Background
Methods
Study area and population
Study area
Study design, population studied and outcomes
Statistical analysis
Wealth index construction
Modeling multiple pregnancies in the same subject
Results
Health service characteristics in 2003 and 2011
Variables | 2003 | 2011 |
---|---|---|
Number of health units
| ||
Health Centre | 01 | 01 |
Basic Health Unit | 00 | 01 |
Indigenous Health Care Unit | 01 | 01 |
Mixed Unit | 01 | 01 |
Number of professionals (Basic Health Unit)
| ||
Community Health Agent | 06 | 17 |
Pharmacy Clerk | 00 | 02 |
Dental technician | 01 | 02 |
Nursing Assistant/Nursing Technician | 02 | 06 |
Dentist | 01 | 02 |
Nurse | 01 | 02 |
Physiotherapist | 00 | 01 |
Medical Doctor | 01 | 02 |
Number of professionals (Mixed Unit)
| ||
Pharmacy Clerk | 01 | 01 |
Nursing Assistant/Nursing Technician | 08 | 11 |
Biochemist | 01 | 01 |
Nurse | 01 | 04 |
Pharmacist | 00 | 01 |
Medical Doctor | 02 | 05 |
Laboratory Technician | 02 | 02 |
X-ray Technician | 02 | 02 |
Characteristics of the study population in 2003 and 2011
Variables | 2003 (all ethnicities) | 2011 (all ethnicities) | p valueb | ||
---|---|---|---|---|---|
N (154)c | % | N (412)c | % | ||
Religion
| 0023 | ||||
not adept | 11 | 9.01 | 71 | 17.30 | |
adept | 111 | 90.98 | 349 | 82.70 | |
Ethnicity
| <0.001 | ||||
indigenous | 0 | 0.00 | 59 | 14.40 | |
Black | 7 | 5.79 | 17 | 4.10 | |
“parda” | 94 | 77.69 | 274 | 66.70 | |
White | 20 | 16.52 | 61 | 14.80 | |
Education
| 0.292 | ||||
0 to 4 years | 28 | 26.93 | 105 | 28.60 | |
> 4 years | 76 | 73.08 | 262 | 71.40 | |
Maternal marital situation during pregnancy
| - | ||||
Lack of partner | - | - | 82 | 20.00 | |
Presence of partner | - | - | 327 | 80.00 | |
Cigarette smoking during pregnancy
| 0.072 | ||||
yes | 25 | 16.89 | 46 | 11.17 | |
no | 123 | 83.11 | 366 | 88.83 | |
Alcohol consumption during pregnancy
| 0.427 | ||||
yes | 18 | 12.30 | 41 | 10.00 | |
no | 128 | 87.70 | 370 | 90.00 | |
Current gestational status
| - | ||||
multiparous | - | - | 281 | 68.40 | |
primiparous | - | - | 130 | 31.60 | |
Previous abortions or stillbirths
| - | ||||
yes | - | - | 73 | 18.90 | |
no | - | - | 314 | 81,14 | |
Number of previous pregnancies
| - | - | 412 | 1.96a | - |
Age at current pregnancy (in years)
| - | 22.18a | 411 | 23.45a | 0.853 |
Maternal health care in 2003 and 2011
Indicators | 2003 | 2011 | p valuea | ||
---|---|---|---|---|---|
N (154)b | (%) | N (412)b | (%) | ||
Had access to atal care
| 0.300 | ||||
no | 10 | 6.50 | 18 | 4.40 | |
yes | 144 | 93.50 | 394 | 95.60 | |
Number of prenatal consultations
| 0.841 | ||||
less than 6 | 49 | 39.20 | 139 | 38.19 | |
equal to or greater than 6 | 76 | 60.80 | 225 | 61.81 | |
Type of childbirth
| 0.138 | ||||
normal | 125 | 82.78 | 326 | 79.13 | |
cesarean | 26 | 17.22 | 86 | 20.87 | |
Place of vaginal delivery
| 0.485 | ||||
in hospital | 20 | 16.00 | 45 | 13.80 | |
outside hospital | 105 | 84.00 | 281 | 86.20 | |
Professional conducting the normal childbirth
| < 0.001 | ||||
Nurse/midwife/other | 101 | 82.11 | 110 | 33.74 | |
Medical doctor | 22 | 17.89 | 216 | 66.26 |
Access to prenatal care among all women
Variable | Nc | % | Non-adjusted | (95 % CI) | p valueb |
---|---|---|---|---|---|
ATTENDING PRENATAL CARE (n = 154)
| |||||
Ethnicity
| |||||
Black/“parda” | 101 | 92.08 | 1 | - | - |
White | 20 | 100.00 | - | - | - |
Socioeconomic index
| |||||
Poorer half | 73 | 89.04 | 1 | - | - |
Richer half | 81 | 97.53 | 4.86 | (1.23–69.00) | 0.050 |
Education
| |||||
0 to 4 years | 25 | 88.00 | 1 | - | - |
> 4 years | 69 | 97.10 | 4.57 | (0.72–29.14) | 0.108 |
Cigarette smoking during pregnancy
| |||||
yes | 25 | 88.00 | 1 | - | - |
no | 123 | 95.93 | 3.22 | (0.72–14.45) | 0.127 |
Year of prenatal care
| |||||
1997 to 1998 | 38 | 86.84 | 1 | - | - |
1999 to 2002 | 117 | 94.87 | 3.36 | (0.92–12.33) | 0.067 |
Age at current pregnancy (in years)
a
| 22.18a | 93.39 | 0.99 | (0.70–1.13) | 0.919 |
ATTENDING SIX OR MORE PRENATAL CONSULTATIONS (n = 125)
| |||||
Ethnicity
| |||||
Black/“parda” | 76 | 65.79 | 1 | - | - |
White | 20 | 65.00 | 0.97 | (0.34–2.72) | 0.947 |
Socioeconomic index
| |||||
Poorer half | 56 | 53.57 | 1 | - | - |
Richer half | 69 | 66.67 | 1.73 | (0.84–3.58) | 0.137 |
Education
| |||||
0 to 4 years | 18 | 33.33 | 1 | - | - |
> 4 years | 61 | 68.85 | 4.42 | (1.44–13.55) | 0.009 |
Cigarette smoking during pregnancy
| |||||
yes | 21 | 57.14 | 1 | - | - |
no | 100 | 61.00 | 1.17 | (0.45–3.04) | 0.743 |
Alcohol consumption during pregnancy
| |||||
yes | 16 | 75.00 | 1 | - | - |
no | 103 | 57.28 | 0.45 | (0.14–1.48) | 0.187 |
Year of prenatal care
| |||||
1997 to 1998 | 22 | 68.18 | 1 | - | - |
1999 to 2002 | 103 | 59.22 | 0.68 | (0.25–1.8) | 0.436 |
Age at current pregnancy (in years)
a
| |||||
21.80a | 65.96 | 0.97 | (0.9–1.05) | 0.486 | |
VAGINAL DELIVERY AT A HOSPITAL FACILITY (n = 125)
| |||||
Ethnicity
| |||||
Black/“parda” | 85 | 83.53 | 1 | - | - |
White | 14 | 85.71 | 1.18 | (0.24–5.88) | 0.837 |
Socioeconomic index
| |||||
Poorer half | 61 | 80.33 | 1 | - | - |
Richer half | 64 | 85.94 | 1.50 | (0.58–3.85) | 0.404 |
Education
| |||||
0 to 4 years | 20 | 80.00 | 1 | - | - |
> 4 years | 55 | 90.91 | 2.50 | (0.60–10.45) | 0.209 |
Cigarette smoking during pregnancy
| |||||
yes | 24 | 79.17 | 1 | - | - |
no | 99 | 83.84 | 1.37 | (0.44–4.19) | 0.586 |
Alcohol consumption during pregnancy
| |||||
yes | 16 | 87.50 | 1 | - | - |
no | 105 | 81.90 | 0.65 | (0.14–3.09) | 0.584 |
Year of prenatal care
| |||||
1997 to 1998 | 47 | 82.98 | 1 | - | - |
1999 to 2002 | 78 | 83.33 | 1.03 | (0.39–2.69) | 0.959 |
Age at current pregnancy (in years)
a
| 22.25a | 81.82 | 0.90 | (0.82–0.98) | 0.018 |
Access to prenatal care among indigenous women
Variables | Crude OR | (IC 95 %) | Adjusted ORa | (IC 95 %) | p valueb |
---|---|---|---|---|---|
Maternal schooling
| |||||
0 to 4 years | 1 | - | 1 | - | - |
> 4 years | 5.87 | (0.70–49.38) | 7.68 | (0.81–72.77) | 0.076 |
Year of prenatal care
| |||||
2005 to 2007 | 1 | - | 1 | - | - |
2008 to 2010 | 23.56 | (2.82–197.00) | 26.78 | (3.09–232.19) | 0.003 |
Quality of prenatal care
Variables | Crude OR | (IC 95%) | Adjusted OR | (IC 95 %) | p value b |
---|---|---|---|---|---|
ATTENDING SIX OR MORE PRENATAL CONSULTATIONS (n = 361)
c
| |||||
Ethnicity
| |||||
Black/“parda” | 1 | - | 1 | - | - |
White | 6.50 | (2.90–14.57) | 3.94 | (1.67–9.30) | 0.002 |
Education
| |||||
0 to 4 years | 1 | - | 1 | - | - |
> 4 years | 3.39 | (2.10–5.46) | 2.10 | (1.21–3.67) | 0.009 |
Socioeconomic index
| |||||
Poorer half | 1 | - | 1 | - | - |
Richer half | 2.63 | (1.72–4.04) | 1.72 | (11.07–0.94) | 0.026 |
Age at current pregnancy (in years)
a
| 1.03a | (1.00–1.07) | 1.09 | (1.04–1.15) | < 0.001 |
Number of previous pregnancies
| 0.87 | (0.77–0.98) | 0.80 | (0.68–0.94) | 0.009 |
VAGINAL DELIVERY AT A HOSPITAL FACILITY (n = 324)
d
| |||||
Ethnicity
| |||||
Black/“parda” | 1 | - | 1 | - | - |
White | 3.62 | (1.85–7.11) | 2.61 | (1.24–5.51) | 0.012 |
Education
| |||||
0 to 4 years | 1 | - | 1 | - | - |
> 4 years | 2.76 | (1.48–5.12) | 1.98 | (1.0–3.94) | 0.005 |
Year of childbirth
| |||||
2005 to 2007 | 1 | - | 1 | - | - |
2008 to 2010 | 3.80 | (2.02–7.14) | 3.60 | (1.88–6.89) | < 0.001 |