Assessment of prenatal care adequacy using different normative criteria in a municipality in Santa Catarina, Brazil

Abstract

The current study aimed to evaluate the quality of prenatal care and identify associated factors among women admitted for delivery at a public maternity hospital in greater Florianópolis, Santa Catarina. This cross-sectional study included women who had received prenatal care through the Government Unified Health System in the city of São José and had been subsequently admitted to the hospital for delivery from November 2021 to April 2022. Data were obtained from the pregnant women’s booklet, their health records, and a specific questionnaire. The evaluation criteria included the Takeda-modified Kessner index, adapted adequacy of prenatal care utilization index, and Anversa classification. Adequacy was assessed based on pregnancy parameters and the patients’ characteristics. Among the 237 pregnant women in the sample, prenatal care adequacy ranged from 48.5 to 83.1% and was associated with older age, education, referral to high-risk prenatal care (HRPN) (20 – 30% higher prevalence of adequacy), and pregnancy planning. Notably, there was a tendency toward a reduction in the number of examinations (laboratory and physical) during pregnancy. The adequacy rate decreased with the application of stricter normative criteria and in advanced pregnancy stages. In conclusion, prenatal care quality was predominantly adequate, although it varied across indices and was associated with age, education, HRPN, and pregnancy planning.