Factors associated with antepartum pilgrimage at a reference maternity hospital in Ceará.

OBJECTIVE: To identify factors associated with antepartum pilgrimage in pregnant women in Fortaleza, Ceará, Brazil. METHOD: A cross-sectional study with 300 postpartum women from a state reference maternity hospital, carried out from March 2020 to January 2021. The frequency of pilgrimage was estimated according to socioeconomic characteristics and prenatal care. Analysis with Pearson's chi-square test selected variables for adjusted Poisson regression. RESULTS: The frequency of antepartum pilgrimage to more than one health service was 34.3%. Not knowing the reference maternity hospital (1.16; 95%CI: 1.04-1.30) and not living close to the reference maternity hospital (1.16; 95%CI: 1.03-1.31) were associated with the occurrence of pilgrimage among women. Personal characteristics and prenatal care were not associated. CONCLUSION: There was an association between antepartum pilgrimage and lack of knowledge of the reference maternity hospital and residence far from that maternity hospital, which requires better team communication and the guarantee of easier access to obstetric care services, through effective implementation of regionalization of maternal care.

Desfechos neonatais associados às intervenções obstétricas realizadas no trabalho de parto em nulíparas / Neonatal outcomes associated with obstetric interventions performed during labor in nulliparous women

RESUMO Objetivo analisar os desfechos neonatais associados às intervenções obstétricas realizadas no trabalho de parto em nulíparas de baixo risco. Métodos estudo observacional de corte transversal, realizado com 534 nulíparas de baixo risco. Resultados a interrupção do contato pele a pele após o parto se mostrou associado às intervenções obstétricas como cardiotocografia na admissão, ocitocina no trabalho de parto, amniotomia e episiotomia. A necessidade de ventilação por pressão positiva e oxigenoterapia tiveram associação ao incentivo à manobra de Valsalva; a realização desta manobra está associada, também às intervenções amniotomia, episiotomia e puxo dirigido. Conclusão o estudo evidenciou que a utilização das intervenções obstétricas durante o trabalho de parto de mulheres de baixo risco está associada aos desfechos neonatais desfavoráveis que acarretam a necessidade de mais intervenções após o parto.

ABSTRACT Objective to analyze neonatal outcomes associated with obstetric interventions performed during labor in low-risk nulliparous women. Methods a cross-sectional observational study of 534 low-risk nulliparous women. Results interruption of skin-to-skin contact after delivery was shown to be associated with obstetric interventions such as cardiotocography at admission, oxytocin in labor, amniotomy, and episiotomy. The need for positive pressure ventilation and oxygen therapy was associated with the encouragement of the Valsalva maneuver; the performance of this maneuver was also associated with interventions such as amniotomy, episiotomy and directed pulling. Conclusion the study showed that the use of obstetric interventions during labor in low-risk women is associated with unfavorable neonatal outcomes that lead to the need for further interventions after delivery.