Access and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic.

Nicole Zazula Beatrici, Roxana Knobel, Mariana Schmidt Vieira, Iago Felipe Alexandrini, Alberto Trapani, Carla Betina Andreucci
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Abstract

Objective: To compare access and suitability of antenatal care between years 2020 and 2022 among postpartum individuals at a Hospital in Florianopolis, and evaluate factors associated with antenatal suitability.

Methods: Observational, cross-sectional, and quantitative study carried out in 2022. Collected data were compared with the database of a previous similar study carried out in the same setting in 2020. Data were extracted from medical records and prenatal booklets, in addition to a face-to-face questionnaire. Adequacy was measured using the Carvalho and Novaes index and health access was qualitatively evaluated. Socio-demographic and antenatal variables were analyzed. A statistical significance level of 0.05 was considered. Open-ended questions were categorized for analysis.

Results: 395 postpartum individuals were included. Antenatal care was adequate for 48.6% in 2020 and 69.1% in 2022. Among the barriers to access, 56% reported difficulty in scheduling appointments and/or exams and 23% complained of reduced healthcare staff due to strikes, COVID-19, among others. Adequate antenatal care was associated with being pregnant in 2022, being referred to high-risk units (PNAR), and not reporting difficulties in access. Also, it was associated with twice the chance of investigation for gestational diabetes (GDM) and syphilis.

Conclusion: The 2022 post-vaccination period showed higher antenatal adequacy. The main difficulty for postpartum individuals was scheduling appointments and/or exams. Having antenatal care in 2022, no reports of difficulty in access, and follow-up at a high-risk unit were associated with antenatal adequacy.

在 COVID-19 大流行的两个阶段,巴西某城市产前护理的可及性和充分性。
目的比较 2020 年和 2022 年弗洛里亚诺波利斯市一家医院产后妇女获得产前护理的机会和适宜性,并评估与产前适宜性相关的因素:方法:2022年开展的观察性、横断面和定量研究。收集的数据与 2020 年在同一地点进行的一项类似研究的数据库进行了比较。除面对面问卷调查外,还从医疗记录和产前手册中提取数据。采用卡瓦略和诺瓦埃斯指数来衡量医疗服务的充足性,并对医疗服务的可及性进行定性评估。对社会人口学变量和产前变量进行了分析。统计显著性水平为 0.05。对开放式问题进行了分类分析:结果:共纳入 395 名产后妇女。2020年有48.6%的人获得了适当的产前护理,2022年有69.1%的人获得了适当的产前护理。在获得产前护理的障碍中,56% 的人表示难以安排预约和/或检查,23% 的人抱怨由于罢工、COVID-19 等原因导致医护人员减少。充足的产前保健与 2022 年怀孕、被转诊到高风险科室(PNAR)以及未报告就医困难有关。此外,它还与两倍的妊娠糖尿病(GDM)和梅毒检查机会有关:结论:接种疫苗后 2022 年的产前适当性较高。产后妇女面临的主要困难是预约和/或检查时间的安排。在2022年接受产前护理、没有关于就诊困难的报告以及在高风险单位进行随访与产前适当性有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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