Relação do perfil do acompanhamento nas consultas de pré-natal com os desfechos maternos e perinatais

Abstract

Pregnancy is characterized by changes and demand for social support to promote maternal and child well-being. Referred social support is formed by family and friends, who provide emotional, informative, cognitive and material support to the pregnant woman. Thus, it is fundamental to promote prenatal care covering the companions, since the presence of these favors the listening of information, allowing to perceive and understand the changes that occurred during pregnancy. Objectives: To characterize the profile of the follow-up in prenatal consultations and its relation with adherence to prenatal care objectives and gestational outcomes. Methods: A cross-sectional study with a quantitative approach, carried out in Fortaleza-CE, at the Reference Maternity School in the State of Ceará. The data were collected by consulting the medical charts and prenatal cards of the puerperal women, as well as by means of an interview that investigated the socioeconomic, clinical, gynecological, obstetrical, perinatal profile and the follow-up profile of pregnant women at prenatal consultations And motherhood. The sample was divided into two groups: unaccompanied patients during prenatal care and with caregivers during prenatal care for at least one visit. The data were analyzed by the statistical program SPSS® 22, generating the absolute and relative frequency, mean and standard deviation. Categorical variables were analyzed using the Pearson and Fisher Chi-Square Tests, while the Mann-Whitney U-Test was used for the continuous variables. Results: 351 postpartum women participated, 54.4% of whom were followed up at prenatal visits, mainly by the partner (40%) and the mother (35.8%). Prevalence of young women with a mean age of 26 years, with a mean educational level of 10 years, religious (91.7%), no work (59.0%) and partner (85.8%), Years and had work (93.7%). Prevalence of low-risk pregnant women (70.9%), attended by a multiprofessional team (63.8%), primary care (81.3%), who started prenatal care early, attended regular care and underwent laboratory tests And of image as recommended; However, it was not evaluated by the Pap smear (74.6%). The majority had a vaginal delivery (54.4%), a newborn male (53.0%) in term (79.8%) and gestational age (82.3%). 51% presented intercurrences at birth and 17.7% were referred to the neonatal intensive care unit. Regarding social support, 96.6% of the women received financial support, by husband (68.9%) and mother (41%) and emotional support respectively (68.9%, 43.6%). Women were followed up at maternity hospital (92.9%) during labor (72.7%), delivery (86.5%) and postpartum (84.4%); by the husband (50.9%) and the mother (37.4%). In a bivariate analysis, there was a significant association between puerperal work (p: 0.036), companion schooling (p: 0.028), prenatal (p: 0.001) and primary care (p: 0.000), secondary (p: 0.002) and private clinic (p: 0.003), prenatal consultations (p: 0.004); Hemoglobin / hematocrit test (p: 0.038), urine (p: 0.030), toxoplasmosis (p: 0.018), first-trimester ultrasound (p: 0.034), receive financial support (p: (P: 0,008), help received to understand prenatal orientations (p: 0.000), followed puerperous in the maternity ward (p: 0,000) and the spouse as companion in the maternity ward (p: 0.000). In the logistic regression, prenatal care was performed in the private clinic (OR: 9.94, 95% CI: 1.2- 81.3), companion schooling (OR: 1.14, 95% CI: 1.0 - 1,2) and help received to understand the guidelines received during prenatal care (OR: 49.72; 95% CI: 20.69 - 119.51). Conclusion: Women attending prenatal visits were more likely to attend prenatal visits and fulfill prenatal goals; However, without changes in maternal and perinatal outcomes. However, an increase in follow-up was observed at the time of labor.