Prenatal and puerperium nutritional care from an integrality perspective in a city of Baixada Santista, São Paulo, Brazil

Anna Sylvia De Campos Motta Laporte,Lia Thieme Oikawa Zangirolani,Maria Angélica Tavares De Medeiros

doi:10.1590/1806-93042020000100009

Anna Sylvia De Campos Motta Laporte, Lia Thieme Oikawa Zangirolani + Show 1 more

Open Access

https://doi.org/10.1590/1806-93042020000100009

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Abstract

Abstract Objectives: to perform a comparative assessment of the nutritional care process in the prenatal and puerperium periods at a primary care unit in the city of Santos, SP, Brazil before and after the implantation of the Prenatal and Puerperium Nutritional Care Strategy. Methods: a cross-sectional study was composed of 58 pairs of women and their children, of whom, 30 underwent prenatal care before and 28 of them after the implantation by collecting data from perinatal registrations and children's charts. The care was evaluated by the official National guidelines. The chi-square test was used to compare variables between the pre and post intervention groups. Results: there was a significant improvement after the nutritional intervention, regarding to height (p=0.001), registration on pre-pregnancy weight (p=0.032), follow up on Body Mass Index/gestational week (p=0.001), registration on newborn’s weight at discharge (p=0.011) and daily weight gain at the first pediatric consultation (p=0.019). Conclusions: the Prenatal and Puerperal Nutritional Care Strategy contributed to improve maternal-child nutritional care and the data registration on patients’ charts, demonstrating the necessity to establish processes/flows and an integral care for this population.

Highlights

Despite the reduction in maternal and neonatal mortality in Brazil, it is still critical how a large number of young individuals die due to direct obstetric causes related to hypertension, especially eclampsia, and hemorrhagic problems during childbirth
Data were collected from 30 medical charts of women in the PRE group and 28 in the POST group
The present findings indicate that the accomplishment of a minimum of six prenatal consultations established by the National Prenatal and Childbirth Humanization Program was higher in comparison to data found in the literature, which reports adequacy rates of up to only 60%

Summary

Introduction

Despite the reduction in maternal and neonatal mortality in Brazil, it is still critical how a large number of young individuals die due to direct obstetric causes related to hypertension, especially eclampsia, and hemorrhagic problems during childbirth. The occurrence of premature births and early neonatal deaths is a concern. These situations can be improved with nutritional interventions in the prenatal period.[1,2]. Nutritional disorders, especially overweight and obesity, are common among pregnant women as well as women of childbearing age which can lead to maternal morbidity such as an increase in the prevalence of gestational diabetes and hypertensive diseases.[1,3] To combat this epidemiological problem, the Brazilian Health Ministry established actions and policies to ensure integrality care.[1]

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