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Objectives: to evaluate coverage and identify factors associated with adequate prenatal care for adolescent mothers in Rio Grande, Southern Brazil, in a period of 13 years. Methods: over the years 2007, 2010, 2013, 2016 and 2019, a single standardized questionnaire was applied to all mothers at hospital level in this municipality. The outcome consisted of the proportion of puerperae women who started prenatal care in the first trimester and performed 6+ medical visits, completed 2+ HIV, syphilis, and urine tests. Chi-square test was used for proportions, Poisson regression in the multivariate analysis and the prevalence ratio (PR) as measure of effect. Results: among the 12,645 identified mothers, 2,184 (17.3%) were adolescents. Of this total, 35.2% (CI95%= 33.2%-37.2%) had received adequate prenatal care, ranging from 13.8% (10.8%-16.7%) in 2007 to 52,5% (46.8%-58.1%) in 2019. The adjusted analysis showed a higher PR for adequate prenatal care among those of older age and better schooling level, white/brown skin color, with a partner, never had an abortion, were primiparous and non-smokers. Conclusion: there was substantial improvement in coverage of adequate prenatal care over the period studied, but there is still a long way to go. The increase in this coverage depends on reaching adolescents who are younger, less educated, black skin color, living without a partner, multiparous and smokers. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Mother & Child Health (BJMCH) / Revista Brasileira de Saude Materno Infantil (RBSMI) is the property of Instituto de Medicina Integral and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: to measure the prevalence of acquiring and evaluating the level of completion of the pregnant women's medical booklet on the occasion of childbirth in Rio Grande, Brazil. Methods: this is a cross-sectional study including all puerperals residing in this municipality in 2007, 2010, 2013 and 2016. The mothers were interviewed at the only two local maternities up to 48 hours after childbirth. The data from the pregnant woman's medical booklet were copied on a standard form. The chi-square test was used to compare proportions. Results: 10,242 pregnant women were included in this study. Of these, 54.8% (CI95%=53.8%-55.7%) had their pregnant woman's medical booklet with them at the time of admission. The completion pattern of the pregnant woman's medical booklet is divided into three groups, namely: with at least 95%: date of the last consultation visit, maternal height and blood pressure verification, uterine height, cardio-fetal heart rate and the Rh factor; 85% or more: date of the last menstruation, qualitative urine test, VDRL and HIV; and less than 30%: performance of clinical breast examination and cytopathology of the uterine cervix. In the private sector, the acquisition of the pregnant woman's medical booklet was 41% lower than at the public sector (62% vs. 44%). Conclusions: the use of the pregnant woman's medical booklet and its completion were lower than expected on several items. Local managers need to work together with the health professionals and these health professionals should work with the mothers to promote the full use of this essential document for the maternal and child's health. [ABSTRACT FROM AUTHOR]

Objectives: to evaluate diagnostic criteria and to propose arm and calf circumference cutoff points to predict underweight in adolescents aged 13-19 years in two Brazilian municipalities of the semiarid region. Methods: underweight was defined as a Body Mass Index (BMI) of less than two z-scores, according to World Health Organization criteria (2007). Measurements of arm and calf circumferences were compared to BMI, and the diagnostic criteria for low-weight prediction were evaluated with the area under the Receiver Operating Characteristic (ROC) curve, coefficients of sensitivity, specificity, predictive values, kappa and diagnostic odds ratios. Results: the prevalence of underweight was 4.2% (CI95%= 3.3-5.0). The cutoff points for arm circumference were 22.1 cm (adolescents of both genders aged 13-15 years), and 25.1 cm and 24.0 cm, respectively, for males and females aged 16-19 years. The cutoff points for calf circumference were 30.0 cm in the first group and 31.8 cm and 31.0 cm, respectively, in the second age group. Conclusions: both anthropometric indicators analyzed evidenced a reasonable to excellent diagnostic capacity to predict underweight among adolescents. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Mother & Child Health (BJMCH) / Revista Brasileira de Saude Materno Infantil (RBSMI) is the property of Instituto de Medicina Integral and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: to measure the prevalence and identify factors associated to the occurrence of cesarean section on demand in the municipality of Rio Grande, RS. Methods: all births that occurred in the two maternities between 01/01 to 12/31/2007, mothers who lived in the municipality were questioned on demographic and maternal reproductive characteristics, family socioeconomic level and health care received during pregnancy and childbirth. The outcome was constituted by cesarean section on demand, in other words, the request was from the parturient. In the analysis, Poisson regression was used with robust adjustment of the variance. The effect measurement used was the prevalence ratios (PR). Results: among the 2,557 parturients included in this study, 51.6% (CI95%:49.6%-53.5%) were submitted to cesarean sections, and 10.7% (CI95%:9.0%-12.4%) were on demand. After the adjustment based on previous hierarchical model, the variables showed significantly the association to the outcomes which were maternal schooling, household income, type of hospitalization (public or private) and being attended by the same physician throughout the prenatal period. Conclusions: the PR obtained show that the probability of occurrence of cesarean section on demand was substantially higher among the mothers who presented the lowest risk of complications during pregnancy and childbirth. [ABSTRACT FROM AUTHOR]

Objectives: to describe the prevalence of late preterm birth (LPB) and identify factors associated with its occurrence in the municipality of Rio Grande, RS. Methods: a standardized questionnaire was applied to all puerperal women resident in the municipality who had children in the year 2013. Preterm birth was defined as birth occurring between the 34th and 36th week of gestation, preferably evaluated by means of ultrasonography in the 6th to 20th weeks. The analysis used Poisson regression with robust adjustment of variance, following the hierarchical model.The effect measure used was the prevalence ratio (PR). Results: of the 2286 births included in the study, 11.8% (CI95%: 10.5-13.1) were LPBs. After adjusted analysis, the PRfor occurrence of LPB among black-skinned motherswas 1.40 (1.01-1.96) in relation to white-skinned women; 1.74 (1.23-2.45) among those who attended less than six prenatal consults compared to those who attended nine or more; the PR was 1.36 (1.11-1.68) for those classified as depressives compared to others and 1.29 (1.01-1.65) for those undergoing caesarian. Conclusions: the results suggest the existence of inequality in relation to skin color and the important impact of the number of prenatal consults on the outcome. More appropriately designed studies are needed to confirm the causal relation among maternal depression, caesarian and LPB. [ABSTRACT FROM AUTHOR]

Objectives: to determine the proportion of children with adequately completed health records and to investigate associations with geographical, socio-economic and the mother and child's biological characteristics, and with the percentage use of health services in two municipalities in the semi-arid region of Brazil. Methods: a population-based cross-sectional study was carried with children aged up to five years. Data were collected by way of a household questionnaire between July and September 2008. The presence of all records relating to identification, growth, development and vaccine status of the child was deemed to be adequate completion. The raw and adjusted prevalence ratios were calculated using the Poisson Regression, following a hierarchized model. Results: of the 342 children studied, 22.2% (CI95% 17.5 - 26.2) had adequately completed health records. A high level of education of the mother was associated with this, after adjusting for the effect of variables in the hierarchized model. Conclusions: the results show a low level of adequate completion of health records. The high prevalence of inadequately completed records in mothers with low levels of education may reflect inequalities in the local health system. Children have a right to adequate completion of health records and failure to do so suggests lack of training of health workers and parents in basic health care needs. [ABSTRACT FROM AUTHOR]

Objectives: to evaluate the knowledge of mother's regarding the sleeping position of babies after a national campaign. Methods: a standardized questionnaire was applied to mothers who had had a baby in 2010 in Rio Grande, in the Brazilian State of Rio Grande do Sul. Results: of the 2395 mothers interviewed, 20% agreed with the campaign that the dorsal decubitus position is the best sleeping position for babies. Of these, 39% stated that they had obtained this information from the national campaign. Of those who stated that the lateral decubitus position was the correct one, 74% said that they had learnt this from their mothers. Conclusions: the study provides evidence of the potential impact of the national campaign and the important influence of the maternal grandmother on the opinion of mothers regarding placing babies in the dorsal decubitus position when sleeping. [ABSTRACT FROM AUTHOR]

Objectives: to identify factors associated with the inadequacy of prenatal care in the municipalities of Caracol and Anísio de Abreu, in the semi-arid region of the State of Piauí, in the Northeast of Brazil. Methods: a population-based cross-sectional study was carried out using home visits to all the mothers of children aged less than five years resident in these localities between July and September 2008. The adequacy of prenatal care was classified from the first consultation up to thel20th day of gestation with a total of, at least, six sessions. The chi-squared test was used to compare proportions and, for multiple analysis, Poisson regression with a robust adjustment for variance. Results: of the 1580 mothers interviewed, the prevalence of inadequate prenatal care fwas 19.2%, with 20.3% in the municipality of Caracol and 17.9% in Anísio de Abreu. In Caracol, the factors that remained associated with the outcome after adjustment for the age of the mother (30 years or more) and not having running water at home or on one's land, while in Anísio de Abreu only schooling was associated. Conclusions: the results presented here show that, even among the poorest, there was inadequate prenatal care during gestation and delivery and the greater likelihood of inadequate prenatal care was among older women with lower levels of schooling. [ABSTRACT FROM AUTHOR]

OBJECTIVES: to measure the prevalence of and identify factors associated with the self-medication of children aged under five years in the municipalities of Caracol in the State of Piauí, and Garrafão do Norte in the State of Pará. METHODS: a cross-sectional method, systematic sampling and a standard household visit questionnaire were used to investigate various characteristics of the mothers, families and children. The chi-squared test was used to compare proportions and Poisson's regression adjusted for robustness of variance for multivariate analysis. RESULTS: of the 590 children studied in Caracol and 1081 in Garrafão, 30% and 25% respectively had been self-medicated in the preceding 15 days. After adjustment for various confounding variables, the fact of not having succeeded in obtaining care for a sick child in the previous 15 days in both municipalities, and that of residing more than 1km from health services in Caracol and of the mother having done paid work in the previous 12 months, in Garrafão, proved to be significantly associated with self-medication among children aged under five years. CONCLUSIONS: the prevalence of self-medication by mothers of children aged under five years in the municipalities under study, although lower than that observed in other parts of Brazil, resulted above all from not being able to gain access to medical assistance. [ABSTRACT FROM AUTHOR]

Objectives: to evaluate inequality in health care during gestation and delivery for women with children under five years of age resident in the Municipality of Caracol, in the Brazilian State of Piaui. Methods: a household questionnaire was applied to a cross-sectional systematic sample to collect data on the demographic characteristics of mothers and children, health care during pregnancy and deliver and socio-economic status. A tercile score was created using the principal component technique. The associations between this score and variables relating to health care for women during pregnancy and childbirth were evaluated using the chi-square and Kruskal-Wallis test. Results: all the 405 children covered by the study came from families with an income of less than one minimum wage per month; 65% lived in rural areas. Mothers belonging to the highest socio-economic tercile had a larger number of pre-natal consults; they had the largest number of urine tests, hemograms, cytopathological tests of the cervix and ultrasound, and their babies were delivered by a doctor with a higher frequency of caesarian sections. Conclusions: even among the poorest sectors of society there are enormous health inequalities. It is imperative that the factors determining this poverty be addressed with more aggressive social programs and priority given to caring for the poorest of the poor. [ABSTRACT FROM AUTHOR]

Objectives: To compare public and private sector maternity care in the municipality' of Rio Grande. in the Brazilian State of Rio Grande do Sul, Methods: a standardized questionnaire was applied to all pregnant women residing in this municipality who had a child in 2007. All aspects. from the beginning of gestation to immediate postpartum were investigated. Statistical analysis took the form of comparison of proportions for these two groups, using the chi-squared test. Rc",ults. of the 2584 children born whose mothers resided in the municipality, information was obtained on 2557. representing 98.9% of the total. Of these mothers, 95% received at least one prenatal consultation. Pregnant women attended kv the private sector began prenatal care earlier, had a larger number of medical consults, blood tests, pelvic ultrasound examinations, and genecological examinations of the breasts and cvtopathological examinations of the cervix. Pregnant women in the public sector had more urine tests and serum tests for syphilis and were often give iron sulfate supplements. All these differences were statistically significant (p< 0.05). Conclusions: pregnant women in the private sector systematically received better prenatal care in terms of consultations and examinations. Their delivery was more often carried out &v a physician and they underwent more unnecessary interventions, such as a caesarian section or episiotomy, while they were less likely to receive iron supplements. [ABSTRACT FROM AUTHOR]