In)completude dos registros e (in)adequação da assistência ao pré-natal de risco habitual na atenção primária à saúde de Cabo Frio

Abstract

This study, anchored in the research entitled “Quality of Information: a study about the habitual risk prenatal performed in Primary Health Care of Cabo Frio”, has as its general objective: to analyse the (in)completeness of records of the pregnant woman's book and its relations with the habitual risk prenatal care adequacy in the APS (Primary Health Care) of Cabo Frio, Rio de Janeiro. Methodology: this is a cross-sectional study with a set of pregnant women pregnant women in the immediate postpartum period and admitted to the Cabo Frio Women's Municipal Hospital. The sampling strategy was for convenience, opening a timeframe of six months, recruiting all women in this period (n=131). The prenatal adequacy degree was calculated by the Kotelchuck Index, and the completeness degree used the Romero and Cunha criteria adjusted for gestational age. Both degrees were treated as outcome variables, with covariates of interest divided into sociodemographic and prenatal care characteristics. The statistical analysis included the prevalence calculation, prevalence ratio and confidence intervals at 95%, as well as the model’s construction by using the Poisson regression with robust variance adjustment. The project was approved by the Ethics and Research Committee of the State University of Rio de Janeiro, under the peer review number 3,223,284. Results: the main results of this study show that the completeness’ degree of the books can be classified as predominantly poor and very poor, with results of 74,05% and 20,61%, respectively. On the other hand, most prenatal care was considered adequate and very adequate, with prevalence of 18,32% (IC95%: 12,53-26,00) and 42,4975% (IC95%: 34,46-51,46). The participation of nurses in prenatal care proved to be an important covariate associated with the improvement of the completeness of the books (RPa=0,89; p=0,009), as well as six or more visits (RPa=0,94; p=0,012). However, it was observed that the variable (in)completeness of the prenatal registration was associated with the worst levels of adequacy (RPa 0,78; p<0,001), regardless of sociodemographic characteristics and prenatal care. Conclusion: the study showed the need for improvement of public policies on prenatal care, especially with regard to improving the quality of information and, even if a relatively high prevalence for prenatal adequacy is observed, it is believed that the goals to be pursued in this follow-up must include all pregnant women. In addition, the presence of the nurse during consultations was a factor associated with positive outcomes in this analysis. Considering that the introduction of the variables on the characteristic of the given care is a pioneer in this master’s thesis, it is recommended that further investigations use similar models in an attempt to evaluate the consistency of these results.