Abstract
Abstract Objectives: to analyze prenatal care process in primary health care units and compare the prenatal adequacy in the third trimester with maternal and perinatal outcomes. Methods: a cross-sectional study of 2,404 pregnant women assisted in 2011in twelve primary health care units in the South region of São Paulo city. The data was collected through medical records. The assessment was based on the indicators process of the Programa de Humanização do Pré-natal e Nascimento (PHPN) (Prenatal and Birth Humanization Program). The prenatal adequacy in the third trimester was analyzed according to three criteria (early-onset, minimum of six consultations and puerperal consultation); and the compared maternal and perinatal outcomes were: type of childbirth, gestational age, birth weight and breastfeeding. The analysis was descriptive for the PHPN indicators and comparative for the prenatal adequacy by the chi-square test. Results: early prenatal (82.9%), minimum of six consultations (73.0%) and puerperal consultation (77.9%). In the overall of the PHPN indicators, there was an expressive decrease in the medical records (10.2%). Prenatal care was adequate for 63.6% with a significant difference in relation to gestational age (p=0.037) and birth weight (p=0.001). Conclusions: There were deficiencies in prenatal care. The difference between the groups in the perinatal outcomes reinforcing the need for prenatal care according to national indicators.
Highlights
In Brazil, the maternal mortality rate is 64 women per 100,000 live births, three times higher than the World Health Organization (WHO) recommends, which is 20 per 100,000
The Programa de Humanização no Pré-Natal e Nascimento (PHPN) (Prenatal and Birth Humanization Program) emphasized the affirmation of women's rights proposing humanization as a strategy to improve the quality of care.[2]
The objectives of this study were to analyze the prenatal care process in 12 primary health care units in the South region in São Paulo city according to the process of the PHPN indicators, and comparing the prenatal care adequacy in the third trimester with maternal and perinatal outcomes
Summary
In Brazil, the maternal mortality rate is 64 women per 100,000 live births, three times higher than the World Health Organization (WHO) recommends, which is 20 per 100,000. The reduction target for Brazil, according to the Objetivos de Desenvolvimento do Milênio (Millennium Development Goals) was to reach 35 deaths in 2015. The Programa de Humanização no Pré-Natal e Nascimento (PHPN) (Prenatal and Birth Humanization Program) emphasized the affirmation of women's rights proposing humanization as a strategy to improve the quality of care.[2]. In 2011, the so-called Rede Cegonha (RC) (Stork Network) was established with an aim to ensure women the right to reproductive planning, humanized pregnancy care, childbirth and puerperium, and child’s right to safe birth, healthy growth and development up to 24 months of life, from four components: prenatal care, childbirth and birth, puerperium and essential child health care and logistic system (medical transport and regulation).[3]
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