Analysis of the pregnant woman's prenatal cards completion of adolescents and adults and compliance with recommendations of the Ministry of Health
Prenatal Care. Health Records. Pregnancy in Adolescence.
Introduction: The pregnant woman’s prenatal card is an important tool that should be always with the pregnant woman. All health care to the pregnant woman must be recorded in the pregnant woman’s prenatal card, since this record and its quality reflect the clinical practice and serve as parameters to guide future decisions. Through these records, it is also possible to follow the compliance with prenatal care guidelines and identify policy needs that improve the quality of care. This is particularly important when pregnancy is associated with greater risks for the pregnant woman and the child, as during adolescence. Objective: To compare the quality of prenatal care by evaluating the record of information in the pregnant woman’s prenatal cards of first-time pregnant adolescents and adults who underwent prenatal care in the Sistema Único de Saúde (SUS) in municipalities from the Trairi Region of the Rio Grande do Norte state. Methodology: This is a cross-sectional analysis of a longitudinal study called AMOR (Adolescence and Motherhood Research) project, carried out in the municipalities of Santa Cruz, Lajes Pintadas, Tangará, Campo Redondo and São Bento do Trairi, located in the Trairi region of the Rio Grande do Norte state. The sample consisted of 76 women, 38 adolescents (13-18 years) and 38 adults (23-28 years) whose prenatal cards were evaluated between 4 to 6 weeks postpartum. The data collection followed a standardized protocol, in which sociodemographic data were collected. We also evaluated the record of information in the pregnant woman’s prenatal cards and the proportion of compliance with the Ministry of Health recommendations described in Rede Cegonha, such as a minimum of 6 consultations and participation in educational meetings, ultrasound (USG) exam and laboratory tests (ABO and Rh factor, uroculture, cervical-vaginal cytopathology, HBsAg, toxoplasmosis, glycaemia, VDRL, Hemoglobin/Hematocrit and Anti-HIV). The percentages of record of the items in the prenatal cards and compliance with the recommendations among adolescents and adults were compared using the Chi-square test. Both groups were compared in relation to the medians of record percentages for each item using the Mann-Whitney test. Results: None of the 11 categories analyzed were completely recorded for both groups. The groups were statistically different in relation to "information about USG", with a lower percentage of completion among adolescents (p=0,021). Of the 13 items analyzed regarding the compliance with Rede Cegonha, the adult group presented a greater proportion of record in 12 of them when compared to the adolescents, being statistically significant in relation to glycaemia (p=0,004), VDRL (p=0,040) and hemoglobin/hematocrit (p<0,001). Conclusion: A lower proportion of adolescent mothers presents record of compliance with the recommendations of the Ministry of Health, which shows the need for health policies aiming to improve prenatal care for this population.