Prevalence and Determinants of Adequate Compliance with Antenatal Care in Peru

Abstract Objective To determine the adequacy of compliance with antenatal care (ANC) by pregnant women in Peru and to identify the associated factors. Methods An analytical cross-sectional study of data from the 2019 Peruvian Demographic and Family Health Survey (Encuesta Demográfica y de Salud Familiar, ENDES, in Spanish) was conducted. The dependent variable was adequate compliance with ANC (provided by skilled health care professionals; first ANC visit during the first trimester of pregnancy; six or more ANC visits during pregnancy; ANC visits with appropriate content) by women aged 15 to 49 years in their last delivery within the five years prior to the survey. Crude and adjusted prevalence ratios and their 95% confidence intervals were calculated using a log-binomial regression model. Results A total of 18,386 women were analyzed, 35.0% of whom adequately complied with ANC. The lowest proportion of compliance was found with the content of ANC (42.6%). Sociodemographic factors and those related to pregnancy, such as being in the age groups of 20 to 34 years and 35 to 49 years, havingsecondaryor higher education, belonging to a wealth quintile of the population other than the poorest, being from the Amazon region, not being of native ethnicity, having a second or third pregnancy, and having a desired pregnancy, increased the probability of presenting adequate compliance with ANC. Conclusion Only 3 out of 10women in Peru showed adequate compliancewith ANC. Compliance with the content of ANC must be improved, and strategies must be developed to increase the proportion of adequate compliance with ANC.

摘要 目的：明确秘鲁孕妇对产前保健（Antenatal Care）的依从达标现状，并识别相关影响因素。
方法：采用2019年秘鲁人口与家庭健康调查（西班牙文原名Encuesta Demográfica y de Salud Familiar，缩写ENDES）的数据开展分析性横断面研究。本研究的因变量为调查前5年内曾分娩的15~49岁女性，是否满足以下全部ANC达标依从标准：由熟练的医疗卫生专业人员提供服务；首次ANC就诊于妊娠早期；妊娠期内完成6次及以上ANC就诊；ANC就诊内容符合规范要求。采用对数二项回归模型计算粗患病率比及调整后患病率比，及其95%置信区间。
结果：共纳入18386名女性进行分析，其中35.0%的女性ANC依从情况达标。ANC内容依从率最低，仅为42.6%。社会人口学因素及妊娠相关因素与达标概率呈正相关：年龄处于20~34岁、35~49岁组，受教育程度为中等及以上，属于非最贫困财富五分位组，来自亚马孙地区，非原住民族群，妊娠次数为2次或3次，以及计划内妊娠，均会提升ANC依从达标的概率。
结论：秘鲁仅三成女性的ANC依从情况达标。需进一步提升ANC内容的依从性，并制定相关策略以提高ANC达标依从率。