Acquisition and completion of pregnant woman's medical booklet in four populational-based surveys

Abstract 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.

摘要 目的：评估巴西里奥格兰德（Rio Grande）地区分娩时孕产妇保健手册（pregnant women's medical booklet）的获取率及其填写完成度。方法：本研究为横断面研究，纳入2007、2010、2013及2016年居住于该市的所有产褥期妇女。于产后48小时内，在当地仅有的2家助产机构对产妇进行访谈，将孕产妇保健手册中的相关信息誊抄至标准化调查表中，并采用卡方检验比较组间比例。结果：本研究共纳入10242名孕产妇。其中54.8%（95%置信区间：53.8%~55.7%）的产妇入院时持有孕产妇保健手册。孕产妇保健手册的填写完成情况可分为三类：① 完成率≥95%的项目：末次就诊日期、产妇身高与血压检测、宫高、胎心监测及Rh血型鉴定；② 完成率≥85%的项目：末次月经日期、尿常规定性检测、VDRL试验及HIV检测；③ 完成率<30%的项目：临床乳腺检查及宫颈细胞学检查。私立医疗机构中孕产妇保健手册的获取率较公立机构低41个百分点（私立机构62% vs. 公立机构44%）。结论：孕产妇保健手册的使用及多项内容的填写完成率均低于预期。当地管理者应与卫生专业人员协同合作，卫生专业人员亦应与产妇协作，以促进这份对母婴健康至关重要的文件得到充分利用。