Fatores associados à assistência pré-natal precária em uma amostra de puérperas adolescentes em maternidades do Município do Rio de Janeiro, 1999-2000

Abstract

This study characterizes the women receiving precarious prenatal care according to socio-demographic variables, mother's reproductive history, family support, satisfaction with pregnancy, and risk behavior during pregnancy. A total of 1,967 adolescents were interviewed in the immediate post-partum in public and outsourced maternity hospitals in the City of Rio de Janeiro. The dependent variable was the number of prenatal appointments (0-3; 4-6; 7 or more). The statistical analysis aimed to test the hypothesis of homogeneity of proportions, including bi- and multivariate analysis, using multinomial logistic regression, in which the reference category for the response variable was 7 or more prenatal visits. Higher (and statistically significant) proportions of insufficient number of prenatal visits (0-3) were associated with: precarious sanitation conditions; not living with the child's father; attempted abortion; and smoking, drinking, and/or drug use during pregnancy. The results strongly indicate that mothers with worse living conditions and risk behavior during pregnancy were the same who lacked access to prenatal care.

Assistência pré-natal no Brasil

“…Brazil, a delayed booking of care and fewer visits, results also observed in other studies 22 , demonstrating the importance of differentiated strategies for this age group. Prenatal care itself should be viewed with an opportunity guidance to prevent a recurrent unplanned pregnancy in adolescents 26 .…”

“…Several barriers for not attending prenatal care or early booking were identified, highlighting the social inequalities that persist in the country, with less access to indigenous and black women 21 , those with less education 4,7,11 , with higher number of pregnancies 4,7,22 , and residents in the North and Northeast region 11,23 .…”

Diferenças regionais e fatores associados ao número de consultas de pré-natal no Brasil: análise do Sistema de Informações sobre Nascidos Vivos em 2013

“…Consequently, the results are better intrauterine growth, higher birth weight, fewer occurrences of prematurity and neonatal mortality, and, for the mother, lower rate of complications during pregnancy and at delivery 1 . Studies show that the higher the number of prenatal visits, the lower the neonatal 2 and maternal 3,4 mortality rates, the prevalence of prematurity 3 , the low birth weight 5,6 , and the hypertension during pregnancy 3,4 . In this scenario, the anti-tetanus vaccination coverage 7 and supplementation with ferrous sulfate 7 are also greater.…”

“…Studies that analyzed the factors associated with low number of prenatal care visits found that this negative outcome is more common among women with low education 8 , pregnant adolescents 2,8 , with high parity 6,8 , and living without a partner 6 . However, in Brazil, Rev BRas epidemiol oUT-deZ 2016; 19(4): [835][836][837][838][839][840][841][842][843][844][845][846][847][848][849][850] published studies refer to municipal and/or regional data 2,6,8 , and the national data are essentially descriptive 9 .…”

“…Among other guidelines, the document recommends that pregnant women attend at least six prenatal visits during pregnancy: one in the first quarter, two in the second, and three in the third 1 . Studies that analyzed the factors associated with low number of prenatal care visits found that this negative outcome is more common among women with low education 8 , pregnant adolescents 2,8 , with high parity 6,8 , and living without a partner 6 . However, in Brazil, RESUMO: Objetivo: Investigar os fatores associados à realização de sete ou mais consultas pré-natal, no Brasil, no ano de 2013.…”