Process and outcome of prenatal care according to the primary care models: a cohort study.
Renata Leite Alves de Oliveira, Anna Paula Ferrari, Cristina Maria Garcia de Lima Parada
PMID 31340338WHAT IT FOUND
Newborn outcomes did not differ between prenatal care models in Botucatu, although mothers in Family Health Strategy units received more health education and postpartum visits.
Key findings
01Prenatal care quality score was higher in Family Health Strategy units than traditional units (mean 3.53 vs 2.71 on a 0-7 scale).
02Health education and postpartum consultation were more frequent in Family Health Strategy units (RR=13.70 and RR=1.48).
03After adjustment, early and late newborn outcomes did not differ between care models.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a single municipality in Brazil, so results may not apply to other health systems. It compared existing care models, not a randomized intervention, so the better process score cannot be proven to be caused by the Family Health Strategy model. 10% of the original cohort were lost or refused, and the analysis used 273 of 338 eligible mothers. Data partly depended on records, and if an action was not registered it was counted as not performed, which may understate true care quality. The process score was created by the authors, and the low-score cut-off was chosen after looking at the mean and median.
Declared interests
The study was supported by FAPESP, Brazil, and is extracted from a doctoral dissertation. No other funding or conflict statements are given.
The easy way to misread this
Do not conclude that Family Health Strategy prenatal care improves newborn outcomes. The process quality was higher, but adjusted newborn outcomes showed no significant differences.