the State of São Paulo, Brazil

Epidemiological profile of patients with congenital and gestational syphilis in a city in the State of São Paulo, Brazil

Neonatal near miss determinants at a maternity hospital for high-risk pregnancy in Northeastern Brazil: a prospective study

Prenatal follow-up of high-risk pregnancy in the public service

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