Prenatal and puerperal care and indicators of severity: a study about the information available on pregnant women’s card

Abstract Objectives: to identify and to discuss the frequency of the prenatal and puerperal care of pregnant women from the eastern zone of São Paulo city, São Paulo State, Brazil, categorizing it according to the Kessner Index modified in 1993 by Takeda. We used the data avai-lable on the card of pregnant woman and the discharge summaries, correlating the results with the indicators of severity in childbirth. Methods: this is a descriptive, cross-sectional quantitative study based on the analysis of the variables of the pregnant woman's card and the diagnoses identified in the discharge summaries. Data were collected through a field survey conducted in the Eastern zone of the city of São Paulo city, São Paulo State, Brazil. A statistical analysis was used to identify asso-ciations between the categorization and the severity indicators listed in the discharge summaries. Results: it was observed that prenatal care in the Eastern zone of São Paulo city, São Paulo State, Brazil was classified as intermediate (56.9%) in the majority of women. Regarding this categorization with the severity indicators, there is a higher incidence of risks for inappropriate categorization (8.89%) when compared to the appropriate (1.67%) and the intermediate (4.44%) ones. Conclusions: it was possible to conclude that the more adequate prenatal care, the lower the chances of unfavorable outcomes and incidence of risks.

摘要 目的：识别并探讨巴西圣保罗州圣保罗市东部城区孕妇产前与产褥期保健的开展情况与频次，并依据1993年竹田（Takeda）修订的凯斯纳指数（Kessner Index）对其进行分类。本研究采用孕妇保健手册及出院小结中的可用数据，将研究结果与分娩严重程度指标进行关联分析。
方法：本研究为描述性横断面定量研究，基于对孕妇保健手册变量与出院小结中确诊病症的分析开展。数据通过在巴西圣保罗州圣保罗市东部城区实施的现场调查收集。采用统计学分析方法，探究保健分类与出院小结中列明的分娩严重程度指标之间的相关性。
结果：研究观察到，圣保罗市东部城区多数孕妇的产前保健被归类为中等水平（56.9%）。就该分类与严重程度指标的关联而言，分类不当的风险发生率（8.89%）高于分类恰当（1.67%）与分类中等（4.44%）的情况。
结论：本研究可证实，产前保健越完善，出现不良妊娠结局与风险事件的概率越低。