[Evaluation of knowledge on prenatal care and pregnancy risk among women living in a peripheral area of Rio Grande, Rio Grande do Sul State, Brazil]

[Adequacy of prenatal dental care: social and geographical inequalities in a metropolitan region of Brazil]

This study set out to analyze social and geographical inequalities in the adequacy of prenatal dental care in the Unified Health System (SUS) of the Greater Vitória Metropolitan Region, Espírito Santo, Brazil. A cross-sectional study was carried out with 1209 postpartum women living in the region admitted to hospital at SUS facilities for childbirth between 2010 and 2011. Data were collected on prenatal medical-dental care, the impact of oral health on the quality of life of pregnant women (Oral Health Impact Profile-14), and predisposing characteristics. Prenatal care was adequate when care corresponded to the recommended treatment. The adequacy of dental care during prenatal care was analyzed using a multivariate logistic model. Oral health was found to have an impact on the quality of life of 102 (8.4%) pregnant women and the adequacy of dental care during prenatal care was only 15.4% (n=156). There was a greater chance of adequacy of prenatal dental care in Vitória (OR=2.44; IC=1.63-3.66), in regions covered by the family health strategy (OR=1.88; IC=1.22-2.89), and in areas with a higher proportion of pregnant women with access to quality prenatal care (OR=3.59; IC=1.64-7.84). Contextual inequalities were decisive for the inadequacy of dental care in prenatal care.

Social and geographical inequalities in the performance of prenatal care in a metropolitan area of Brazil

This study analyzed the social and geographical inequalities in the performance of prenatal medical care in the Unified Health System (SUS) in the Metropolitan Region of Grande Vitória, Espírito Santo, Brazil. A cross-sectional study was carried out with 1,209 puerperae living in this region, admitted for childbirth from 2010 to 2011. Data about prenatal care and contextual, enabling, and social characteristics were collected, following the Andersen's Behavioral Model. The performance of prenatal care was classified into five levels, including information on the number of prenatal visits, initial and repetitive examinations, tetanus vaccination, gestational risk management, and participation in educational activities. The likelihood of different levels of prenatal care performance was analyzed using a multivariate multinomial model, according to maternal social variables. High prenatal coverage (98%) and 4.4% care adequacy were identified. The likelihood of access to prenatal care was increased by enabling, contextual, and social factors. The relationship between prenatal care quality and pregnant women's social and geographical conditions must be considered in the organization of services to achieve equity and reduce maternal and perinatal morbimortality.

The Signs of alert and Labor: knowledge among pregnant women

Abstract Objectives: ididentify the scores on the pregnant women’s knowledge on the signs of alert and labor and correlate the scores with the maternal age, number of children and the guidance they received during pregnancy. Methods: this is a descriptive, cross-sectional study with a quantitative approach on pregnant women's previous knowledge of the signs of alert and labor performed with 100 pregnant women on their 30th week of gestation at the Hospital de Clínicas da UFTM (Clinical Hospital). The data collection was carried out from April to June 2016, using a semi-structured instrument tested as a pilot study. Results: only 21% of the pregnant women reported taking part in the pregnant women's group; 61% of them referred to not receiving any information on the signs of alert and labor. A statistically significant association was verified between the number of correct answers and the guidance they received during prenatal consultations. However, there was no correlation between the correct scores on maternal age and the number of children. Conclusions: the pregnant women who did not receive any kind of guidance, they had lower scores on the correct answers, which shows the importance of guiding them about Health Education during their prenatal consultations.

Assessment of the knowledge of Brazilian Community Health Workers regarding prenatal care

Aim

To evaluate prenatal care knowledge of Brazilian community health workers (CHWs).

Background

Routine prenatal care is critical for reducing health risks in women and their children. One of the responsibilities of primary healthcare providers is the provision of prenatal care. The CHWs, with their frequent contact with populations, work to improve health outreach efforts and therefore may be key role players in prenatal care.

Methods

This was a cross-sectional study. A questionnaire was developed to ascertain the degree of knowledge regarding prenatal care of CHWs, including: (1) general responsibilities of CHWs; (2) the initial contact with a pregnant woman; (3) examinations and vaccinations recommended for pregnant women; (4) pregnancy complications and signs of labor; and (5) lifestyle considerations for pregnant women. Responses were categorized into levels for knowledge. Demographic data were also collected. Descriptive analyses were conducted. Proportions of subjects with different levels of knowledge were compared according to each demographic variable, separately for each block of knowledge, using the χ² and Fisher’s exact tests.

Findings

In total, 194 CHWs were interviewed. Overall, the majority of the CHWs presented high levels of knowledge in blocks 1 (43%), 2 (59%) and 5 (83%). However, in block 3 the proportions of subjects with high levels of knowledge regarding examinations and vaccinations were 35 and 40%, respectively. Only 24% of the participants presented a high level of knowledge in block 4. Stratified data analyses suggest that females were statistically more likely to have high levels of knowledge, whereas no statistically significant differences were found for the other demographic variables. Health services are already routinely using the questionnaire.

Conclusion

The results suggest that CHWs, especially female CHWs, have an important role in assisting pregnant women in the community. The study indicates the areas of knowledge that require more specific attention from training providers.

Assistência pré-natal na percepção de puérperas provenientes de diferentes serviços de saúde

OBJETIVO: conhecer a percepção de puérperas acerca da assistência pré-natal. MÉTODO: foram entrevistadas em até 48 horas após o parto, 150 puérperas, provenientes de diferentes serviços de saúde que acessaram o Hospital Universitário de Santa Maria/RS, no período de dezembro de 2010 a fevereiro de 2011. RESULTADOS: das 150 puérperas, 91,33% realizaram consultas de pré-natal em algum serviço de saúde do município e 8,67% não realizaram nenhuma consulta. 56,67% das puérperas entrevistadas consideraram que fazer o pré-natal é importante tanto para a mãe quanto para o bebê; quanto à assistência pré-natal realizada no município 84,67% das puérperas julga que não há necessidade de mudanças. CONCLUSÃO: apesar das usuárias considerarem a assistência como adequada, as autoras avaliam que existem carências na atenção pré-natal nos diferentes serviços e que poderiam ser supridas com a realização de um trabalho multiprofissional e interdisciplinar. Nesse sentido, intensificar o processo educativo entre as gestantes pode melhorar a qualidade da atenção, eliminar a falta de realização de pré-natal e diminuir a morbi-mortalidade materno-infantil no município.

[How a group of women perceives gestational hypertension disease]

This study aims to identify the knowledge women in childbirth (puerperas) have regarding gestational hypertension disease (GHD), to learn how they perceive its risk and gravity, and to understand the repercussions of GHD for these women and their families. This is a descriptive exploratory study using qualitative research methods. Data collection took place through individual semi-structured interviews with ten women in childbirth (puerperas) who were diagnosed with GHD. The analysis of the data was performed using Content Analysis. Thematic categories emerged addressing the women's knowledge of GHD; how they perceive diagnosis and the professional care offered; and the repercussions GHD had for them and their families. The study highlights the necessity to rethink and to reorganize the model of perinatal care, not only at the tertiary level but also at primary healthcare centers.

Perdas de oportunidades na prevenção do câncer de colo uterino durante o pré-natal

A gravidez representa uma excelente oportunidade para prevenção do carcinoma cervical, já que o exame ginecológico faz parte da rotina de pré-natal. Foi realizado um estudo transversal, no qual foram entrevistadas 445 puérperas utilizando-se questionários padronizados. A prevalência de CP atualizado era de 38,9% no início da gestação, chegando a 59,1% no puerpério (p>0,001). As puérperas com 19 anos ou menos, não brancas, com escolaridade inferior a onze anos, com renda familiar inferior a um salário mínimo, sexarca aos 15 anos ou menos, início do pré-natal após o primeiro trimestre e com o acompanhamento no Sistema Único de Saúde (SUS) apresentaram menor cobertura do citopatológico. Na análise ajustada, essas variáveis não mostraram significância associada à cobertura do citopatológico. Entretanto, a realização do pré-natal mostrou uma tendência à melhora da cobertura do CP com razão de prevalência de 1,18 (95%CI: 0,98-1,42). O serviço local de saúde mostrou-se pouco efetivo, revelando a necessidade de aumentar a cobertura do citopatológico, motivando e capacitando os profissionais quanto à importância dos procedimentos da rotina pré-natal.

[Clinical breast examination during prenatal visits: analysis of coverage and associated factors in a city in the State of Rio Grande do Sul, Brazil]

The Brazilian Ministry of Health recommends that breast examination be performed along with breastfeeding orientation during the first prenatal visit. The aims of the current study were to analyze breast examination during prenatal care and describe the factors associated with insufficient coverage. A cross-sectional study was performed in Rio Grande, Rio Grande do Sul State, Brazil, from May to July 2007. Data for women who had just given birth were recorded on a standardized questionnaire. Of 445 women, 266 (59.8%) had not undergone breast examination during prenatal care. Non-white women and those with a monthly income below the minimum wage (BRL 380.00) or with prenatal care and delivery in the public health system showed the highest probability of not having a breast examination during prenatal care. The results show the low prevalence of breast examination during prenatal care and indicate serious problems related to quality of prenatal care, besides unequal access for poor women.