Adequacy of antenatal care and its relationship with low birth weight in Botucatu, São Paulo, Brazil: a case-control study

Abstract

BackgroundBirth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. The purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil.MethodsA case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the official medical records of pregnant women). The study population consisted of two groups, each with 860 newborns. The case group comprised newborns weighing less than 2,500 grams, while the control group comprised live newborns weighing greater than or equal to 2,500 grams. Adequacy of ANC was evaluated according to three measurements: 1. Adequacy of the number of ANC visits adjusted to gestational age; 2. Modified Kessner Index; and 3. Adequacy of ANC laboratory studies and exams summary measure according to parameters defined by the Ministry of Health in the Program for Prenatal and Birth Care Humanization.ResultsAnalyses revealed that LBW was associated with the number of ANC visits adjusted to gestational age (OR = 1.78, 95% CI 1.32-2.34) and the ANC laboratory studies and exams summary measure (OR = 4.13, 95% CI 1.36-12.51). According to the modified Kessner Index, 64.4% of antenatal visits in the LBW group were adequate, with no differences between groups.ConclusionsOur data corroborate the association between inadequate number of ANC visits, laboratory studies and exams, and increased risk of LBW newborns. No association was found between the modified Kessner Index as a measure of adequacy of ANC and LBW. This finding reveals the low indices of coverage for basic actions already well regulated in the Health System in Brazil. Despite the association found in the study, we cannot conclude that LBW would be prevented only by an adequate ANC, as LBW is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery and to newborns, focusing on reduced LBW rates.

Quality of Antenatal Care and Outcome of Pregnancy in a Semi-Urban Area in Fako Division, Cameroon: A Cross-Sectional Study

“…Those who had poor care were more likely to suffer from preterm birth, low birth weight, still birth, low APGAR score, post term birth, induction of labor, augmentation of labor, and dystocia. This result is similar to that obtained in similar studies, 13,27,38 however most studies compared adequacy of care and one or two adverse outcomes. Regina and colleagues 38 showed an association between low birth weight and inadequate care but did not find any association between poor care and the other adverse outcomes.…”

Placenta previa, anemia, care in antenatal, employment score: Development of a scoring system to predict low birth weight in underserved area in Indonesia

“…[12] However, da Fonseca et al (2014) found no association between adequacy of ANC and LBW. [13] Although antenatal care is one of the most effective ways of reducing maternal and perinatal mortality and morbidity, this study found contradictory results in LBW pregnancy. Complete antenatal care increased the risk of having a LBW baby.…”

Prematurity and Low Birth Weight did not Correlate with Anti-Toxoplasma gondii Maternal Serum Profiles – a Brazilian Report

“…The decision to use this document as a data source is due to the fact that they constitute an official record established by Brazilian legislation. [ 41 , 42 , 46 ].…”

“…The interest in conducting proper screening for T . gondii infection in risk groups has grown considerably in recent years, as well as the interest in studies to establish some relation to the conditions presented by newborns, such as prematurity and disease severity [ 5 , 18 , 35 – 42 ].…”