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Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(2):56-64
DOI 10.1590/S0100-72032014000200003
To evaluate the adequacy of the process of prenatal care according to the
parameters of the Program for the Humanization of Prenatal Care (PHPN) and of the
procedures provided by the Stork Network of Unified Health System (SUS) in the
microregion of Espirito Santo state, Brazil.
A cross-sectional study was conducted in 2012-2013 by interviewing and analyzing
the records of 742 women during the postpartum period and of their newborns in 7
hospitals in the region chosen for the research. The information was collected,
processed and analyzed by the χ2 and Fisher's exact test to determine
the difference in proportion between the criteria adopted by the PHPN and the
Stork Network and the place of residence, family income and type of coverage of
prenatal service. The level of significance was set at 5%.
The parameters showing the lowest adequacy rate were quick tests and repeated
exams, with frequencies around 10 and 30%, respectively, in addition to
educational activities (57.9%) and tetanus immunization (58.7%). In contrast, risk
management (92.6%) and the fasting plasma glucose test (91.3%) showed the best
results. Adequacy was 7.4% for the PHPN, 0.4% for the Stork Network, with respect
to the parameters of normal risk pregnancies, and 0 for high risk pregnancies.
There was a significant difference between puerperae according to housing location
regarding the execution of serology for syphilis (VDRL), anti-HIV and repeated
fasting glucose tests, and monthly income influenced the execution of blood
type/Rh factor tests, VDRL, hematocrit and anti-HIV test.
Prenatal care in the SUS proved to be inadequate regarding the procedures
required by the PHPN and Stork Network in the micro-region of a state in
southeastern Brazil, especially for women of lower income, PACS users and
residents of rural areas.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(2):56-64
DOI 10.1590/S0100-72032014000200003
To evaluate the adequacy of the process of prenatal care according to the
parameters of the Program for the Humanization of Prenatal Care (PHPN) and of the
procedures provided by the Stork Network of Unified Health System (SUS) in the
microregion of Espirito Santo state, Brazil.
A cross-sectional study was conducted in 2012-2013 by interviewing and analyzing
the records of 742 women during the postpartum period and of their newborns in 7
hospitals in the region chosen for the research. The information was collected,
processed and analyzed by the χ2 and Fisher's exact test to determine
the difference in proportion between the criteria adopted by the PHPN and the
Stork Network and the place of residence, family income and type of coverage of
prenatal service. The level of significance was set at 5%.
The parameters showing the lowest adequacy rate were quick tests and repeated
exams, with frequencies around 10 and 30%, respectively, in addition to
educational activities (57.9%) and tetanus immunization (58.7%). In contrast, risk
management (92.6%) and the fasting plasma glucose test (91.3%) showed the best
results. Adequacy was 7.4% for the PHPN, 0.4% for the Stork Network, with respect
to the parameters of normal risk pregnancies, and 0 for high risk pregnancies.
There was a significant difference between puerperae according to housing location
regarding the execution of serology for syphilis (VDRL), anti-HIV and repeated
fasting glucose tests, and monthly income influenced the execution of blood
type/Rh factor tests, VDRL, hematocrit and anti-HIV test.
Prenatal care in the SUS proved to be inadequate regarding the procedures
required by the PHPN and Stork Network in the micro-region of a state in
southeastern Brazil, especially for women of lower income, PACS users and
residents of rural areas.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(8):386-393
DOI 10.1590/S0100-72032012000800008
PURPOSE: To evaluate sociodemographic, behavioral and reproductive factors and morbidities associated with inadequate weight gain during pregnancy. METHODS: Cohort study conducted from December 2007 to August 2008 with women in the first trimester of pregnancy looking for prenatal care in the Public Health System who lived in the cities of Petrópolis or Queimados, Rio de Janeiro state (Brazil). Women with multiple pregnancy, who had a miscarriage in the index pregnancy or who lacked information for the assessment of pregravid nutritional status or weight gain were excluded. Pregravid nutritional status and weight gain during pregnancy were determined according to the criterion established by the Institute of Medicine (IOM). Statistical analysis was performed using a multinomial logistic regression model. RESULTS: A total of 1,287 women were included in the study; 26.6% of them were overweight or obese while 11% were underweight. Inadequate weight gain during pregnancy was observed in 71.4% of pregnant women; 35.6% of them did not gain enough weight while 35.8% gained more weight than recommended by the IOM. In the multivariate analysis, women with hypertension (OR=2.1; 95%CI 1.4-3.1), pregravid overweight (OR=2.5; 95%CI 1.4-4.5) or obesity (OR=2.7; 95%CI 1.8-3.9) and who had a higher educational level were more likely to gain more weight than recommended, while pregravid underweight (OR=0.6; 95%CI 0.4-0.9) represented a protection against excessive gain. CONCLUSION: Pregravid nutritional diagnosis and weight gain monitoring should be actions effectively instituted in the routine of health professionals.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(8):386-393
DOI 10.1590/S0100-72032012000800008
PURPOSE: To evaluate sociodemographic, behavioral and reproductive factors and morbidities associated with inadequate weight gain during pregnancy. METHODS: Cohort study conducted from December 2007 to August 2008 with women in the first trimester of pregnancy looking for prenatal care in the Public Health System who lived in the cities of Petrópolis or Queimados, Rio de Janeiro state (Brazil). Women with multiple pregnancy, who had a miscarriage in the index pregnancy or who lacked information for the assessment of pregravid nutritional status or weight gain were excluded. Pregravid nutritional status and weight gain during pregnancy were determined according to the criterion established by the Institute of Medicine (IOM). Statistical analysis was performed using a multinomial logistic regression model. RESULTS: A total of 1,287 women were included in the study; 26.6% of them were overweight or obese while 11% were underweight. Inadequate weight gain during pregnancy was observed in 71.4% of pregnant women; 35.6% of them did not gain enough weight while 35.8% gained more weight than recommended by the IOM. In the multivariate analysis, women with hypertension (OR=2.1; 95%CI 1.4-3.1), pregravid overweight (OR=2.5; 95%CI 1.4-4.5) or obesity (OR=2.7; 95%CI 1.8-3.9) and who had a higher educational level were more likely to gain more weight than recommended, while pregravid underweight (OR=0.6; 95%CI 0.4-0.9) represented a protection against excessive gain. CONCLUSION: Pregravid nutritional diagnosis and weight gain monitoring should be actions effectively instituted in the routine of health professionals.