Network care: relationship between prenatal care adequacy and hospital obstetric care in a cross-sectional study.
Fernanda Marçal Ferreira, Kelly Cristina Máxima Pereira Venâncio, Nádia Zanon Narchi
PMID 35802658WHAT IT FOUND
Inadequate prenatal care among pregnant women was linked to more hospital obstetric visits that were not appropriate for that level of care.
This cross-sectional study cannot prove prenatal care caused the visits.
Key findings
01Women with inadequate prenatal care had 2.2 times higher odds of making hospital obstetric visits that were not appropriate for that level of care.
02Only 42.4% of women had adequate prenatal care across all three trimesters.
03Of 1,067 hospital visits, 63.1% were classified as not appropriate for that level of care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only one hospital and six basic health units in one São Paulo region were studied, so results may not apply to other areas. The design was cross-sectional, so it showed an association, not that inadequate prenatal care caused inappropriate hospital visits. 17.9% of women were lost to follow-up, and sampling was not stratified, which may affect how well the results represent pregnant women. Adequacy was judged against an 80% cut-off, which the authors note is high compared with some literature. The study did not test a nursing or care-network intervention.
The easy way to misread this
Do not read the 2.2 times higher odds as proof that poor prenatal care caused inappropriate hospital visits. The study measured an association in one region and could not rule out other reasons for seeking hospital care.