[Prenatal care: a temporal analysis using data from the 2013 and 2019 Brazilian National Health Survey]

【产前保健:基于2013年和2019年巴西全国健康调查数据的时序分析】

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Abstract

Inadequate prenatal care is associated with adverse outcomes for both mothers and newborns, making adherence to the Brazilian Ministry of Health's guidelines essential for ensuring quality care. This study aimed to analyze indicators related to prenatal care using data from the 2013 and 2019 editions of the Brazilian National Health Survey. The target population comprised women who had given birth in the two years preceding each survey. Indicators related to prenatal care were developed, including the number of visits, performance of exams, clinical-obstetric monitoring, and the guidance provided. The prevalences of these indicators and their corresponding 95% confidence intervals were estimated and compared between 2013 and 2019 using the Pearson chi-squared test, adjusted by the Rao-Scott correction to account for the sampling design. A significant increase was observed in the number of prenatal visits (p < 0.05) and in the performance of clinical-obstetric exams (p < 0.05). Moreover, the proportion of women who received guidance on the referral service for delivery increased significantly from 75% to 83% (p < 0.001), as did the testing rates for syphilis (from 66% to 79%, p < 0.001) and HIV (from 95% to 99%, p < 0.001). The analysis reveals important progress in both the coverage and quality of prenatal care in Brazil. However, challenges remain, including the late initiation of prenatal care and insufficient guidance regarding referral services for delivery.

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