<i>Rede Cegonha</i>: maternal characteristics and perinatal outcomes related to prenatal consultations at intermediate risk

Brito, Franciele Aline Machado de; Moroskoski, Marcia; Shibawaka, Bianca Machado Cruz; Oliveira, Rosana Rosseto de; Toso, Beatriz Rosana de Oliveira Gonçalves; Higarashi, Ieda Harumi

doi:10.1590/1980-220X-REEUSP-2021-0248

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 56 • 2022 • https://doi.org/10.1590/1980-220X-REEUSP-2021-0248 copy

Rede Cegonha: maternal characteristics and perinatal outcomes related to prenatal consultations at intermediate risk^* * Extracted from the dissertation: “Perinatal outcomes and maternal characteristics associated with the number of prenatal consultations under the Rede Mãe Paranaense”. Universidade Estadual de Maringá, 2021.

Rede Cegonha: características maternas y resultados perinatales relacionados con consultas prenatales en riesgo intermedio

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to analyze the correlation between maternal characteristics and perinatal outcomes, with the number of prenatal consultations performed.

Method:

a cross-sectional study, carried out with 1,219 mothers and newborns stratified as intermediate risk according to the Programa Rede Mãe Paranaense, adaptation of the Rede Cegonha at the state level. Data were collected from the Birth Certificates. Spearman, Wilcoxon and Kruskal-Wallis tests were used to analyze the correlation between the variables of interest.

Results:

married women, with higher education, white and aged 30 years or older were the ones who most attended prenatal consultations. With regard to perinatal outcomes, children whose mothers had more frequent prenatal consultations had better Apgar and birth weight scores. High rates of cesarean delivery were identified before the onset of labor.

Conclusion:

maternal characteristics influence the process of adherence to prenatal care, impacting perinatal outcomes, indicating the relevance of these risk factors and the need to improve actions aimed at greater compliance with risk stratification and qualified and resolute care for pregnant women at intermediate risk.

DESCRIPTORS
Prenatal Care; Maternal-Child Health Services; Infant Mortality

Variable	Frequency		Prenatal consultations			p^* * p value calculated from Kruskal-Wallis/Wilcoxon comparison tests.
Variable	n	%	Mean	Standard deviation	Median
Mother’s marital status						<0.001^† † p < 0,05.
Married	702	57.59%	10.09	3.74	10
Cohabitation	251	20.59%	9.24	3.40	9
Single	239	19.61%	8.33	3.59	8
Divorced	20	1.64%	8.40	1.93	9
Widow	3	0.25%	9.67	1.53	10
Ignored	4	0.33%	5.75	3.86	7.5
Education years						<0.001^† † p < 0,05.
None	5	0.41%	7.40	2.07	7
1 to 3 years	4	0.33%	8.75	3.30	9
4 to 7 years	60	4.92%	8.62	3.81	9
8 to 11 years	681	55.87%	9.15	3.61	9
12 years and older	460	37.74%	10.30	3.64	10
Ignored	9	0.74%	6.11	4.48	7
Mother’s color type						<0.001^† † p < 0,05.
White	703	57.67%	9.93	3.72	10
Black	244	20.02%	8.52	3.46	8
Brown	251	20.59%	9.39	3.58	9
Yellow	12	0.98%	10.83	2.62	11
Indigenous	2	0.16%	9.50	9.19	9.5
Ignored	7	0.57%	6.71	4.89	7
Pregnancy type						0.001^† † p < 0,05.
Single	1156	94.83%	9.43	3.61	9
Double	59	4.84%	11.07	4.57	10
Triple or more	3	0.25%	16.00	0.00	16
Ignored	1	0.08%	7.00	–	7

Variable	Descriptive measures				Prenatal consultations
Variable	N	Mean	Standard deviation	Median	r_s*	p^†
Mother’s age	1219	31.50	6.83	32	0.144	<0.001^‡
Number of previous pregnancies	1217	2.01	1.27	2	–0.010	0.723
Number of cesarean deliveries	1217	0.69	0.89	0	0.016	0.584
Number of normal births	1216	0.50	0.93	0	–0.091	0.001^‡
Number of living children	1217	1.07	1.07	1	–0.097	0.001^‡
Number of dead children	1217	0.96	0.76	1	0.129	<0.001^‡
Month of pregnancy in which prenatal care started	1212	2.14	3.03	2	–0.285	<0.001^‡

Variable	Frequency		Prenatal consultations			p*
Variable	N	%	Mean	Standard deviation	Median	p*
Birthplace						0.209
Hospital	1214	99.59%	9.51	3.60	9
Home	4	0.33%	9.00	2.16	8.5
Other health facilities	1	0.08%	38.00	–	38
Birth was assisted by whom?						0.287
Doctor	1214	99.59%	9.54	3.68	9
Nurse/midwife	5	0.41%	7.20	4.44	8
Delivery type						<0.001^†
Cesarean section	949	77.85%	9.84	3.67	10
Normal	270	22.15%	8.42	3.52	8
Was labor induced?						0.248
No	1094	89.75%	9.51	3.73	9
Yes	124	10.17%	9.65	3.32	9
Ignored	1	0.08%	15.00	–	15
Did cesarean occur before labor started?						<0.001^†
No	218	17.88%	9.47	3.69	10
Yes	695	57.01%	10.00	3.65	10
Not applicable	34	2.79%	8.88	3.84	8
Ignored	272	22.31%	8.45	3.53	8
Newborn presentation type						0.760
Cephalic	1138	93.36%	9.49	3.58	9
Pelvic or podalic	70	5.74%	9.93	5.14	9
Transverse	3	0.25%	10.00	1.00	10
Ignored	8	0.66%	11.13	4.32	9.5
Method employed						0.024^†
Physical examination	1	0.08%	8.00	–	8
Alternative method	1115	91.47%	9.39	3.50	9
Ignored	103	8.45%	11.01	5.10	10
Sex						0.989
Male	639	52.42%	9.56	3.82	9
Female	580	47.58%	9.50	3.54	9
Anomaly identified						0.921
No	1211	99.34%	9.53	3.69	9
Yes	8	0.66%	9.50	3.30	9

Variable	Descriptive measures						Prenatal consultations
Variable	N	Mean	Standard deviation	Median	Minimum – Maximum	IQR	rSrS*	p^†
Apgar at the 1^st minute	1218	8.34	1.33	9	(0 – 10)	(8 – 9)	0.042	0.146
Apgar at the 5^th minute	1218	9.38	0.79	9.5	(3 – 10)	(9 – 10)	0.114	<0.001^‡
Robson group code	1219	4.70	2.60	5	(1 – 11)	(3 – 5)	–0.027	0.347
Number of gestation weeks	1216	37.91	2.24	38	(23 – 44)	(37 – 39)	0.036	0.207
Weight	1219	3151.84	614.73	3205	(470 – 4976)	(2850 – 3564)	0.072	0.012^‡

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Franciele Aline Machado de Brito Avenida Colombo, 5790, Bloco 2 87020-900 – Maringá, PR, Brazil francielebrito51@gmail.com